WEEK: LECTURE: HEART DISORDERS 1 MYOCARDIAL INFARCTION (MI) Also known as a heart attack and is the death/necrosis of heart muscle as a result of ischaema (inadequite bloodflow). Mostly caused by acute thrombosis in the coronary arteries. it is an acute event which causes acute inflammation A Common B Uncommon CLINICAL FEATURES Intense chest pain that may radiate to the neck, jaw, epigastrium (upper adomen ) or left arm . in a Few cases it can present with no pain DIAGNOSIS Muscle cell content move out of the cell into the blood stream. These proteins can be monitored to diagnose a MI episode A rapid & weak pulse Excessive or abnormal sweating (diaphoresis) 3 40 1 2 Myasis Actin Bruymes, such as CK-MB 30 Nausea - Trponin I -CXMB Falatve concentration (-mutiples of upper apelerence limit; Tropanin freo in cynplanm 20 Acute pulmonary congestion Shortness of breath ( dyspnoea) Troponin released from actr Hament Acute myocardial infarction R Abnormal ECG Hours after onset of chest pains 1. Orset of myocardial infarction as biomarkors for diagnosis of myocardial inbarction PATHOGEN?S?S Develops when atherosclerotic plaque is already present, which disturbs the laminar Flow causing the occlusion to the bloodFlow. This reduced blood causes ischemia and restricts oxygen which may result in irreversible damage to tissue if this continues For extended periods and/or an embolism causing widespread necrosis CONSEQUENCES Affects From a MI depend on the size, site & type of the infarct but include: Death TREATMENT Pharmacologic: Nitroglycerin For chest pain Uncommon on ist episode and due to poor intervention Left Ventricular dysfunction Affects the pulmonary circuit (blood in lungs) Mitral valve dysFunction (Blood regurgitation) Myocardial rupture (rare but Fatal) Pericarditis (if all the heart muscle is affected ) Mural thrombus (late complication) Opens up blood vessels Break up blood clots Fibrinoloytics (+PA) Anticoagulants (heparin) Antiplatelets (aspirin) A heart chamber clot &break OFF and become an embolism Ventricular aneurysm (latecomplication) Beta blockers To control heart rate Surgical: Ballooning of ventricle due to weakness From necrosis From pressure Arrhythmias (injury causing alterations to heart beat) Congestive heart Failure (CHF) PCI (percutaneous coronary intervention) to address where the occlusion NAS occurred Thromboembolism (stroke) Cardiogenic shock (severe MI) Balloon angioplasty Stent