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Cardiology > Myocardial Infarction > Flashcards

Myocardial Infarction Flashcards

1
Q

What are the signs and symptoms of an MI?

A 
Chest/back/jaw pain
Indigestion
Sweatienss / claminess
Dyspnoea
Tachycardia
Distressed patients
Heart failure
Shock
Arrythmia
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2
Q

The release of which protein into the bloodstream is a marker of. cardiac necrosis?

A

Troponin

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3
Q

Elevated troponin is always an indicator of an MI. T/F?

A

False - this could be an MI but there are also other causes

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4
Q

Describe type I MI?

A

Spontaneous MI due to a primary coronary event e.g. coronary plaque rupture and formation of thrombus

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5
Q

Describe type II MI?

A

Increased oxygen demand or decreased oxygen supply e.g. heart failure, sepsis, anaemia, arrhythmia, hypertension, hypotension

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6
Q

Describe type III MI?

A

Sudden cardiac death

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7
Q

Describe type 4A MI?

A

MI associated with percutaneous coronary intervention

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8
Q

Describe type 4B MI?

A

Mi stent thrombosis documented by angiography or PM

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9
Q

Describe type 5 MI?

A

MI associated with CABG

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10
Q

What is unstable angina?

A

An acute coronary event without a rise in troponin

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11
Q

An acute coronary syndrome with ST elevation is indicative of…?

A

MI

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12
Q

An acute coronary syndrome with no ST elevation but troponin elevation is indicative of…?

A

MI

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13
Q

An acute coronary syndrome with no ST elevation and no troponin elevation is indicative of…?

A

Unstable angina

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14
Q

Why is ST elevation not seen with a posterior infarct of the heart?

A

No ECG leads look directly at the posterior aspect of the heart

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15
Q

Anteroseptal infarcts indicate occlusion of which artery?

A

Left anterior descending artery

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16
Q

Posterior infarcts indicate occlusion of which artery?

A

Circumflex artery (sometimes right coronary artery)

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17
Q

Lateral infarcts indicate occlusion of which artery?

A

Left circumflex artery

18
Q

What. finding on an ECG indicates a previous MI?

A

Negative Q wave

19
Q

Which are the anterior leads of an ECG?

A

V1,2,3 and 4

20
Q

An anterior STEMI is shown in the anterior leads. There is also reciprocal ST depression in which leads?

A

Inferior leads (II, III, aVF)

21
Q

A high lateral STEMI shows elevation in which leads?

A

The high lateral leads (I and aVL)

22
Q

A high lateral STEMI shows elevation in leads I and aVL. This also shows reciprocal ST depression in which leads?

A

Inferior leads (II, III, aVF)

23
Q

An inferior STEMI shows ST elevation in the inferior leads (II, II and aVF) and reciprocal ST depression in which leads?

A

High lateral leads (I and aVL)

24
Q

How can posterior ST elevation be shown indirectly on an ECG?

A

Reciprocal ST depression in the anterior leads (V 1,2,3 and 4)
Sometimes subtle ST elevation in inferior leads (II,III and aVF)

25
Q

What are the indications of a left bundle branch on an ECG>

A

QRS >120ms and a dominant S wave in V1

26
Q

What protocol is used for the immediate management of MI?

A

ABCD protocol

27
Q

What drugs are given in the immediate management of MI?

A 
300mg Aspirin PO
Unfractionated her pain 5000U IV
Morphine 5-10mg IV
Anti-emetics
Clopidogrel if in ambulance and ticagrelor is in hospital
28
Q

What are the advantages of primary percutanoues coronary intervention when compared to thrombolysis?

A 
Improves survival
Reduces trokes
Reduces the chance of further MI
Reduces the chance of further angina
Speeds up recovery and shortens the time spent in hospital
29
Q

What technique can be used to place a small coronary stent in the immediate management of MI?

A

Transradial percutaneous intervention

30
Q

What drugs should be given to all MI patients for the secondary prevention?

A

ACE inhibitors
Beta blockers
Statins
Aspirin

31
Q

Which patients should receive eplerenone for secondary prevention of MI?

A

Diabetes
Left ventricular systolic dysfunction
Clinical heart failure

32
Q

What are the potential complications of MI?

A 
Arrythmias
Heart failure
Cardiogenic shock
Myocardial rupture
Psychological ( anxiety/depression)
33
Q

Myocardial rupture of the papillary muscle due to MI will cause…?

A

Mitral regurgitation

34
Q

How does myocardial rupture of the free wall due to MI lead to death?

A

By causing cardiac tamponade

35
Q

Myocardial rupture of the septum due to MI will cause…?

A

Ventricular septal defect

36
Q

How is cariogenic shock as a result of MI treated?

A

Intra-aortic balloon pump

Ventricular assist device

37
Q

How is heart failure as a complication of MI treated?

A

Diuretics
Inotropes
Vasodilators

38
Q

If there is left ventricular dysfunction at >9months after MI then what treatment should be considered?

A

Implantable cardioverter defibrillator

39
Q

What risk score system is used to determine which patients get further inpatient care for NSTEMIs?

A

GRACE risk score

40
Q

What are the requirements in order for a finding of ST elevation to be significant>

A

> 1mm in limb leads and >2mm in chest leads

Present in at least two leads

41
Q

In what situations would oxygen be given for MI?

A

When the patient is hypoxic (just as with any other condition)

42
Q

When would thrombolysis be used instead of PCI to reperfuse a STEMI patient?

A

When for geographical reasons a patient can’t reach a PCI centre in time

Cardiology (8 decks)

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