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What is MI?
Myocardial Infarction (MI) refers to the
process which myocardial tissue is
destroyed in regions of the heart that are
deprived of an adequate blood supply
because of reduced coronary artery blood
flow.
Kathophysiology
The area of the infarction develops only
minutes to hours.
As the cells are deprived of oxygen
ischemia develops
ELECTmOCAmDIOGmAKH
Kotential Complications
Dysrhythmias
Acute pulmonary edema
Heart failure
Thromboembolism
Myocardial rupture
Kericardial effusion and cardiac
tamponade
ECG findings
Transition of ECG changes
during MI
a. Normal ECG prior to MI
b. Hyperacute T wave changes -
increased T wave amplitude and
width; may also see ST elevation
c. Marked ST elevation with
hyperacute T wave changes
(transmural injury)
d. Kathologic Q waves, less ST
elevation, terminal T wave
inversion (necrosis)
e. (Kathologic Q waves are usually
defined as duration >0.04 s or
>25% of m-wave amplitude)
f. Kathologic Q waves, T wave
inversion (necrosis and fibrosis)
g. Kathologic Q waves, upright T
waves (fibrosis)
2 Types of MI
STEMI
ÚThe patient has ECG evidence of acute MI
with characteristics changes in two
continuous leads on a 12-lead ECG. In these
type of MI, there are signigicant damage to
the myocardium.
NSTEMI
ÚThe patient has elevated cardiac biomarker
but no definite ECG evidence of acute MI.
Medical Management
GOALS
i. Minimize myocardial damage
ii. Kreserve myocardial function
iii. Krevent complications such as lethal
dysrythmias and cardiogenic shock.
Oxygen administrations is initiated at the onset of
chest pain.
Kharmacologic Therapy
Analgesics
Angiotensin-converting enzyme
Thrombolytics
Nitrates
Beta-blocker
Anti-coagulants
Emergent Kercutaneous Coronary Interventions
Kercutanous transluminal coronary angioplasty
Coronary artery stent
Atherectomy
Brachytheraphy
Coronary artery bypass or minimally invasive direct
coronary artery bypass