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 |