Myocardial Infarction Flashcards
To learn all about MI
What is Myocardial Infarction?
Referred to as acute coronary syndrome, referred to as Acute Coronary Syndrome, which include:
- Unstable angina
- Non ST elevation MI
What are the criteria for diagnosing MI?
Rise and fall of cardiac bio markers, ie troponin with evidence if ischemia and one of following:
- Symptoms of ischemia
- ECG changes indicative of new ischemia: new ST-T changes or new LBBB
- Development of pathological Q waves
What are the clinical features of MI?
- Central crushing pain
- Radiation to neck, jaw both arms
- More severe than angina pain
- Nausea vomiting
- Distressed
- Mild pyrexia
What investigations are carried out for MI?
- CXR
- FBC
- ESR
- Cardiac biomarkers
What cardiac differential diagnoses include?
- Angina
- Pericarditis
- Myocarditis
- Mitral valve prolapse
- Aortic dissection
What pulmonary DD is there for MI?
- Massive pulmonary embolism
2. Pleurisy
What GI DD Is there for MI?
- Oesophageal
2 Peptic ulcer - Pancreatitis
- Cholecystitis
What chest wall DD is there for MI?
- Rib fracture
- Metastatic deposits in the ribs
- Costochondritis - Tietze’s syndrome
- Shingles
What are the initial goals in the management of MI?
- Prompt and accurate diagnosis
- Admission to CCU
- MI reperfusion
- Secondary prophylaxis
What are the treatments for MI? (medical)
Medical: MONA B
- Morphine
- Oxygen
- Nitrates
- ACE
- Beta Blockers
What are the treatments for MI (surgical)?
- Reperfusion with PCI if STEMI
2. If not PCI for NSTEMI then give LMWH low molecular weight heparin.
What are the complications of MI, C PEAR DROP?
Remember AF increases Stroke incidence. Cardiogenic shock/ Cardiogenic arrhythmias
- C ardiogenic shock/arrhythmias
- P ericarditis
- E mboli
- A neurysm
- R upture of ventricle
- D ressler’s syndrome (pericarditis after MI)
- R upture of free wall
- O
- P illiary muscle. rupture
