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Related Topics
Cards In This Set
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30-Day mortality of acute MI?
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5-10%
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Spont ____ and ___ of a coronary atherosclerotic plaque may occur, exposing a highly ___ surface. ___ ___ and ___ ___ follow, and the pt clinically presents with an ___ ___ ___
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Fissure and rupturing; thrombogenic; platelet aggregation adn fibrin formation; acute coronary syndrome
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What if thrombus--> complete occlusion? what if this is untreated? pathologic Q waves indicate what?
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*get ST-elevation MI= STEMI *if untreated, get necrosis of myocardium *that necrosis occured throughout the entire thickness of the affected myocardium (doesn't always happen)
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Get NSTEMI when?
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Acute coronary syndromes with ischemic chest pain adn elevated biochem markers of myocaridal injury but no classic diagnostic ST elevation on ECG (NSTEMI)
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In NSTEMI, path Q waves present?
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NO
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Conditon that's similar to NSTEMI? how are they diff?
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*unstable angina (transient thrombus adn occlusion) *no markers of infarction in unstable angina
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Other than acute mi, mechs for which coronary blood flow or o2 supply or both can be acutely compromised--> mocardial ischemia and infarct?
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*demand ishcemia (tachycardia, hypotension and/or severe hypoxia in setting of existing fixed CAD)
*coronary artery dissection (often in setting of dissecting aortic aneurysm *coronary vasospasm (idiopathic Prinzmetal angina or drug-induced, eg: cocaine) *in situ thrombus formation (in the setting of a hypercoag state) *coronary embolism *vasculitis (eg: Kawasaki disease) *CO poisoning |
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Complications that can lead to death within 1 month from AMI?
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*arrythmias (v fib/tachycardia, complete heart block) *heart failure (cardiogenic shock) *ventricular rupture (peak incidence within 3-5 days of AMI) *other mech complications (vnetricular septal defecta, mitral papillary rupture)
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Death occuring >1 month after an AMI can be caused by what?
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Reinfarction, progressive heart failure, or sudden arrhythmia
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Pain symtpom in AMI?
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Retrosternal chest pain, often starting at rest
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Timing of pain in AMI?
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Reaches a max over several min and then is prolonged and persistent
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Radiation of AMI pain? how does nitrate affect pain?
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*back, neck, arms, or jaw *may provide some relief but generally doesn't resolve the pain
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Other symtpoms in AMI
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Diaphoresis, dyspnea, nausea/vomiting, anxiety
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Unstable angina may present in what ways/
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Rest pain, new-onset exertional pain, or increasing severity or frequence of established angina
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Atypical presentations of ami?
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*pleuritic or sharp chest pain (10-20%) *elderly (esp ihave dementia), diabetics, post-op pts on analgesics: may not give hx of chest pain * instead have fatigue, nausea, syncope, sob
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