Myocardial Infarction

Question 1

Symptoms of myocardial infarction?

Answer 1

Chest pain
Spreads to arms and neck
Nausea, vomitting, sweatiness, breathlessness

Question 2

Clinical signs?

Answer 2

Low BP and heart rate fast

Question 3

Risk factors

Answer 3

Overweight
Diabetic
family history
high cholesterol
male
south asian
smoking
age
low activity

Question 4

What is coronary atheroma?

Answer 4

Cholesterol deposits in the wall of the artery - called “plaques” or “stenoses”

Question 5

Why does angina happen?

Answer 5

Occurs when the demand for blood by the heart exceeds the supply of the coronary arteries

Question 6

What causes heart arteries to narrow?

Answer 6

Atherosclerosis and coronary thrombosis

Question 7

Investigation?

Answer 7

ECG - shows ST segment elevated if coronary artery is completely blocked

Blood test shows - increased troponin

coronary angiogram

Question 8

Treatment

Answer 8

Pain relief with morphine
aspirin
Primary percutaneous intervention - thin tube placed in arm or leg, clot is removed, small balloon is opened up // stent

Question 9

Follow up care?

Answer 9

-Aspirin - antiplatelet action
Clopidogrel - antiplatelet action
Beta blockers - lowers heart rate and BP through blocking effects of adrenaline

Statins - lowers cholesterol

Ace inhibitors - blocks angiotensin converting enzyme