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16 Cards in this Set
- Front
- Back
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Men:Women risk ratio for MI
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Ages 45-54 men 5x as likely as women
Ages 71-80 men 2x as likely as women Younger than 50, women have 2x the mortality rate though |
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Non-thrombus causes of an MI
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Segmental coronary spasm
Emboli, arteritis (Kawasaki's), cocaine, dissection |
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Infarct Distribution
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Vast majority involve LV
Primary RV infarct is very rare |
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Arteries commonly involved in MIs
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50% - LAD -- anterior LV, anterior 2/3 septum
30% - RCA -- posterior LV, posterior 1/3 septum 20% - LCCA -- lateral LV |
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Most common and most serious MI
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Transmural
Shows wave front phenomenon |
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Locations in arteries of significant arterial disease
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Proximal first 2-4 cm of LAD and LCCA
Proximal and DISTAL thirds of RCA (why causes posterior LV infarct) |
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Changes after 12 hours
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Gross -- Nothing
Histo -- Wavy fibers, early coagulation necrosis |
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Changes after 24-48 hours
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Gross -- Pallor (yellow)
Histo -- Hypereosinophilic, PMNs @ borders |
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Changes atfer 2-5 days
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Gross -- Tan/Yellow depressed central infarct, red margins
Histo -- Mummified center, granulomatous borders |
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Changes after 6-10 days
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Gross -- Gray/Red borders, infiltrating central infarct
Histo -- Granulation throughout, COLLAGEN deposition |
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Changes after 2-8 weeks
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Gross -- gelatinous scar, greater healing at border
Histo -- Collagen, prominent large CAPILLARIES |
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Infarct Extension
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Increase in area necrotic muscle
Due to reduced oxygen supply after initial infarct |
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Clinical features of an MI
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Severe ischemic pain
Biochemical markers -- Inc. CKMB, and troponin Fever, Inc. PMN count Inc. FIBRINOGEN and HAPTOGLOBIN Inverted T wave, ST Elevation, Abnormal Q wave |
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Complications of an MI
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Arrhythmias (greater than 70%)[mainly first few hours]
Heart block (common after posterior MI) (RCA) BBB related to anteroseptal infarcts (LAD) LV Failure (10%) Pericarditis (first 2-3 days post-TRANSMURAL infarct) Embolism from mural thrombus (15-50%) Rupture (5%) [max. weakness is 5-7 days post] Ventricular aneurysm (5%) [2 weeks - several months post] |
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Types of angina
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Stable (can show ST depression)
Unstable (increased frequency and intensity) Prinzmetal's (@ rest, can show ST elevation) |
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Sudden Cardiac Death
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Unexpected death from caridac causes
WITHIN 1 HOUR of acute symptoms Smoking is a very high risk factor |
