Myocardial Infarctions and Cardiac arrest Flashcards
What does STEMI stand for?
ST Elevation Myocardial Infarction
What does NSTEMI stand for?
None ST Elevation Myocardial Infarction
Whats the difference physiologically between a STEMI and NSTEMI?
STEMI involves total occlusion of the blood vessel whilst NSTEMI is only partly occluded by the thrombus plaque
What is the triggering factor in both?
Acute plaque rupture leading to occlusion or partial occlusion of the vessel
What factors influence likely hood of a plaque rupture?
Younger, Fattier, thiner, Increased intraluminal pressure, mechanical injury all increase rupture threat
Which two chemical are released by the platelets to attract other factors and more platelets to the site?
ADP and Thromboxane
STEMI Diagnosis- History
Sever crushing central chest pain
More prolonged GTN doesn’t relieve
Nausea Sweaty Pallor
STEMI Diagnosis- ECG
ST elevation, T wave inversion, Q Wave
Left bundle Branch MI ECG
Prolonged ST phase V1-V4
STEMI Diagnosis- Troponin
Don’t really have time to wait on the results so not really part of the diagnosis
What is the double antiplatelet therapy used in MI
Aspirin + Clopidogrel
Ticagrelor is more potent that clopidogrel used if no threat of bleeding
If the patient is more than 120mins away from a hospital with angioplasty and stent lab what happens?
Given Thrombolysis but still taken to a hospital with ability to do angioplasty and stenting; either for emergency stenting if thrombolysis failed or routine a while after if thrombolysis worked.
6 steps in treating MI
Analgesia- Diamorphine IV Anti-emetic IV Aspirin + Tricagrelor/ clopidogrel GTN if BP> 90 mmHg Oxygen if hypoxic Primary Angioplasty
Post MI complications
Death, Structural, functional and arrythmic
Structural complications as a results of an MI
Cardiac rupture- fatal untreatable
Mitral Valve Regurgitation- papillary muscle damaged
Septal defect- treated with surgery to block hole
