case 2 - Cardiac Markers in the Diagnosis and Treatment of ACS

Question 1

What tools do we have to answer the question- ‘is he/she having a heart attack/MI?’

Answer 1

⚫ History/ examination
⚫ ECG
⚫ Blood tests
⚫ More sophisticated investigations

Question 2

In a myocardial infarction (MI), the characteristic ECG changes include:

Answer 2

In a myocardial infarction (MI), the characteristic ECG changes include: hyperacute T waves (tall, pointed T waves) appearing early, followed by ST segment elevation in the leads corresponding to the affected area, and eventually the development of pathological Q waves, which indicate tissue necrosis; these changes can evolve rapidly over time, with T wave inversions also seen in some cases depending on the stage of the MI

Question 3

what do pathological Q waves in an MI indicate?

Answer 3

pathological Q waves indicate tissue necrosis

Question 4

what does ST depression indicate?

Answer 4

Cardiac issues

Question 5

causes of ST depression in an ECG

Answer 5

Iscahemia
Electrolyte imbalances
Some medications can also cause ST depressions

Question 6

types of ST depression in an ECG

Answer 6

horizontal
downsloping
upsloping

Question 7

management of the causes of ST depressions

Answer 7

medication
revascularisation
monitoring