II. Course: Hospital
- See Goldman Criteria for ICU Chest Pain Admission
- Angiography, Angioplasty and stenting has modified the inpatient ACS protocol dramatically
- Prior protocols with prolonged hospital stays, ICU admits and prolonged Heparin have been replaced
- Evaluation prior to discharge
- Echocardiogram prior to discharge
- Consider sub-maximal stress test prior to discharge
- See Post Myocardial Infarction Evaluation
III. Disposition: Discharge Planning
IV. Complications
- Post-MI Pericarditis (common)
V. Prognosis: Serum markers for worse prognosis
- C-Reactive Protein (CRP) increased
- White Blood Cell Count increased (Leukocytosis)
VI. Prognosis: Risk of subsequent infarction or death
- Age over 70 years
- Left Ventricular Ejection Fraction under 40%
- Congestive Heart Failure
- Residual ischemia
- Ventricular ectopy (>10 PVCs per minute)
- Non Q-Wave infarction
- Diabetes Mellitus
- Anterior Myocardial Infarction
- Hypertension
-
Major Depression increases mortality within 4 months
- Beck Depression Inventory Score <4: 2.6% mortality
- Beck Depression Inventory Score 4-9: 17.1% mortality
- Beck Depression Inventory Score >10: 23.3% mortality
- Bush (2001) Am J Cardiol 88:337-41 [PubMed]
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| Definition (MEDLINEPLUS) |
Each year over a million people in the U.S. have a heart attack. About half of them die. Many people have permanent heart damage or die because they don't get help immediately. It's important to know the symptoms of a heart attack and call 9-1-1 if someone is having them. Those symptoms include
These symptoms can sometimes be different in women. What exactly is a heart attack? Most heart attacks happen when a clot in the coronary artery blocks the supply of blood and oxygen to the heart. Often this leads to an irregular heartbeat - called an arrhythmia - that causes a severe decrease in the pumping function of the heart. A blockage that is not treated within a few hours causes the affected heart muscle to die. NIH: National Heart, Lung, and Blood Institute |
| Definition (NCI_FDA) | Gross necrosis of the myocardium, as a result of interruption of the blood supply to the area, as in coronary thrombosis. |
| Definition (NCI_CTCAE) | A disorder characterized by gross necrosis of the myocardium; this is due to an interruption of 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 (CSP) | gross necrosis of the myocardium, as a result of interruption of the blood supply to the area. |
| Definition (MSH) | NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION). |
| Concepts | Disease or Syndrome (T047) |
| MSH | D009203 |
| ICD10 | I22 , I21 |
| SnomedCT | 66514008, 266288001, 155304006, 194796000, 233824008, 22298006 |
| LNC | LP98884-7, MTHU035551, LA14274-7, LA10558-7 |
| English | Myocardial Infarct, Infarctions, Myocardial, Myocardial Infarction, Myocardial Infarctions, Infarcts, Myocardial, Myocardial Infarcts, HEART ATTACK, Infarct, Myocardial, Infarction, Myocardial, MI, Myocardial infarction (MI), Attack heart (NOS), Infarct myocardial, cardiac infarction, Myocardial Infarction [Disease/Finding], attacking heart, heart attacks, attack hearts, infarctions myocardial, infarcts myocardial, myocardial infarctions, Infarction;heart, myocardial infarcts, Infarction;myocardial, AMI, attacks coronary, attacks hearts, coronary attack, disorder infarction myocardial, myocardial necrosis, syndrome myocardial infarction, heart attack, mies, Heart Attack, Attack - heart, Cardiac infarct, myocardial infarction, myocardial infarction (diagnosis), MI, MYOCARDIAL INFARCTION, MYOCARDIAL INFARCTION, MYOCARDIAL INFARCTION, (MI), INFARCTION (MI), MYOCARDIAL, -- Heart Attack, Cardiovascular Stroke, Cardiovascular Strokes, Stroke, Cardiovascular, Strokes, Cardiovascular, Myocardial infarct, Myocardial infarction, Heart attack, MI - Myocardial infarction, Cardiac infarction, Infarction of heart, Myocardial infarction (disorder), cardiac; infarction, infarction; myocardial, Cardiac infarction, NOS, Heart attack, NOS, Infarction of heart, NOS, Myocardial infarction, NOS, Heart Attacks, Infarctions (Myocardial), Myocardial infarction NOS, Attack coronary, heart infarction |
| German | MYOKARDINFARKT, Koronarattacke, Herzanfall, MI, Herzanfall (NNB), HERZANFALL, Herzinfarkt, Myokardinfarkt |
| Dutch | hartaanval, hartinfarct, hartaanval (NAO), MI, cardiaal; infarct, infarct; myocard, myocardinfarct, Hartinfarct, Infarct, myocard-, Myocardinfarct |
| French | Crise coronaire, IM, Crise cardiaque SAI, Crise cardiaque, CRISE CARDIAQUE, INFARCTUS DU MYOCARDE, IDM (Infarctus Du Myocarde), Infarctus du myocarde, Infarctus myocardique |
| Italian | MI, Attacco cardiaco, Attacco coronarico, Attacco cardiaco (NAS), Infarto del miocardio, Infarto miocardico |
| Portuguese | Ataque coronário, Ataque do coração, Ataque cardíaco NE, EM, ATAQUE CARDIACO, ENFARTO DO MIOCARDIO, Enfarte do miocárdio, Infarto do Miocárdio |
| Spanish | IM, Crisis coronaria, Ataque al corazón, Ataque al corazón (NEOM), Infarto miocárdico, ATAQUE CARDIACO, INFARTO DE MIOCARDIO, Infarto al Miocardio, ataque al corazón, infarto cardíaco, infarto de corazón, infarto de miocardio (trastorno), infarto de miocardio, Infarto de miocardio, Infarto del Miocardio |
| Japanese | 心臓発作（ＮＯＳ）, 冠発作, 心臓発作, ｶﾝﾎｯｻ, ｼﾝｿﾞｳﾎｯｻNOS, ｼﾝｿﾞｳﾎｯｻ, ｼﾝｷﾝｺｳｿｸ, 冠状動脈梗塞, 心筋梗塞, 冠動脈梗塞, 心筋梗塞症 |
| Swedish | Hjärtinfarkt |
| Czech | infarkt myokardu, Srdeční záchvat, Srdeční záchvat (NOS), IM, Koronární záchvat, Infarkt myokardu |
| Finnish | Sydäninfarkti |
| Russian | INFARKT MIOKARDA, ИНФАРКТ МИОКАРДА |
| Croatian | SRČANI INFARKT |
| Polish | Świeży zawał serca, Zawał serca świeży, Zawał mięśnia sercowego, Zawał serca |
| Hungarian | Coronaria roham, Szívroham (k.m.n.), Szívroham, Infarctus myocardii, Szívizom infarctus, MI |
| Norwegian | Hjerteinfarkt, Hjerteattakk, Myokardinfarkt |
