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acute STEMI

most common cause of acute MI thrombus formation due to unstable athersclerotic plaque
thrombolytic therapy contraindicated embolic phenomenon, thoracic aortic dissection
criteria for MI dx (need 2/3) sx, EKG, serum cardiac markers
detects MI w/in 24hrs - 5 days Tc-pyrophosphate scan
scan performed 24hrs after injection In-antimyosin scan
can detect acute MI, unstable angina, active myocarditis, cardiac transplant rejection In-antimyosin scan
detects both acute and chronic MI late galolidium enhancement CMR
first to inc w/acute MI myoglobin
second to inc w/acute MI total CK and troponin
inc several days after acute MI LDH
dec by beta blockers, anti-HTN drugs, digoxin, & analgesics double product (SV and HR)
used for tachycardia associated w/hypotension or CHF digoxin
ways to dec O2 demand bed rest, NPO, dec double product
dec by diuretics, IV NTG, and MSO4 pulm HTN
used for cardiogenic shock Intra-aortic balloon pump
lyses coronary A thrombus and improves LV function thrombolytic therapy
AE = bleeding, anaphylaxis, hypotension, and arrhythmia thrombolytic therapy
most beneficial time to administer thrombolytics <6hrs
EKG criteria for MI ST elevation >1mm in 2 or more contigous leads, new LBBB
prior intracranial hemorrhage contraindication for thrombolytic therapy
ateriovenous formation contraindication for thrombolytic therapy
known malignant intracranial neoplasm contraindication for thrombolytic therapy
ischemic stroke w/in 3 months contraindication for thrombolytic therapy
significant close-headed or facial trauma w/in 3 months contraindication for thrombolytic therapy
suspected aortic dissection contraindication for thrombolytic therapy
active bleeding contraindication for thrombolytic therapy
time frame for most effective thrombolytic treatment <6 hrs
ST elevation >1mm, new LBBB EKG criteria for MI
used for pts w/cardiogenic shock or high risk for thrombolytic therapy catheter-based intervention
used for pts w/mechanical complications or high risk for catheter-based intervention CABG
diagnosed by echo and treated w/IABG and/or emergent surgery mechanical complications
peak incidence = 3-5 days post MI mechanical complications
Created by: drhermy