Myocardial Infarction

Question 1

What complication is associated with inferior MI ?

Answer 1

Right ventricular infarction resulting in right ventricular loss of function. This may lead to hypovolaemic shock.

Question 2

What medication is given post-MI for secondary prevention ?

Answer 2

Aspirin

Ace-inhibitor

Statins

Anti-platelet like clopidogrel (plavix) can be added. Used for 12 months.

Question 3

What is the NICE guidelines recommendation for all patients that have had MI be discharged with ?

Answer 3

Ace-inhibitor
B-blocker
Statin
Anti-platelet therapy (clopidogrel, plavix)

Question 4

What is the most sensitive and specific cardiac biomarker ?

Answer 4

Cardiac troponin I and T - rise 3-4 hrs after infarction, resolves after 1 week

CKMB - rise 3-4 hrs, resolves after 3 days

Question 5

What is the management of AF ?

Answer 5

If patient is hemodynamically unstable —> cardioversion

If patient is hemodynamically stable —> anticoagulate patient for 3 weeks (INR 2-3)

Question 6

What is the absolute contraindication of thrombolysis ?

Answer 6

A = AV malformation, aneurysm, CNS neoplasm

B = blood pressure ( > 180/110 )

C = cerebrovascular accident within 3 months

D = diathesis (active bleeding)

Question 7

What is the criteria for thrombolysis in myocardial infarction ?

Answer 7

1mm ST elevation in 2 or more limb leads or 2mm ST elevation in adjacent limb leads