Myocardial infarction Flashcards
What must always be present to diagnose somebody with an MI
Rise/ fall of troponin with at least one value> 99% of URL
One of which five things must accompany a change in troponin levels to diagnose somebody with an MI
1) Symptoms of ischaemia
2) New ST segment or T waves changes/ new left bundle branch block on ECG
3) Development of pathological q waves
4) Loss of viable myocardium
5) Intracoronary thrombus
Define NSTEMI
Non ST elevation MI
Ruptured coronary plaque with subocclusive thrombus
Define STEMI
ST elevation MI
Rupture coronary plaque with occlusive thrombus
Is an ECG diagnostic in NSTEMI, STEMI or both?
Just STEMI
How does aspirin change coagulation?
Which type of MI is it therefore more likely to cause
Decreases coagubality
NSTEMI
How does smoking change coagulation?
Which type of MI is it therefore more likely to cause
Increases coaguability
STEMI
2 main/ overall ways an acute MI manifests clincally
- Ischaemic myocardial injury
- Autonomic disturbance
Signs/ symptoms of ischaemic myocardial injury
- Chest pain
- Fourth heart sound
- Low grade fever
- Leucocytosis and raised inflammatory markets
- Troponin leak
Signs/ symptoms of autonomic disturbance
- Tachycardia
- Sweating
- Vomiting
What % of people who die from AMI do so before they reach hospital
33
What % of people who have an acute MI are dead after a year
40
What does primary PCI stand for?
Primary percutaneous coronary intervention
What is the aim of primary PCI?
Restore blood flow to heart by opening vessels without invasive intervention
3 aspects that make up reperfusion therapy for STEMI
- Aspirin and ticagrelor
- Heparin
- PPCI
