s an accumulation of degenerative material in the inner layer of an artery wall. The material consists of mostly macrophage
cells,[1][2] or debris, containing lipids, calcium and a variable amount of fibrous connective tissue. The accumulated material forms a
swelling in the artery wall, which may intrude into the channel of the artery, narrowing it and restricting blood flow. Atheroma occurs
in atherosclerosis
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Myocardial Infarction
Definition
Myocardial infarction is the death of the cells of an area of the
heart muscle (myocardium) as a result of oxygen deprivation,
which in turn is caused by obstruction of the blood supply.
The myocardium receives its blood supply from the two large
coronary arteries and their branches. Occlusion of one or more of
these blood vessels is one of the major causes of myocardial
infarction.
Pathogenesis
Signs and Symptoms
Pressure or tightness in the chest
Pain in the chest, back, jaw, and other areas of
the upper body that lasts more than a few
minutes or that goes away and comes back
Dyspnea (shortness of breath)
Diaphoresis (sweating)
Nausea
Vomiting
Anxiety
Dizziness
Tachycardia
Note that not
all patients
experience the
same number
and severity of
symptoms.
How is angina different from mi?
investigations
NSTEMI ECG changes
ECG changes in infarcts
ST depression
ST elevation
T-waves (peaked, flattened, inverted)
Appearance of pathologic Q-waves
Different types and stages of infarcts have different ECG changes
ECG and MI
STEMI ECG changes depending on different stages
Blood test (Biomarkers)
Cardiac enzymes (isoenzymes):
Lactate dehydrogenase (LDH)
Creatine Kinase (CK)
2- Cardiac Proteins:
Myoglobin
Troponins
management
angina
Paroxysmal attacks of
substernal chest discomfort
radiating to left shoulder (15
sec-15 min)
Types:
Complications
ISCHEMIC (including failure of reperfusion): angina, re-infarction, infarct extension.