Myocardial Infarction Flashcards
What is atherosclerosis?
Thinning of blood vessels due to atheroma (oxidised LDL cholesterol)
What are some risk factors for CAD?
- high BMI
- central adiposity
- Type II Diabetes
- Hypertension
- High cholesterol
- Family history
- Diet
- South Asian ethnicity
What are the steps which lead atherosclerosis to cause an MI?
- Rupture/erosion of coronary artery plaque’s fibrous cap
- Platelets aggregate/adhere to cap
- Localised thrombosis —> vasoconstriction —> Distal thrombus embolisation
What is MI? What are the features of the pain that results?
Death of part of the heart muscle due to ischaemia (lack of oxygen)
This results in severe, central chest pain that radiates to the jaw and arm
What is angina?
Limited blood flow during exertion, relieved by rest
What are some of the signs and symptoms of MI?
- “crushing band” across chest
- pallor
- vomiting
What are the ways of diagnosing a MI?
12-lead ECG (STEMI)
[Troponin T] <- gold standard
or [CK-MM] & [CK-MB]
What are some differentials which would also match the type of pain characteristic of MI?
- aortic dissection
- pulmonary embolism
- peptic ulceration
What is the emergency treatment for an MI?
- streptokinase (dissolves clots)
- aspirin (prevents more clots forming - won’t do anything to clots already present - give quickly)
- GTN spray (glyceryl trinitrate) (vasodilator)
+ oxygenation, analgesia, possible surgery required e.g. angioplasty
What is the long-term treatment following an MI?
- lifestyle changes e.g. diet, stop smoking, reduce weight, etc.
(lower BMI/abdominal fat/BP) - beta-blockers (lower BP)
- statins (lower cholesterol by inhbiting HMG-CoA reductase)
- ACE inhibitors (lowers BP by inhibiting angiotensin-converting enzymes which cause vasoconstriction)
What is a STEMI ECG?
ST-elevation in MI
