Myocardial Infarction Snapshot

Myocardial Infarction

AKA: MI, Heart attack, Coronary thrombosis, STEMI, NSTEMI, AMI, ACS

SYMPTOMS: Chest pressure, chest tightness, chest pain, shortness of air, nausea, impending doom, anxiety, left arm, left jaw pain, dizziness

RISK FACTORS: Family hx heart disease, smoking, hyperlipidemia, previous MI, hypertension, Diabetes

MEDICATIONS USED FOR IMMEDIATE TX: Aspirin, Morphine, Nitroglycerin, Oxygen

OTHER MEDS THAT MAY BE USED: Clopidogrel, Prasugrel, Ticagrelor

SOME POTENTIAL DRIPS: Heparin drip, Nitro drip, Alteplase, Integrilin

TESTS: EKG, Cardiac enzymes (ex: troponin), lipids, CBC, CMP, BNP, CXR, Echo, stress tests

TREATMENT GOAL: Restore as much perfusion of blood flow to heart to reduce/mitigate amount of heart damage-ischemia

PROCEDURES: Percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery, stent placement

MEDICATIONS RX ONGOING: Statin, aspirin, anticoagulant, ace inhibitor, beta blocker

AFTER CARE: Cardiac rehab, heart healthy-low sodium diet, Weight loss as indicated, smoking cessation

DIFFERENTIAL DX: Pulmonary embolism, CHF exacerbation, COPD exacerbation, Anxiety, Acid reflux

 

REFERENCES:

http://emedicine.medscape.com/article/155919-treatment#d25

NIH

The 5 Minute Clinical Consult Standard 2015, 23rd Edition Wolters Kluwer. Frank J Domino (Editor in Chief) Associated editors R. Balder, J. Golding, J. Grimes.

 

 

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