Myocardial Infarction Flashcards Preview

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Flashcards in Myocardial Infarction Deck (14):
1

Common causes of STEMI

Coronary artery disease:
Atherosclerosis with plaque fissuring
Rupture and thrombus formation

2

3 categories of acute coronary syndrome (ACS)

STEMI: ECG shows persistent ST elevation in 2 or more leads.
NSTEMI: ECG doesn't show STEMI but there is elevated cardiac biomarkers.
Unstable angina: non-specific ischaemic changes but no elevated biomarkers

3

Name 5 risk factors for MI

Smoking
Hypertension
Diabetes
Obesity
Metabolic syndrome
Dyslipidaemia
Renal insufficiency
FHx of premature CAD (male <55, female<65)
Cocaine use

4

Signs and symptoms of MI

Chest pain
Dyspnoea (SOB)
Pallor
Diaphoresis (excessive abnormal sweating)
Nausea/Vomiting
Dizziness/light headed
Tachycardia
Additional heart sounds

5

investigations for MI

ECG: look for STEMI or ischaemic changes. ST depression in 2 or more leads in V1-4 should be considered as STEMI

Cardiac biomarkers (CK, CK-MB, Troponin)
Troponin elevated 4-6 hrs after trauma last 10 days

Portable CXR but should not delay treatment (exclude other causes of chest pain and asses current cardiac function)
Widened mediastinum (aortic dissection)

Coronary angiogram (identify occlusion)

After treatment ECHO

6

Which leads show an inferior MI

Leads II, III, aVF

7

MI treatment if there's access to PCI within 90 minutes

Percutaneous coronary intervention
Anticoagulation (e.g. Abciximab and enoxaparin)
Aspirin and PY

8

Which leads show a lateral MI

I, aVL, V5-V6

9

Which leads show an anterior MI

v1-6 predominantly v1, v2

10

What does v3 and v4 show?

anterior wall

11

Which leads will show a possible RCA occlusion

Inferior: II. III, aVF
Posterior: Tall R in V1 (also v2, v3)
Horizontal ST depression
upright T waves

12

Which leads show LAD occlusion

v1, v2. -anteroseptal
v3 & v4 (distal) - anteroapical

13

Which leads show Cx occlusion

I, aVL, v5, v6

14

Which leads show proximal LCA occlusion

I, aVL, v2, v6