Myocardial Infarction

Question 1

What are the symptoms of MI?

Answer 1

Chest discomfort of almost any character but often pressure

• wide range of anatomical locations
• can have dyspnoea, sweating, nausea
• can be painless (eg some diabetics)
• usually spontaneous onset
• *sense of impending doom -“i fell like I’m going to die”

Question 2

How do you treat myocardial infarctions?

Answer 2

• oxygen
• pain relief
• GTN sublingually
• aspirin
• second anti-platelet

Question 3

What is the definition of MI?

Answer 3

Detection of rise/fall of troponin with evidence of myocardial ischaemia and at least one of the following:
Symptoms of ischaemia
ECG changes indicative of new ischaemia
Development of pathological Q waves
Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality

Question 4

What is type 1 MI?

Answer 4

Spontaneous MI

Plaque rupture/fissuring/ulceration/dissection with resulting intraluminalthrombus leading to decreased myocardial blood flow or distal platelet emboli and myocardial necrosis

Question 5

What is type 2 MI?

Answer 5

Myocardial infarction secondary to ischaemia imbalance

A condition other than CAD contributes to an imbalance between myocardial oxygen supply/demand (eg coronary spasm, Coronary embolism, tachy or brady arrhythmia, anaemia, respiratory failure etc)