Definition - Acute occlusion of coronary artery leading to muscle infarct
Risk Factors - Age
- Male
- FHx
- Smoking
- Hypertension
- Overweight
- Cholesterol
- Diet
- Inactivity
- Alcohol
- Type A personality
Differential diagnosis - Pneumothorax
- Pneumonia
- Pericarditis
- NSTEMI
- Pleural effusion
Epidemiology - Western lifestyle
- Asian ++
Aetiology - Atherosclerosis
- Plaque rupture
- => thrombosis
Clinical features - Crushing central chest pain >20 mins
- ST elevation on ECG
- Dyspnoea
- Diaphoresis
- Pallor
- Nausea
- Additional heart signs
- Levine's sign
Pathophysiology - Muscle death takes hours-days
Investigations- Cardiac enzymes
- CK-MB
- Troponin T
- Troponin I
- ECG
- Angiogram
Managementa) conservativeb) medical - Immediate
- 300 mg aspirin
- Beta blockers to reduce heart rate
- Fluids??
- O2
- Morphine
- Thrombolytics?
- GTN
- ACE inhibitors?
- Long term
- AABCCDE
- Aspirin
- ACE inhibitors
- Beta blocker
- Cholesterol (statins)
- Clopidogrel
- Diabetes
- Exercise
c) surgicalPrognosis |
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