Acute Myocardial Infarctions or more commonly known as Heart attack
Prolonged deficiency or lack of oxygen in the heart
Often as a result of a thrombus that occludes the vessel leading to the heart.
Often thrombus rest at a preexisting site of atherosclerosis
This area has a build-up of plaques and lipids such as cholesterol.
Other causes exist such as: vasospasm, hypotension, coronary artery dissection, and cocaine
Location of MI depends on which artery is affected
Locations:
Anterior descending branch of left cornary artery = Anterior Left Ventricle and Interventricular septum
Left circumflex artery = Anterolateral or Posterolateral
Right Coronary = Posteroinferior of Left Ventricle
Right Coronary = AV node and Sinus node
Q wave vs. Non Q wave infarction
· Related to ST segment elevation
Risk Factors
· Age
· Previous Heart Attack
· Previous Stroke
· Coronary Heart Disease
· Arteriosclerosis
· High LDL
· Low HDL
· Obesity
· High Blood Pressure or Hypertension
· Diabetes
· Stress
Symptoms
- Chest Pain
- Chest Discomfort
- Nausea
- Vomiting
- Angina that doesn’t resolve with nitroglycerin
- Sweating
- Heart racing
- Anxiety
- Light-headness
- Fatigue – more often in women
- Weakness – more often in women
Laboratory Findings
· CK-MB
· Troponin I
· Troponin T
ECG
· Peaked T waves
· ST segment elevation
· Q wave development
· T wave inversion
Chest X-ray may be helpful
Echocardiography can shows functionality of heart
Technetium-99m pyrophosphate scintigraphy can help diagnoses acute MI
MRI can show extent of MI
Angiography
- can ocassionaly return blood flow.
- A catheter is inserted
- done under fluoroscopy (set of specialized X-rays)
Treatment
Medication
· Nitroglycerin
· Aspirin
· Clopidogrel (Plavix)
· Oxygen
· Morphine
· Alteplase
· Reteplase
· Tenecteplase
· Heparin
Coronary Angiography
Primary Percutaneous Coronary Intervention
Coronary artery bypass surgery