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Cardiology > Acute MI > Flashcards

Acute MI Flashcards

1
Q

what are the symptoms of AMI? (3)

A

pressure-like chest pain
more than 20 mins
radiation to jaw, neck, shoulders, arms

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2
Q

what are the 2 characteristics of a STEMI?

A

ST elevation
elevations in cardiac enzymes

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3
Q

what is commonly caused by advanced atherosclerotic plaque with thrombosis that is not occlusive and may be associated with increased myocardial demand?

A

Non-ST elevation MI (NSTEMI)

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4
Q

what is S3 also known as and when does it occur?

A

ventricular gallop - blood rushing into left ventricle
ischemia

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5
Q

what is S4 also known as and when does it occur?

A

atrial gallop (kick) - atrial kick against ventricles
heart failure

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6
Q

what are 4 things I may find in a physical exam for AMI?

A

jugular venous distention
S3 gallop with ischemia
S4 gallop with heart failure
rales, pedal edema with heart failure

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7
Q

what are 6 causes of acute chest pain that cause rapid mortality?

A

PE
spontaneous pneumothorax
unstable angina
acute MI
aortic dissection
pericardial tamponade

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8
Q

what 2 important symptoms would be seen in an AMI with right ventricular infarction?

A

elevated jugular venous pressure
Kussmaul’s sign

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9
Q

what is kussmaul’s sign?

A

drop in jugular venous pressure during inspiration

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10
Q

what is an important physical exam finding to indicate an AMI with rupture of the interventricular septum?

A

loud holosystolic murmur at the lower left sternal border + a thrill

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11
Q

which cardiac biomarker is elevated within hours of an AMI?

A

troponin

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12
Q

what 2 things must be present to diagnose an MI?

A

elevated cardiac enzymes
ECG evidence of ischemia (ST changes)

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13
Q

what should be ordered to evaluate the severity and myocardial function?

A

echocardiogram

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14
Q

which cardiac enzymes should be checked?

A

CK-MB and troponin

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15
Q

what should be given to patients with an AMI at presentation and continue indefinitely thereafter?

A

aspirin

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16
Q

what can be given to patients that are aspirin-sensitive?

A

clopidogrel

17
Q

what can be given to NSTEMI patients depending on risk of morbidity/mortality?

A

heparin or enoxaparin

18
Q

what can be given to patients to relieve ischemic chest pain?

A

nitroglycerin?

19
Q

which patients should NOT receive nitroglycerin? (2)

A

hypotensive
right ventricular infarction

20
Q

how should nitroglycerin be titrated?

A

based on blood pressure reduction, not symptoms

21
Q

what should be given to all hemodynamically stable patients with an AMI?

A

beta blocker

22
Q

what should be given to ALL patients within 24 hours after MI?

A

ACE inhibitor

23
Q

what can be given to patients who are intolerant of ACEI?

A

ARB

24
Q

why are ACEIs and ARBs used in situations of AMIs?

A

reduce incident of ventricular remodeling and heart failure

25
Q

how/when is long term therapy with ACEIs or ARBs determined/indicated?

A

left ventricular function - for EF < 40%

26
Q

what medication should be given within 14 days of AMI to reduce occurrence of unstable angina at 4 months?

A

statins

27
Q

what is the treatment of choice for AMI?

A

percutaneous coronary intervention (angioplasty with stent)

28
Q

in which patients should I consider a PCI? (2)

A

severe heart failure
symptoms for more than 3 hours

29
Q

what is the door to balloon time for a primary PCI?

A

less than 90 mins

30
Q

what 3 things make a patient a candidate for CABG?

A

diabetes
left main stenosis > 50%
triple-vessel involvement

31
Q

what should be given within 30 minutes of medical contact when primary PCI is not available or if a delay of more than 90 mins to balloon time is expected?

A

fibrinolytic

32
Q

what is associated with a higher risk of death after AMI?

A

NSAIDs

Cardiology (19 decks)

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