MI Basics Flashcards
Understand what happens in MI, causes, Risk Factors, etc
What is the most common cause of MI
Rupture of an atherosclerotic plaque, with the development of thrombosis and total occlusion of the artery.
Alternative causes of MI (excluding most common)
- Vasospasm
- Severe hypotension
- Excessive metabolic demand
- Less often embolic event
- Cocaine use
- Vasculitis
Why does MI occur?
- Ischemic event affecting cardiac tissue
2. Cardiac muscle is dying due to insufficient oxygen supply
Risk factors of MI
Risk factors
- Male
- Increasing age
- Smoking
- Family Hx
- HTN
- DM
- Dyslipidemia
What is the most classic presentation of MI
Crushing chest pain - Increasing in severity lasting longer than 30 min
* 33% pts do not have chest pan esp women and diabetics
What are alternative clinical presentations to MI (non-chest pain) symptoms
- “Indigestion”
- Often occur early in the morning due to hormone changes
- Diaphoresis
- Weakness
- Anxiety
- Syncope
- Restlessness
- Dyspnea
- Nausea and Vomiting
When does Dressler syndrome occur?
Occurs 1-2 weeks after an MI
What are the 5 characterizations of Dressler syndrome?
- Pericarditis
- Fever
- Leukocytosis
- Pericardial effusion
- Pleural Effusion
What are PE findings of MI
- Hypertensive OR Hyoptensive
- Tachycardia OR Bradycardia
- Lungs may be clear, + rales OR Wheezing
- JVD
- Softened Heart Sounds
- S4 gallop
- After 12 hours- FEVER may develop
- *** S4 gallop
- After 24 hrs Pericardial Friction Rub may develop
- If 1-2 weeks post myocardial infarction- think Dressler syndrome
What serologies would you want to test?
- Myoglobin,
- Troponins I and K,
- CK-MB
When cardiac enzyme would be seen in the earlies amount to time?
Myoglobin 1-3 hrs
When does myoblobin normalize?
24 hrs
When does troponins and CK MB peak?
24 hours
Which 2 cardiac enzyme markers rise together?
Troponin and CK-MB
What is the troponin cycle?
Elevate 2-12 hours
Peak 24 hours (double elevation time)
Return to normal 2 weeks
(Remember Troponin is on the 2s)
What is the CK-MB cycle
Elevated 3-12 hours
Peak 24 hours
Normalizes 72 hours (3 days)
Which cardiac enzyme takes the longest to normalize?
Troponin
A woman in her 30s went for Mexican food and a movie. She took her jacket off in the movies because she was hot. She felt like she ate too many peppers because of increased indigestion. She was feeling really weak and she left prior to the movie because she felt like she was going to pass out. She was anxious to get home to let the dog out.
Think of MI 1. Diaphoresis 2"Indigestion" 3. Weakness 4. Syncope / Nausea/Vomiting 5. Anxiety/Restless ness
