Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Prepared by
Khaled Mohamed Ahmed
Under supervision of
Myocardial Infarction
Out Lines
• Definition
• Classification
• Causes
• Pathophysiology
• Complications
• Diagnosis
• Management
• REFRRENCE
Objective
•
At the end of presentation the student able to define
myo cardialinfarction
•
At the end of the presentation the student able to
classified MI
•
At the endof the presentation the student able to
understandthe cause & pathophysiology of
myocardial infarction
•
At the end of the presentation able to management
thecase
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Definition:
• Classification
S&S:
Causes:
Pathophysiology
Diagnosis
The diagnosis of myocardial infarction is made by integrating
the history of the presenting illness and physical examination
with electrocardiogram findings and cardiac markers (blood
tests for heart muscle cell damage).[1][53] A coronary angiogram
allows visualization of narrowings or obstructions on the heart
vessels, and therapeutic measures can follow immediately. At
autopsy, a pathologist can diagnose a myocardial infarction
based on anatomopathological findings.
Surgical Care
Patients at moderate-to-high risk for adverse events, such as
those with ST depression greater than 1 mm on ECG,
troponin positivity or NQMI, or chest pain refractory to
medical therapy should be scheduled for cardiac
catheterization with likely revascularization within the next
48 hours. The TACTICS/TIMI-18 trial showed that this
early invasive strategy reduced 30-day rates of death,
myocardial infarction, or rehospitalization for unstable
angina from 19.4% to 15.9%, or a relative risk reduction of
18%.
FRISC II showed that even a delayed invasive strategy
(mean time to revascularization 4 d, 71% revascularization
rate vs 9% in the conservative arm) coupled with LMWH
(dalteparin) therapy provides durable benefit for individual
hard end points. At 1 year, the invasive group had
statistically significant reductions in death (2.2% vs 3.9%,
relative risk reduction, 43%) and myocardial infarction
(8.6% vs 11.6%, relative risk reduction, 26%).11