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Flashcards in MI Deck (20)
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1

What are the classical signs & symptoms of MI?

Central chest pain - "crushing", "tight band"
Radiation to left arm, jaw, back
Grey colour
Clammy
Sweaty
Breathless

2

What is a gastrointestinal differential diagnosis of MI?

Acid reflux

3

How many times should angina spray be taken before phoning ambulance?

Twice - still chest pain, call ambulance
Chest pain >30 minutes

4

What are some of the predisposing factors to MI?

Angina
Hypertension
High cholesterol
Peripheral arterial disease
Obesity
Family history

5

What is the pathogenesis of an MI?

Atherosclerotic disease - plaque rupture (could be due to insertion of stent)
Aggressive clotting response causing thromboemboli
Coronary artery lumen occluded
Oxygen not able to perfuse myocardium

6

What are some of the complications that can occur following MI?

Cardiac failure
Dressler's syndrome
Arrhythmias
Sudden death
Angina
Mitral incompetence
Pericarditis
Cardiac rupture
Ventricular aneurysm

7

What ECG changes might be seen in an acute MI?

ST elevation in STEMI
ST depression - could be NSTEMI
Long term - pathological Q waves

8

Which ECG leads would show ST elevation in inferior MI?

AvF, 2, 3

9

Which ECG leads would show ST elevation in anterior MI?

Usually, V3 & V4
But, any of V2-V5

10

Which ECG leads would show ST elevation in anteroseptal MI?

V1-V4

11

Which ECG leads would show ST elevation in anterolateral MI?

V4-V6, AvL, 1

12

Which ECG leads would show ST elevation in a lateral MI?

1, 2, AvL

13

What is the initial treatment for patients presenting with acute MI?

Remember: MONA+C
Morphine
Oxygen
Nitrates
Aspirin
Clopidogrel

Consider an anti-emetic

14

Which length of time determines the treatment for the patient?

90 minutes

15

Which treatments are available (dependant on the time passed from onset of symptoms)?

90 minutes: thrombolysis e.g. with streptokinase

16

What non-pharmacological treatment would be suggested to patient who had suffered from an MI?

Dietary changes
Exercise changes
Smoking cessation

17

What pharmacological treatment would you put a patient on following an MI?

Aspirin
Clopidogrel
A statin
ACE inhibitor

18

Which blood test should be ordered both on admission and 12-16 hours later?

Troponin T and troponin I

19

Is the troponin blood test a specific, diagnostic marker for an MI?

No, it simply indicates damage to the myocardium

20

How long can troponin levels stay elevated in the blood for?

May stay elevated for 1-2 weeks, and take 6-12 hours to become raised initially