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54 Cards in this Set
- Front
- Back
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why is a sedentary lifestyle a risk factor for MI?
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because HDL is low when sedentary and exercise is the best way to increase HDL
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why is there a time minimum for chest pain?
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to rule out trauma
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what are 3 symptoms besides chest pain that present with MI?
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diaphoresis
dyspnea nausea |
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what are 3 atypical characteristics of chest pain that do not rule out MI?
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pain radiating to the R side
pain in fingers rather than arm pain lasting less than 5 mins or longer than several hours |
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what may develop hours after an MI?
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low grade fever
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if jugular venous pulse is increased, what might it indicate?
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right ventricular involvement
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what type of HR is common in MI?
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mild tachycardia
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when should you consider CHF with MI? (2)
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if MI is associated with hypertension or rales
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what does the S3 heart sound indicate?
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severe damage with impending heart failure
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what does a new murmur indicate?
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mitral reguritation due to papillary muscle injury
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what can be heard late in the course of a few MI cases?
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pericardial friction rub
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what are 2 of the earliest indicators of MI?
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Troponin and myoglobin
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why is troponin not useful to test for repeat infacrtion?
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because it stays elevated for up to a week
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what early marker of MI is not very specific?
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myoglobin
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what CPK band is most useful for testing new infarctions and why?
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MB band because it peaks 12-36 hours after infarction
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how long til SGOT peaks in MI?
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24-36 hours
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how long til SGOT falls to normal in MI?
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3-4 days
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what are 2 markers for MI that are also elevated with liver disease?
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SGOT
LDH |
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how long til LDH peaks with MI?
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24-36 hours
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how long til LDH falls to normal in MI?
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7-10 days
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what is the first indicator of MI in EKG?
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ST elevation
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what may develop on the EKG 3-6 hours after MI? (2)
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Q wave followed by a T wave
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what type of MI defines a transmural infarct?
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STEMI
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what type of MI usually has more myocardial necrosis than other types?
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STEMI
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what type of MI will actuely cause more mortality?
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STEMI
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what are 2 findings in a STEMI?
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ST elevation
enzymes |
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what type of MI has a lower acute mortality but subsequent mortality is higher?
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non-STEMI
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what type of MI is associated with more extensive coronary plaque?
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non-STEMI
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what arrhythmia is common in the acute phase of MI?
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PVCs
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what arrythmia will not affect long term prognosis if it occurs within 36 hours of infarct?
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v tach
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how is accelerated idioventricular rhythm differentiated from v-tach?
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AIR has a slower rate
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what is a common sign of reperfusion after thrombolysis?
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accelerated idioventricular rhythm
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what arrythmia is usually transient and a marker of LV dysfunction?
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atrial flutter/fibrillation
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which type of AV block is common with inferior MI?
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first degree
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what type of AV block is usually asymptomatic?
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first degree
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what type of AV block will usually require a pacemaker unless completely stable and asymptomatic?
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second degree, type 2
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what type of heart block is rare but requires pacing?
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complete heart block
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what is the highest risk marker for subsequent cardiac mortality? (2)
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CHF/LV failure
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what results from papillary dysfunction?
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mitral regurgitation
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what is a late complication of MI, usually anterior MI?
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LV aneurysm
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what may cause refractory heart failure, arrythmias, or embolus?
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LV aneurysm
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what is associated with inferior wall MI?
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RV infacrtion
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when should you suspect RV infarction?
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when BP remains low despite therapy
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how do you treat RV infarct?
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high volume infusion
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what other infarct must also occur with RV infarct and why?
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inferior wall infarction because the right coronary artery also supplies the inferior wall
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when is a thrombus most common?
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with anterior or large MI
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what may occur 4-7 days post MI and why?
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cardiac rupture due to progressive loss from necrosis
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who is cardiac rupture more common in? (3)
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elderly
females first MI |
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how do you detect cardiac rupture? (2)
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sudden loss of pulse
electromechanical dissociation |
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what EKG finding is required when giving IV thrombolysis?
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ST elevation in 2 leads
NOT ST depression |
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what is the time window for IV thrombolysis?
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< 12 hours post MI
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what are 5 contraindications for IV thrombolysis?
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acute bleeding
recurrent CVA surgery bleeding disorder trauma |
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when do you use IV thrombolysis?
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when you can't get a STEMI to the catheter lab
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what are 7 adjunctive therapies for MI?
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full dose heparin
IV nitro aspirin beta blocker oxygen ACE inhibitor 2b3a inhibitor |
