MI is myocardial injury due to ischaemia. It is defined pathologically as myocardial cell death due to prolonged ischaemia. MI is diagnosed when there is a rise and\/or fall in cardiac troponins and accompanied with at least one of the following:
\uf0b7 Clinical history of chest pain from ischaemic origin lasts more than 30 minutes.
\uf0b7 ECG changes of ischaemia\/infarction and\/or the
\uf0fc Development of pathological Q waves.
\uf0fc New or presumed new significant ST-T wave changes or left bundle branch block
\uf0b7 Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality.
\uf0b7 Identification of an intracoronary (IC) thrombus by angiography or autopsy.<\/p>\n\n\n\n
\uf0b7 Type 1: Spontaneous MI due to coronary athero-thrombosis – atherosclerotic plaque rupture, ulceration, fissuring, erosion, or dissection with resulting intraluminal thrombus in coronary artery leading to decreased myocardial blood flow or distal platelet emboli with ensuing myocyte necrosis.
\uf0b7 Type 2: MI secondary to an imbalance between myocardial oxygen demand and supply – it may occur in the presence of coronary atherosclerosis without plaque rupture or in the absence of atherosclerosis eg coronary endothelial dysfunction, coronary artery spasm, coronary embolism, coronary artery dissection, tachy \/ bradyarrhythmias, anaemia, respiratory failure, sepsis, hypotension, and hypertension with or without left ventricular hypertrophy (LVH).
\uf0b7 Type 3: MI resulting in death when biomarker values are unavailable unrelated to acute coronary athero-thrombosis<\/p>\n\n\n\n
\uf0b7 Type 4: MI related to PCI
\uf0b7 Type 5: MI related to coronary artery bypass surgery (CABG)<\/p>\n\n\n\n
Chest pain located in the centre of the chest and may radiate to the jaw or down the left arm. It may occur at rest or with activity. The pain can just be a tightness or heaviness in nature, or more often a squeezing, severe type of crushing pain. They are usually accompanied with sweating, nausea, vomiting and shortness of breath.<\/p>\n\n\n\n
Elderly, females and diabetic patients may present with unexplained fatigue, shortness of breath, dizziness, light-headedness, unexplained sweating and syncope. They may not have chest pain.<\/p>\n\n\n\n
The clinical spectrum may range from patients free of symptoms at presentation to individuals with ongoing ischaemia, electrical or haemodynamic instability or even cardiac arrest. Some patients may present with ongoing myocardial ischaemia, characterized by one or more of the following:
\uf0b7 Recurrent or ongoing chest pain,
\uf0b7 Marked ST depression on 12-lead ECG,
\uf0b7 Heart failure
\uf0b7 Haemodynamic or electrical instability.<\/p>\n\n\n\n
Upon clinical suspicion of ACS, a 12-lead ECG should be performed and interpreted immediately within 10 minutes of presentation. If the initial ECG is non diagnostic and the index of suspicion of STEMI is high: the ECG should be repeated at close intervals of at least 15 minutes.
\uf0b7 To look for progressive ST changes.
\uf0b7 Compared with previous ECG\u2019s.
\uf0b7 Additional chest leads (V 7-9) and right ventricular leads should be done to identify posterior and right
ventricular infarcts.<\/p>\n","protected":false},"excerpt":{"rendered":"
Myocardial Infarction (MI) MI is myocardial injury due to ischaemia. It is defined pathologically as myocardial cell death due to prolonged ischaemia. MI is diagnosed when there is a rise and\/or fall in cardiac troponins and accompanied with at least one of the following:\uf0b7 Clinical history of chest pain from ischaemic origin lasts more than […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-618","post","type-post","status-publish","format-standard","hentry","category-med"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/blog\/wp-json\/wp\/v2\/posts\/618","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/blog\/wp-json\/wp\/v2\/comments?post=618"}],"version-history":[{"count":2,"href":"https:\/\/kidneydiseaseclinic.net\/blog\/wp-json\/wp\/v2\/posts\/618\/revisions"}],"predecessor-version":[{"id":620,"href":"https:\/\/kidneydiseaseclinic.net\/blog\/wp-json\/wp\/v2\/posts\/618\/revisions\/620"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/blog\/wp-json\/wp\/v2\/media?parent=618"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/blog\/wp-json\/wp\/v2\/categories?post=618"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/blog\/wp-json\/wp\/v2\/tags?post=618"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}