Myocardial Infarction

Question 1

Risk Factors

Answer 1

Modifiable:
Alcohol, smoking, diet, exercise, weight loss/cholesterol, HTN, diabetes.

Non modifiable:
Male, age, family history

Question 2

Symptoms

Signs

Answer 2

Central crushing chest pain, radiates to jaw and left arm, SoB, clammy hands, nausea.

Not many signs apart from tachycardia and S3,4 heart sounds, pan systolic murmur.

Question 3

Investigations

Answer 3

Cardio and Resp examination

Imaging: ECG, maybe echo.
Bloods: FBC, UandE, troponin, lipids, HbA1c.

Question 4

Management

Answer 4

MONAR. Morphine w/antiemetic (metacloperamide), oxygen, nitrates, aspirin, reassure.

Book in for PPCI.

If no PPCI, then alteplase.

HEART and GRACE score used to determine risk of mortality and early discharge of patient.

Question 5

Long Term

Answer 5

Bromance.

Beta-blocker, ramipril, clopidogrel, aspirin low dose.

General advice for modifiable risk factors.

1 month, no sex. 1 week no driving. Must let DVLA know if group 2 drivers (lorry and bus).