STEMI Flashcards
1
Q
Clinical features
A
Severe central crushing chest pain Lasts >30 mins Can occur at rest Radiates to the jaw, left arm, neck Not relieved by GTN spray Sweating Nausea Vomiting
2
Q
Investigations
A
ECG - ST elevation
Can test for cardiac biomarkers but in STEMI these are not required immediately as we can work out the diagnosis from the ECG
3
Q
Emergency management
A
Morphine (+ anti-emetic) Oxygen - if required Nitrates - GTN spray Aspirin - 300mg chewed Clopidogrel
4
Q
Hospital management (2 options)
A
Either:
PCI
- if within 40 mins from a hosp with a cath lab
- if door-needle time will be < 90 mins
Thrombolysis
- if PCI can’t be carried out
5
Q
PCI/Angioplasty
A
Insert a stent to re-open occluded artery.
Preferred treatment option
Explained in coronary revascularisation flashcards
6
Q
Thrombolysis
A
Breaking up the clot using fibrinolytic drugs in order to re-establish blood flow
7
Q
Further management of MI (post op)
A
Atiplatelets
Anticoagulants - fondaparinux
B-blockers
Statin
8
Q
Complications of STEMI
A
Arrhythmias VSD Dressler's syndrome HF Cardiogenic shock
