Myocardial Infarction Bojana Gardijan 4 th year March
Myocardial Infarction Bojana Gardijan 4 th year March 16, 2010 Mentor: A. Žmegač Horvat
Definition � destruction of heart tissue resulting from obstruction of the blood supply to the heart muscle � part of acute coronary syndrome, ACS � non- STEMI non ST-elevation MI � STEMI ST-elevation MI
Risk factors diabetes hyperlipoproteinemia, especially high LDL and low HDL high blood pressure family history of ischemic heart disease obesity BMI>30 kg/m² age M>45, F>55 stress alcohol
Pathophysiology a manifestation of coronary artery disease, also called ischemic heart disease most common triggering event: disruption of an atherosclerotic plaque in an coronary artery clotting cascade sometimes results in total occlusion of the artery
Clinical presentation � chest pain (typically radiating to the left arm or left side of the neck) � shortness of breath (dyspnea) � nausea, vomiting � palpitations � sweating � anxiety
What to do? � history � EKG and physical examination � CBC � cardiac markers, preferably troponin T (and complete biochemistry) � differential diagnosis includes pulmonary embolism, aortic dissection, pericardial effusion causing cardiac tamponade, tension pneumothorax, pancreatitis and esophageal rupture
Treatment of MI � MONA as soon as possible morphine, oxygen, nitrates, aspirin � clopidogrel, heparin, eptifibatide � procedure of choice : PCI (percutaneous coronary intervention) if unavailable: fibrinolysis � postinfarctial therapy: SAAB statins, ACEI, aspirin, beta blockers
Prognosis varies greatly, depending on a person’s health, the extent of the heart damage and the treatment given time to reperfusion is of great importance a quick reaction saves lives
Thank you for your attention!
References � http: //en. wikipedia. org/wiki/Myocardial_infar ction � http: //www. escardio. org
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