Sunday, September 18, 2011

Cardiovascular diseases-Myocardial infarction-IV

Myocardial Infarction-
  • Untreated angina leads to myocardial infacrtion.
  • Many early deaths are due to ventricular fibrillation or cardiac arrest.
  • C/f-Pain,Dyspnoea,Vomiting,Nausea,perspiration.
  • Nausea and vomitting during the attack can be due to sympathetic stimulation.
  • Tachycardia(due to sympathetic stimulation),Cold extremities,Hypotension.
  • Investigations-
  1. ECG- In initial hours there is ST segment elevation and latter followed by deepening of Q wave followed by T wave inversion.
  2. Changes in plasma enzyme levels of Creatinine kinase(CK),Aspartate dehydrogenase(ADH),Lactic acid dehydrogenase.CK starts appearing into blood after 4-6 hrs of infarction and reaches its peak after 12 hours of infarction and Vanishes after 2-3 days of infarction.LDH start to appear after 12 hours of attack and reach its maximum after 2-3 days of attack.
  3. X ray-cardiomegaly with pulmonary congestion
  4. Echocardiography
  5. Drug regime-Oxygen therapy,I.V Morphine(10mg),Streptokinase/Alteplase, Anti platelet drugs(aspirin and clopodigrel),Beta Blockers,TNG
Regular drug regime includes Aspirin/clopodigrel or combination,ACE inhibitors,Beta blockers.

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