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acute STEMI
| Question | Answer |
|---|---|
| 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
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