myocardial infarction

chest pain
1. heart problems
2. lung problems
3. gastrointestinal problems
4. anxiety/panic attack
angina
1. chest pain or discomfort
2. symptom of heart disease
3. caused by reduced oxygen in the blood in the heart
4. types
  1. typical/stable
    1. on exertion
    2. <20 min
    3. 70% atherosclerosis
    4. reversible
    5. ST segment depression
    6. relieved by rest/nitrates
  2. prinzmetal/variant
    1. unrelated to exertion
    2. due to coronary vasospasm
    3. reversible injury
    4. ST segment elevation
    5. relieved by nitrates/calcium-channel blockers
  3. unstable/crescendo
    1. occurs at rest
    2. due to acute plaque changes
    3. reversible injury
    4. ST segment depression
    5. relieved by nitrates
    6. high risk of progression to MI
5. emergency treatment
  1. morphine
  2. oxygen
  3. nitrates
  4. aspirin
types of MI
1. subendocardial injury
  1. ST depression
2. transmural injury
  1. ST elevation
signs and sypmtoms
1. chest discomfort
2. trouble breathing
3. feeling faint
4. sick or discomfort in stomach
gross and microscopic findings of MI
1. 0-24 hrs
  1. no gross changes
  2. coagulation necrosis present within 12-24 hrs
  3. nenutrofils begin to enter
2. 1-3 days
  1. pallor of infarcted tissue
  2. myocyte nuclei and striations disappear
  3. neutrophils are abundant and lyse the dead myocardial cells
3. 3-7 days
  1. red granulation tissue
  2. macrophages begin to remove necrotic debris
4. 7-10 days
  1. necrotic area is brightly yellow
  2. granulation tissue and collagen are well developed
5. during 2 months
  1. white patchy noncontractile scar
investigations
1. ECG
2. lipid profile
3. chest x-ray
  1. pulmonary edema
  2. left ventricular hypertrophy
4. blood test
  1. biomarkers
5. echocardiogram
  1. uses ultrasound
6. coronary angiography
  1. uses special dyes and x-rays
complications
1. arrhythmia
2. cardiogenic shock
3. thromosis
4. acute pericarditis
5. rupture
6. cardiac tamponade
7. dressler syndrome
8. ventricular aneurysm
risk factors of MI
1. age
2. smpking
3. high BP
4. high cholesterol/ TG/ LDL
5. diabetes
6. family history
7. lack of physical activity
8. obesity
9. stress
10. illegal drug use
11. preeclampsia
12. autoimmune condition
treatment of MI
1. aspirin/heparin
2. oxygen
3. nitrates
4. ACE inhibitors
5. fibrinolysis/angioplasty
6. surgical
  1. coronary angioplasty
7. psychological/ lifestyle changes
  1. support groups

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myocardial infarction

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	Created by rama ibrahim about 7 years ago