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Myocardial Infarction

Myocardial Infarction

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Myocardial Infarction

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  1. Myocardial Infarction Bojana Gardijan 4th year March 16, 2010 Mentor: A. Žmegač Horvat

  2. Definition • destruction of heart tissue resulting from obstruction of the blood supply to the heart muscle • part of acute coronary syndrome, ACS • non- STEMInon ST-elevation MI • STEMIST-elevation MI

  3. Risk factors • diabetes • hyperlipoproteinemia, especially high LDL and low HDL • high blood pressure • family history of ischemic heart disease • obesity BMI>30 kg/m² • ageM>45, F>55 • stress • alcohol

  4. Pathophysiology • a manifestation of coronary artery disease, also called ischemic heart disease • most common triggering event: disruption of an atherosclerotic plaque in an coronary arteryclotting cascade sometimes results in total occlusion of the artery

  5. Clinical presentation • chest pain (typically radiating to the left arm or left side of the neck) • shortness of breath (dyspnea) • nausea, vomiting • palpitations • sweating • anxiety

  6. What to do? • history and physical examination • EKG • CBC • cardiac markers, preferably troponin T (and complete biochemistry) • differential diagnosis includes pulmonary embolism, aortic dissection, pericardial effusion causing cardiac tamponade, tension pneumothorax, pancreatitis and esophageal rupture

  7. Treatment of MI • MONA as soon as possiblemorphine, oxygen, nitrates, aspirin • clopidogrel, heparin, eptifibatide • procedure of choice : PCI (percutaneous coronary intervention) if unavailable: fibrinolysis • postinfarctial therapy: SAABstatins, ACEI, aspirin, beta blockers

  8. Prognosis • varies greatly, depending on a person’s health, the extent of the heart damage and the treatment given • time to reperfusion is of great importance • a quick reaction saves lives

  9. Thank you for your attention!

  10. References • http://en.wikipedia.org/wiki/Myocardial_infarction • http://www.escardio.org