Myocardial Infarction

Question 1

What investigations do you do if you suspect an acute MI?

Answer 1

ECG
Creatinine kinase
Troponin

Question 2

What are the ECG changes in a STEMI

Answer 2

St elevation
T wave inverstion
Q waves
new onset bundle branch block

Question 3

What do you need to diagnose an MI

Answer 3

St elevation of more than 1 mm in two adjacent limb leads

ST elevation of more than 2 mm in two adjacent chest leads

Question 4

Where is the elevation in a inferior MI

Answer 4

II, III , aVF

Question 5

Anteriorseptal

Answer 5

V1-4

Question 6

Anteriolateral

Answer 6

I, AvL, v1-V6

Question 7

What is the inital treatment of MI

Answer 7

Morphine plus antiemetic
Oxygen
Nitrate
Aspirin
Clopidogrel

Question 8

When would you consider reperfusion

Answer 8

chest pain more than 20mins less than 24 hrs ago
St elevation or new bundle branch block
no contraindications

Question 9

when would you thrombolyse

Answer 9

if unable to perform PCI within 120 minutes of ECG confirmed STEMI

Question 10

What is the management post MI

Answer 10

aspirin
statin
beta blocker
ACE

Question 11

what are the complication

Answer 11

death
arrythmias
mitral regurge
septal defect
pericarditis
dresselrs syndrome
heart failure

Question 12

what other conditions can troponin be elevated

Answer 12

renal failure
PE
pericarditis
myocarditis
sepsis
CCF
arrythmia

Question 13

what would you do if NSTEMI

Answer 13

heparin and angiography if high risk