Myocardial Infarction Flashcards
What MI is a total blockage of a minor coronary artery?
NSTEMI
What is the cause of a STEMI?
Total blockage of a major coronary artery
What is the cause of unstable angina?
Partial blockage of major coronary artery
Symptoms of unstable angina
Ischaemia with no troponin rise
May or may not have changes on ECG
Chest pain on exertion and at rest
What causes a bundle branch block?
Ischaemia -> infarction of a section of the heat, causing hypo or akinesia in that section. L or R
What is teh criteria for bundle branch block?
Smith modified Symbossa criteria
What is the features of the SMith modified Symbossa criteria for Left bundle branch block
> 1 lead w >1mm concordent ST elevation
1 lead VI - V3 concordant ST elevation
1 lead anywhere with ST elevation and proportionally excessive eg >25% previous S wave
Criteria for STEMI diagnosis - clinical length
Clinical symptoms over 20 mins with persistent
Height of ST elevation to be a STEMI men vs women
Men = >2.5 mm ST elevaton leads V2-3 uner 40, >2 in men over 40
Women - >1.5m ST elevation V2-V3
Criteria for STEMI ECG
ST elevation in V2-V3 (>1.5mm women, >2mm men over 40, >2.5mm under)
>1mm ST elevation in other leads
New LBBB
How to make diagnosing MI with existing CAD or CVS disease
Compare with old EG
Smith modified Sgarbossa criteria - if LBBB or paced
What is teh management of STEMI reliant on?
Assumed presentation in 12 hours
Initial management of STEMI
300 mg dcose loading aspririn
Assess for eligibility for reperfusion therapy
When to do PCI vs fibrinolysis
Only PCI if can be done in 120 mins, otherwise fibrinolysis
Both 12 hour presentation assumed
Consider PCI if still MI or cardiogenic shcok after 12 hours
What do after fibrinolysis
Antithrombin at same time
(fondaparinux or unfractionated heprin if F contraindicated)
ECG 60-90 mins after
