MI Flashcards
What are the characteristics of an MI
- site, radiation
- character
- triggers
- relief
- duration
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
Why do we get pain in MIs
Stenosis > 80% => ischemia as demand > supply
Increase in metabolites (bradykinin, adenosine) => visceral pain
Why do we get breathless in MIs
Decreased CO => increased LVEDP => net mv of fluid into lungs => decreased gas exchange
How would you diagnose an MI
- ECG
- Troponin
ECG
-ST elevation or no ST elevation
Troponin
-significantly increased
What are the 2 types of MI
STEMI
-transmural, complete occlusion
NSTEMI
-subendocardial, partial occlusion
How does atherosclerotic plaque rupture lead to MI
Foam cells induce SM death => protease release
=> soften collagen in cap
Platelets gather at rupture side => thrombus => stenosis
How would you treat the thrombus
- drugs
- mechanical
Drugs
- statins
- antiplatelets
- anticoagulants
Mechanical
-PCI => increase perfusion, decrease stroke and bleed risk
How would you treat the decreased coronary flow
Why would you use these drugs
Antianginals
- B blockers
- L type Ca blockers
- nitrates
Decrease the cardiac load and strain
Increase the amount of coronary perfusion
How would you prevent future MIs
-2 methods
What drugs would you use
Reduce effect of stenosis
- Statins
- ACEi
- B block
- Aspirin
- ADP inh
Reduce wall stress from dilation
- ACEi
- B block
- MC RAs