MI diagnosis and treatment Flashcards

1
Q

What is required for a diagnosis of MI?

A
  • A rise (or fall) or troponin with at least 1 value >99th percentile + at least one of the following
  • Identification of a thrombus
  • Pathological changes to ECG
  • Damage to myocardium on the echo
  • Symptoms of MI
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2
Q

ST segment depression indicates…

A

Multivessel disease and therefore a poorer prognosis

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3
Q

When does ST elevation begin, and when does it end

A

Within minutes

Persists for up to 2 weeks

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4
Q

A persisting ST elevation indicates..

A

LV aneurysm

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5
Q

What are the inferior leads?

What artery is this?

A

II, III, aVF

RCA

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6
Q

What are the lateral leads?

What artery is this?

A

1, aVL, V5, V6

Circumflex

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7
Q

What are the septal leads?

What artery is this?

A

V1, V2

LAD

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8
Q

What are the anterior leads?

What artery is this?

A

V3, V4

RCA

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9
Q

Troponin is a marker of…

A

Cardiac Necrosis

Highly specific and selective

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10
Q

Describe the timeline of troponin

A

May be elevated within 6 hours
Usually detected 7-10 hours
Can remain elevated for 7 days

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11
Q

When is creatinine kinase level categorised as abnormal

A

When double the baseline

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12
Q

Is creatinine kinase specific to cardiac tissue?

A

No

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13
Q

Describe the timeline of creatinine kinase levels post MI

A

Rise 4-6 hours post STEMI
Peak 24 hours
Fall in 3-4 days

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14
Q

Emergency management of STEMI?

A
  • Morphine
  • Oxygen is O2 SATS <94%
  • Nitrates
  • Aspirin 300mg, Clopidogrel/ ticagrelor 300mg (esp if going for PCI)
  • Go to primary PCI asap
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15
Q

When is thrombolysis indicated?

A

When PPCI can’t be done within 120 minutes of chest pain

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16
Q

What drugs are given to the pt for secondary prevention of MI?

A
  • Ace inhibitor
  • Beta Blocker
  • Statin
  • Aspirin
  • Clopidegril/ ticagrelor
17
Q

Does an inferior, anterior, or posterior site have the worst prognosis

A

Anterior

18
Q

What drugs should a patient be on if they are going to have PCI

A
  • Aspirin
  • A2Y12 inhibitor
  • Unfractionated LMWH
19
Q

What ECG changes indicate PCI

A
  • ST >2mm in 2 consequetive anterior leads
  • ST >1mm in 2 consequetive inferior leads
  • New LBBB