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Post Myocardial Infarction Evaluation
- Evaluation
- Echocardiogram
- Ejection Fraction is best predictor of prognosis
- Stress Test (Class I evidence - standard of care)
- Do not perform if revascularization was performed
- Submaximal test days 4-6 post-MI (before discharge)
- Perform if no contraindications
- Alternative: 14-21 days post-MI (after discharge)
- Symptom limited maximal test at 3-6 weeks post-MI
- Perform if initial study was submaximal
- Coronary Angiogram
- Indications
- Check Re-perfusion after:
- Large or Anterior Myocardial Infarction
- Thrombolytic use
- Check Re-perfusion after:
- Indications
- Thallium Imaging
- Indications
- Identify surviving myocardium
- Indications
- Echocardiogram
- Other evaluation
- Treat Comorbid Major Depression (present in 15-22%)
- See Depression Management in Cardiovascular Disease
- Risk of MI related death increased 3.5 fold
- Observe for Cerebrovascular Accident symptoms
- Risk increased 44 fold in first 30 days post-MI
- Witt (2005) Ann Intern Med 143:785
- Treat Comorbid Major Depression (present in 15-22%)
- References
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. |
| Concepts | Disease or Syndrome (T047) |
| ICD9 | 410.9 |
| MSH | D009203 |
| English | AMI, 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 |
| Spanish | ataque al corazon, infarto cardiaco, infarto de corazon, infarto de miocardio |
| Parent Concepts | Heart (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) |
| Sources | AIR, AOD, COSTAR, CSP, CST, DXP, MEDLINEPLUS, MSH, MTH, MTHICD9, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT Derived from the NIH UMLS (Unified Medical Language System) |
