Myocardial Infarction

Question 1

What is a STEMI?

Answer 1

A myocardial infarction that illustrates ST elevation on an ECG

Question 2

What is a NSTEMI?

Answer 2

A myocardial infarction that doesn’t illustrate ST elevation on an ECG

Question 3

What is an unstable angina?

Answer 3

Where there is partial occlusion of a coronary artery that leads to ischaemia that causes pain at rest

Question 4

What causes a STEMI?

Answer 4

There is a rupture of a coronary plaque which leads to an occlusive thrombus (completely blocking a blood vessel) leading to large amount of ischaemia

Question 5

What is ST elevation in myocardial infarction indicative of?

Answer 5

This indicates ischaemia

Question 6

What are Q waves in myocardial infarction indicative of?

Answer 6

Infarction, irreversible myocardial death.

Question 7

What are the clinical signs and symptoms of acute myocardial infarction?

Answer 7

As a result of ischaemic myocardial injury: chest pain (angina), a 4th heart sound, low grade fever, leukocytosis and raised CRP and troponin I and T release

As a result of autonomic disturbance: tachycardia, sweating and vomiting

Question 8

What drugs may be given post-MI as a form of secondary prevention?

Answer 8

• Aspirin
• Ticagrelor (platelet aggregation inhibitor)
• Statin
• Beta-blocker
• ACE inhibitors

Question 9

What are the treatments for NSTEMI?

Answer 9

Anti-coagulants, vasodilators and antiplatelet drugs.

Question 10

How does fondaparinux prevent coagulation?

Answer 10

By inhibiting factor Xa (prevents prothrombin to thrombin conversion, and therefore prevents fibrin formation to form a stable clot)