MI Flashcards
What are the symptoms of MI?
Acute central/left chest pain >20min Radiates to left jaw or arm Nausea Sweating Dyspnoea Palpitations
What are some symptoms of silent MI in elderly or diabetics?
Syncope
Delerium
Post op oilguria/hypotension
What are some signs of MI?
Anxiety sweating pulse and bp may be up or down 4th heart sound signs of LVF
What are some signs of LVF?
Basal creps
Raised JVP
3rd heart sounds
What are some differentials for MI?
Angia, Peri/endo/myo carditis Dissection PE, pneumothorax, pneumonia Costochonrdritis GI eg GORD Anxiety
What bloods should be done for suspected MI?
Troponin, FBC, U&E, glucose, lipids, clotting
What CXR findings may be found in MI?
Cardiomegaly
Pulmonary oedema
Widened medistinum in aortic rupture
How to differentiate between STEMI, NSTEMI and UA?
STEMI: symtoms, ST elevation, trop
NSTEMI: symptoms, no st elevation, trop
UA: symptoms, no st elevation, negative trop
Treatments for STEMI
PCI or thrombolysis
Treatment for NSTEMI and UA
Medical and elective angio +/- PCI/CABG
What is PCI?
Percutaneous coronary intervention to improve blood flow to the heart
What is CABG?
Coronary artery bypass graft
What are the complications of MI?
Death, pump failure, pericarditis, rupture, arrhythmias, aneurysm, embolism
What is the presentation of pericarditis?
Occurs early after MI Mild fever central chest pain/change in pain relieved by leaning forward pericardial friction rub
What is seen on ECG in pericarditis?
Saddle shaped ST elevation
What is dressers syndrome?
Late pericarditis
Dressler syndrome is a secondary form of pericarditis that occurs in the setting of injury to the heart or the pericardium (the outer lining of the heart). It consists of fever, pleuritic pain, pericarditis and/or a pericardial effusion.
What O2 should be given in MI?
2-4L aim for sats 94-98%
Which anti platelets should be given in MI?
Aspirin 300mg PO
Clopidogrel 300mg PO
What are the contraindications for thrombolysis in STEMI?
AGAINST
Aortic dissection, GI bleed, allergic reaction previously , iatrogenic - recent surgery, neuro, sever HTN 200/120, trauma incl CRP
What agents can be used to thrombolysis?
Streptokinase
alteplase
tenecteplase
Treatment for MI
ACEi
B blocker
Statin
Dual anti platelet
cardiac rehab
