Cardiovascular Disease

Acute Myocardial Infarction 

Acute MI

 any degree of myocardial necrosis causes by myocardial ischemia

 and detected using sensitive and specific preferred biomarker

 such as cardiac troponin

•         Stable angina- lumen stenosis >70%

            → impaired blood supply to heart only during exertion or increased metabolic demand

•         Acute coronary syndrome-

             vessel becomes occluded by thrombus

Unstable angina – when atherosclerotic plaque shoot of embolus downstream to cause microinfarct

 NSTEMI – necrosis confined to endocardial layers (most susceptible to ischemia)

 STEMI – full thickness necrosis of the ventricular wall occurs

Clinical features:
None – sudden cardiac death

•         Ischemic symptoms - chest, upper extremity, mandibular or epigastric discomfort (with exertion or at rest).

–        The discomfort lasts >20 min, is diffuse and may be accompanied by diaphoresis, nausea or syncope.

–        The pain may radiate to the left arm, neck or jaw

•         Atypical symptoms - palpitations, dyspnoea, fatigue, pre-syncope, syncope or cardiac arrest

Without symptoms - in women, the elderly, diabetics, or post-operative and critically ill patients.