Myocardial infarction

Question 1

Definition

Answer 1

Damage to the heart through a sudden block in blood supply to the heart

The most common cause of death in developed countries.

Question 2

Aetiology/ causes

Answer 2

Almost always the result of a rupture of an atherosclerotic plaque, with the development of a thrombosis and total occlusion of the artery

Question 3

Risk factors

Answer 3

Lack of physical activity
Obesity
Smoking
High sodium, sugar, and fat diet
Family history can increase risk
Hypertension, high cholesterol, diabetes

Question 4

Epidemiology/ Population affected

Answer 4

Most common in males over 45
More common for women over 50/ after menopause

Question 5

Clinical presentation

Answer 5

Central chest pain similar to angina is the most common symptom

^^Commonly occurs at rest (unlike stable angina)

Pain may radiate to the left arm, neck, and jaw
20% of patients have no pain but can present with hypotension, arrhythmias, or pulmonary oedema (most common in elderly patients or those with diabetes or hypertension

Shortness of breath, heart palpitations, sweating, nausea

Question 6

Prognosis

Answer 6

Can be life threatening if left untreated

Aspirin (300mg) or other anti-platelet meds should be used on first suspicion

Question 7

DDX

Answer 7

Aortic dissection
Pericarditis
Acute gastritis
Acute cholecystitis
Asthma
Esophagitis
Myocarditis
Pneumothorax
Pulmonary embolism

Question 8

Additional aspects (Treatment and Pathophysiology)

Answer 8

Coronary angioplasty, clot-busting medicine injection, insulin, Beta-blockers, oxygen supplementation