Myocardial Infarction Flashcards Preview

Cardiology > Myocardial Infarction > Flashcards

Flashcards in Myocardial Infarction Deck (12)
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1
Q

STEMI criteria?

A

> 1mm ST elevation in 2 adjacent limb leads

> 2mm ST elevation in at least 2 continuous chest leads

New onset Left bundle branch block

2
Q

ECG changes in NSTEMI?

A

ST depression or T wave inversion; troponin rise

3
Q

ECG changes in unstable angina?

A

ST depression or T wave inversion; no troponin rise.

4
Q

Chest leads for anterior MI

A

V2 - V5

5
Q

ECG leads and artery for anteroseptal MI?

A

V1-V3, left anterior descending artery

6
Q

ECG changes for anterolateral MI and artery

A

I, aVL, V5 and V6 (circumflex)

7
Q

Posterior MI ECG changes and artery

A

ST depression and upright T waves in V1-V3 (right coronary artery) [reciprocal changes]

Dominant R wave in V1 and V2

8
Q

Inferior MI ECG changes and artery

A

II, III, aVF (right coronary artery)

9
Q

Management of STEMI:

A

MONAC

IV morphine 
Oxygen 
GTN spray (nitrates)
Aspirin 300mg
Clopidogrel / Tiacagrelor

Give some IV metoclopramide too.

Primary PCI should be given within 120minutes if presenting within 12 hours of symptom onset, otherwise use fibrinolysis.

If patient has undergone fibrinolysis, an ECG should be performed 90mins after this:
- if not > 50% resolution of ST elevation then transfer to PCI lab

10
Q

Management of NSTEM?

A

GTN Spray, IV morphine, IV metoclopramide can be given

Aspirin 300mg

Clopidogrel should be given and continued for 12 months

Fondaparinux should be offered. (Factor Xa inhibitor)

Coronary angiography

11
Q

List the common complications of MI:

A

Arrhythmias:

  • Ventricular fibrillation (most common cause of death post MI)
  • Bradyarrhythmia (AV block)
  • left ventricular aneurysm (persistent ST elevation and LVF)
  • Pericarditis / Dressler’s syndrome
  • Heart failure.
12
Q

Managament of angina?

A

All patients should receive aspirin and a statin in the absence of any contraindications.

1st line = beta blocker (atenolol) or calcium channel blocker

If CCB used a mono therapy = verapamil or diltiazem

If used in combination with B blocker then change CCB to nifedipine.

Other therapies include isosorbide mononitrate, nicorandil, ivabradine