Drugs for MI

Question 1

What is the first question you ask the patient to differentiate diagnosis of chest pain?

Answer 1

First: Ask the patient if the pain is exertional
Myocardial infarction pain is exertional (Stress test shows EKG changes)

Question 2

What is the second question you ask the patient to diff diagnosis of chest pain?

Answer 2

Second: Ask the patient if the pain changes with respiration
Myocardia infarction pain doesn’t change with respiration
Pleuritic pain changes with respiration
Think of pneumonia, PE, Pericarditis

Question 3

What is the third question you ask the patient to diff diagnosis of Chest pain

Answer 3

Third: Ask the patient if the pain in tender on Palpation
Myocardial infarction pain is not tender on palpation
If the pain is tender on palpation
Think of Costochondritis

Question 4

What is the clinical presentation of chest pain

Answer 4

EKG ST segment elevation
Elevated cardiac enzyme: CPK-MB and Tropon

Question 5

What are the difference between angina pectoris and MI list three

Answer 5

Angina decrease blood/oxygen flow
Angina ST depression or normal
Angina it is a warning

Question 6

What is the goal of treatment of myocardial infarction?

Answer 6

Prompt diagnosis and early intervention
Relieve of Chest Pain
Stabilize the heart rhythm
Reduce cardia work
Revascularization

Question 7

ER Management of Myocardial Infarction:

Answer 7

Oxygen
Morphine for pain
Nitroglycerin SL
Aspirin to chew on
Loading dose of Clopidogrel
Maximum dose of statins
ACE inhibitors to reduce preload and afterload
Beta blockers to decrease cardiac load
Anticoagulants, Thrombolytics and Cath Lab for PCI or CABG

Question 8

Antiplatelet therapy after acute coronary syndrome

Answer 8

Dual Antiplatelet therapy DAPT
Indication: Drug eluted stent
Antiplatelet: Clopidogrel and Aspirin
Duration: 12 months and re-evaluate