MI Flashcards

1
Q

What are the characteristics of an MI

  • site, radiation
  • character
  • triggers
  • relief
  • duration
A

Site, radiation
-diffuse, ant chest, l arm, neck

Character
-tight, pressure, dull, weight

Triggers

  • physical, emotional stress
  • cold

Relief
-rest, GTN

Duration

  • <30mins => angina
  • > 30mins => MI
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2
Q

Why do we get pain in MIs

A

Stenosis > 80% => ischemia as demand > supply

Increase in metabolites (bradykinin, adenosine) => visceral pain

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3
Q

Why do we get breathless in MIs

A

Decreased CO => increased LVEDP => net mv of fluid into lungs => decreased gas exchange

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4
Q

How would you diagnose an MI

  • ECG
  • Troponin
A

ECG
-ST elevation or no ST elevation

Troponin
-significantly increased

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5
Q

What are the 2 types of MI

A

STEMI
-transmural, complete occlusion

NSTEMI
-subendocardial, partial occlusion

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6
Q

How does atherosclerotic plaque rupture lead to MI

A

Foam cells induce SM death => protease release
=> soften collagen in cap

Platelets gather at rupture side => thrombus => stenosis

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7
Q

How would you treat the thrombus

  • drugs
  • mechanical
A

Drugs

  • statins
  • antiplatelets
  • anticoagulants

Mechanical
-PCI => increase perfusion, decrease stroke and bleed risk

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8
Q

How would you treat the decreased coronary flow

Why would you use these drugs

A

Antianginals

  • B blockers
  • L type Ca blockers
  • nitrates

Decrease the cardiac load and strain
Increase the amount of coronary perfusion

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9
Q

How would you prevent future MIs
-2 methods
What drugs would you use

A

Reduce effect of stenosis

  • Statins
  • ACEi
  • B block
  • Aspirin
  • ADP inh

Reduce wall stress from dilation

  • ACEi
  • B block
  • MC RAs
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