Myocardial Infarction

Question 1

Epidemiology of MI

Answer 1

1/2 of all deaths in industrialised countries, 600 in 100,000 yearly
increased risk with age
>60 years
W

Question 2

Aetiology of MI

Answer 2

90% thrombus/stuck in a athersclerotic coronary artery

Males 55+ and females post menopause, smoking, alcohol, stress, dislipidemia, atherosclerosis, hypertension.

More likely in AM.

Question 3

Pathogenesis

Answer 3

Coronary Arteries: thromboembolism - plaque rupture, spasm, drug use, other emboli, CO poisoning, valve disease, hypertrophic cardiomyopathy

Ischemia of myocardium leading to tissue death and akinesia or hypokinesis of heart muscle

Question 4

Natural History

Answer 4

Irreversable myocardial damage after 20 minutes

30% mortality rate

Question 5

Symptoms

Answer 5

dizziness, nausea, anxiety, sense of impending doom, malaise, L chest/arm/jaw pain or back pressure
lasting beyond 5 minutes,not relieved by rest

Question 6

Signs

Answer 6

SOB, weakness, ^BP, cough, frothy sputum, vomiting, cold sweat, pale, clammy
shallow or irregular breathing patterns

Question 7

Complications

Answer 7

congestive heart failure, second MI, arrhythmia, pericarditis, cardiogenic shock

Question 8

Prognosis

Answer 8

1/3 die within 24H, additional 10% die within a year