Cardiovascular Medicine Book

Circulatory Disorders

Electrocardiogram

Myocardial Infarction

Symptoms

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Myocardial Infarction Stabilization

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  1. Course: Hospital
    1. Cardiac Intensive Care Unit Admission
      1. Move from Emergency Department within 1-2 hours
      2. Observe on Critical Care Unit for 24 hours
    2. Heparin for 48-72 hours
      1. Coumadin if indicated
    3. Telemetry (Step Down Unit)
      1. Observe rhythm with activity for 2-4 days
    4. Cardiac Rehabilitation
      1. Education on day 1
      2. Ambulatory on day 2
    5. Evaluation prior to discharge
      1. Echocardiogram prior to discharge
      2. Consider sub-maximal stress test prior to discharge
      3. See Post Myocardial Infarction Evaluation
    6. Discharge
      1. Day 4-5 in Uncomplicated Myocardial Infarction
  2. Discharge Planning
    1. See Activity after Myocardial Infarction
    2. See Post Myocardial Infarction Evaluation
    3. See Post Myocardial Infarction Medications
  3. Complications
    1. Pericarditis (common)
  4. Prognosis: Serum markers for worse prognosis
    1. C-Reactive Protein (CRP) increased
    2. White Blood Cell count increased (Leukocytosis)
      1. Sabatine (2002) J Am Coll Cardiol 40:1761
  5. Prognosis: Risk of subsequent infarction or death
    1. Age over 70 years
    2. Left Ventricular Ejection Fraction under 40%
    3. Congestive Heart Failure
    4. Residual ischemia
      1. Post-infarct Angina
      2. Exercise-induced ischemia by EKG or Imaging
    5. Ventricular ectopy (>10 PVCs per minute)
    6. Non Q-wave infarction
    7. Diabetes Mellitus
    8. Anterior Myocardial Infarction
    9. Hypertension
    10. Major Depression increases mortality within 4 months
      1. Beck Depression Inventory Score <4: 2.6% mortality
      2. Beck Depression Inventory Score 4-9: 17.1% mortality
      3. Beck Depression Inventory Score >10: 23.3% mortality
      4. Bush (2001) Am J Cardiol 88:337

Myocardial Infarction (C0027051)

Definition (MSH)NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).
Definition (CSP)gross necrosis of the myocardium, as a result of interruption of the blood supply to the area.
Definition (NCI)Gross necrosis of the myocardium, as a result of interruption of the blood supply to the area, as in coronary thrombosis.
Definition (NCI)Gross necrosis of the myocardium, as a result of interruption of the blood supply to the area, as in coronary thrombosis.
ConceptsDisease or Syndrome (T047)
ICD9410.9
MSHD009203
EnglishAMI, Attack - heart, ATTACK CORONARY, Cardiac infarction, HEART ATTACK, HEART INFARCTION, INFARCT MYOCARDIAL, Infarction of heart, MI, MI - Myocardial infarction, Myocardial Infarct, Myocardial Infarction, Myocardial Infarctions, Myocardial Infarcts
Spanishataque al corazon, infarto cardiaco, infarto de corazon, infarto de miocardio
Parent ConceptsHeart (C0018787), Cardio-vascular Findings: Heart (C0150873), Myocardial Ischemia (C0151744), Coronary Arteriosclerosis (C0010054), Cardiomyopathies (C0878544), Injury of anatomical site (C1264235), Structural disorder of heart (C1290384), Ambiguous concept (C1274012)
SourcesAIR, AOD, COSTAR, CSP, CST, DXP, MEDLINEPLUS, MSH, MTH, MTHICD9, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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