Myocardial Infarction

Question 1

what causes a myocardial infarction

Answer 1

Complete blockage of a coronary artery when the lipid-rich plaque in the vessel ruptures

Question 2

What are 5 risk factors for MI

Answer 2

1. Smoking
2. Diabetes
3. Hypertension
4. Hyperlipidaemia
5. Previous history of CVD
6. Pulmonary vascular disease
7. FH fo CVD

Question 3

What are 5 symptoms of MI

Answer 3

1. Pain radiating from chest to one or both arms, jaw, neck, back or stomach.
2. Breathlessness
3. Cough/wheeze
4. Nausea
5. Sweating

Question 4

5 Signs of MI

Answer 4

1. Pallor
2. Tachycardia
3. Raised or reduced blood pressure
4. Raised JVP
5. Anxiety

Question 5

Immediate investiagtions

Answer 5

ECG

Tropoinin

Question 6

Other investigations ( not immediate)

Answer 6

CXR
Bloods ( FBC, U and Es, cardiac enzymes)
exercise test
angiography ( to perform PCI)

Question 7

Immediate treatment

Answer 7

Morphine
Oxygen
GTN spray
Aspirin

Question 8

Further treatments (medical)

Answer 8

Anti-platelets like aspirin clopidogrel
Anti-thrombotics like heparin LMWH
ACE inhib
B-blockers
statins
Opiates
GTN
Thrombolysis (streptokinase)

Question 9

Further treatments (surgical)

Answer 9

CABG

PCI (stent)

Question 10

What drug would you use for thrombolysis

Answer 10

streptokinase or tissue plasminogen activator (TPA)

Question 11

name two ACE inhibitors

Answer 11

ramipril

captopril

Question 12

name two anti-platelets

Answer 12

aspirin

clopidogrel

Question 13

name two antithrombotics

Answer 13

heparin

LMWH

Question 14

what should be prescribed on discharge

Answer 14

Beta blockers
ACEI
Statins
Aspirin
Ca blockers

Question 15

What are the contraindications to thrombolysis (review answers)

Answer 15

Prior Intracranial haemorrhage
Active bleeding
Ischemic stroke within 3 months
suspected aortic dissection