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Cardiorespiratory CC > Myocardial Infarction > Flashcards

Myocardial Infarction Flashcards

1
Q

Diagnostic criteria- NEED this

A

Rise and/or fall of troponin with at least one value >99th percentile of URL

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2
Q

Diagnostic criteria additional- need at least ONE

A 
Symptoms of ischaemia
New ST segment or T wave changes or new LBBB
Pathological Q waves
Loss of viable myocardium
Intracoronary thrombus
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3
Q

Unstable Angina/NSTEMI

A

Ruptured coronary plaque with sub-occlusive thrombus

ECG non-diagnostic

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4
Q

STEMI

A

Ruptured coronary plaque with occlusive thrombus

ECG diagnostic

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5
Q

Coagulability

A

Aspirin decreases

Smoking increases

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6
Q

Type 1 AMI

A

Spontaneous AMI

Plaque rupture

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7
Q

Type 2 AMI

A

Ischaemic imbalance

Coronary spasm, embolism, dissection, hypotension

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8
Q

Type 3 AMI

A

Cardiac death

Presumed AMI

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9
Q

Type 4a AMI

A

Related to PCI

>5 times URL for troponin

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10
Q

Type 4b AMI

A

Caused by stent thrombosis

Confirmed at angiography or autopsy

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11
Q

Type 5 AMI

A

Related to CABG

>10 times URL for troponin

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12
Q

PCI

A

Percutaneous Coronary intervention

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13
Q

CABG

A

Coronary Artery Bypass-Grafting

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14
Q

Consequence of AMI

A

Regional LV wall-motion abnormality

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15
Q

Clinical Manifestations- Ischemic Myocardial Injury

A 
Chest Pain
4th heart sound
Low grade fever
Leucocytosis + raised inflammatory markers (ESR,CRP)
Troponin Leak
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16
Q

Clinical Manifestations- Autonomic disturbance

A

Tachycardia
Sweating
Vomiting

17
Q

Delay in calling for help

A 
Older people
Women
Nocturnal pain
No previous AMI
Diabetics
33% patients who die of AMI die before hospital
18
Q

AMI mortality

A

40% dead after 1 year

19
Q

STEMI treatment

A

Reduce infarct size
SK + Aspirin
Reperfusion therapy

20
Q

Reperfusion therapy

A

Aspirin + ticagrelor
Heparin
PPCI

21
Q

Emergency Treatment NSTEMI

A 
Aspirin + ticagrelor
GP IIb/IIIa inhibitor
Fondaparinux (factor Xa inhibitor)
Anti-ischaemic drugs (BB, nitrates)
Angiography + PCI within 24-96 hours
22
Q

Smoking

A

20% of AMI patients are smokers
Among <60yo, 50% are smokers
Smokers who quit reduce risk of major adverse cardiac events by 40%
Nicotine replacement therapy + counselling
Counselling after discharge increases quitting rates by 60%

23
Q

Implantable defibrillator post AMI

A

Cardiac arrest VT/VF >24 hours after onset of AMI
Sustained VT with syncope >24 hours after AMI onset
LV ejection fraction <35%

24
Q

Prevent pre-hospital death

A

Defibrillator

25
Q

Prevent hospital death

A

Initiate reperfusion therapy

26
Q

Lethal arrythmias

A

Implantable defibrillators

Cardiorespiratory CC (34 decks)

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