Diagnosing MIs and the Types of MI

Question 1

What three things are need for the definitive diagnosis of an MI?

Answer 1

1. Symptoms
2. ECG Changes suggesting ischaemia or infarct
3. Evidence of necrosed myocardial tissue (Raised troponin)

Question 2

What is the troponin test?

Answer 2

Elevated levels appear about 6 hours after the event and they suggest some myocardial damage.

There are needed for diagnosis of MI but are not diagnostic as they can appeat in other conditions.

Question 3

What would you see on the ECG of an Anterior STEMI and what artery is affected?

Where are the reciprocal changes?

Answer 3

Artery - LAD

ECG - ST elevation in V2-V5 and 1 and AVL

AVF, 3

MAY BE just the V leads and no reciprication if very anterior

Question 4

What would you see on the ECG of an Lateral STEMI and what artery is affected?

Where may you see reciprocal changes?

Answer 4

Artery - Circumflex

Leads - 1, AVL, V5, V6

Reciprocal - 3, AVR

Question 5

What would you see on the ECG of an Inferior STEMI and what artery is affected?

Where would you see reciprocal changes?

Answer 5

Artery - Right coronary

Leads - 2, 3, AVF

Reciprocal AVL, 1

Question 6

What is a NSTEMI?

Answer 6

This is an MI that does not have ST elevation but will have ST depression. This suggests the blockage does not go all the way through the artery