Imbalance in myocardial blood supply and oxygen requirement
Acute coronary syndrome (ACS) encompasses a spectrum of disease processes:
Unstable angina pectoris
Acute myocardial infarcti...
Most common presentation of MI
Anginal equivalents (MI without chest pain):
Sublingual nitroglycerin for symptom relief
12-lead ECG, if possible, with transmission or results relayed to receiving hospital
Patients with an AMI require hospital admission.
If the diagnosis is unclear, admission to the hospital or an ED observation unit may be useful for serial cardiac...
Goal of thrombolytic therapy is a 30 min door to needle time if PCI not possible.
New or presumably new LBBB at presentation occurs infrequently, and should not be considered diagno...
Filippo C, Giovanna L. Pathogenesis of acute coronary syndromes. J Am Coll Cardiol. 2013;61:1–11.
Hartman SM, Barros AJ, Brady WJ. The use of a 4-step algorithm in the ele...
410.90 Acute myocardial infarction, unspecified site, episode of care unspecified
410.91 Acute myocardial infarction of unspecified site, initial episode of care
410.92 Acute myocardial infarc...
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Acute anterior myocardial infarction. Transmural injury is manifested by ST-segment elevation of greater than 0.2 mV in leads V1 to V3.
Myocardial infarction, ST elevation.
<bold>FIGURE 26-10</bold> (<bold>Top</bold>) (<bold>A</bold>) ECG tracing showing normal P, Q,R,S, and T waves. (<bold>B</bold>) ST elevation with acute ischemia. (<bold>C</bold>) Q wave with acute myocardial infarction. (<bold>Bottom</bold>) Current-of-injury patterns with acute ischemia. With predominant subendocardial ischemia (<bold>A</bold>), the resultant ST segment is directed toward the inner layer of the affected ventricle and the ventricular cavity. Overlying leads therefore record ST-segment depression. With ischemia inv...
<bold>FIGURE 26-10</bold> (<bold>Top</bold>) (<bold>A</bold>) ECG tracing showing normal P, Q,R,S, and ...
Atherosclerotic coronary occlusion. A coronary artery of a patient who died from an acute myocardial infarction shows severe atherosclerosis and a recent thrombus in the narrowed lumen.
Atherosclerotic coronary occlusion. A coronary artery of a patient who died from an acute myocardial infarction shows severe atherosclerosi...
Acute myocardial infarct. A cross-section of the ventricles of a man who died a few days after the onset of severe chest pain shows a transmural infarct in the posterior and septal regions of the left ventricle. The necrotic myocardium is soft, yellowish, and sharply demarcated.
Acute myocardial infarct. A cross-section of the ventricles of a man who died a few days after the onset of severe chest pain shows a trans...