MI is a sudden blockage of a coronary artery leading to ischemia (lack of oxygen) and necrosis (death) of heart muscle.
Most Common Cause: Thrombus formation at a ruptured atherosclerotic plaque.
Mnemonic: "MI = Muscle Infarct" (Heart Muscle Death)
CAUSES & RISK
FACTORS OF MI
• Non-Modifiable (Cannot Be Changed)
- Age → Risk
increases after 40 years.
- Gender
→ More common in men (women after menopause).
- Genetics
→ Family history of heart disease increases risk.
Mnemonic: "A-G-G" (Age, Gender, Genetics)
• Modifiable (Can Be Controlled)
- Smoking
- Unhealthy Diet (High Fat, Sugar, Salt)
- Physical Inactivity
- Hypertension (High BP)
- Diabetes
- Obesity
Mnemonic: "S.U.G.A.R." (Smoking, Unhealthy Diet, Glucose (Diabetes), Activity Low, Raised BP)
TYPES OF MI
1. STEMI
(ST-ELEVATION MI)
- Complete Blockage of a coronary artery.
- ECG: ST Elevation.
- Severe damage if untreated.
2. NSTEMI (NON-ST
ELEVATION MI)
- Partial Blockage, leading to ischemia.
- ECG: ST Depression or T Wave Inversion.
- Less severe than STEMI, but still dangerous.
Mnemonic: "STEMI = Severe, NSTEMI = Not So Total Blockage"
SYMPTOMS OF MI
- Severe Chest Pain (Crushing, Heavy, Radiates to Left Arm, Jaw, Back).
- Shortness of Breath, Sweating, Nausea, Dizziness.
- Pain lasts >20 minutes & Not Relieved by Rest or Nitroglycerin.
- Silent MI (No Pain, More Common in Diabetics & Elderly).
Mnemonic: "C.H.E.S.T." (Crushing Pain, Heaviness, Extended to Arm, Sweating, Tightness)
INVESTIGATIONS
FOR MI
ECG:
- ST Elevation (STEMI).
- ST Depression/T Wave Inversion
(NSTEMI).
Cardiac Biomarkers (Blood Tests):
- Troponin T/I (Best Marker, Rises in
4-6 Hours, Lasts 10-14 Days).
- CK-MB (Rises in 4 Hours, Normal in 48
Hours, Good for Recurrent MI).
- LDH, AST (Less Specific).
Chest X-ray: Checks for heart size, lung
congestion.
Echocardiography (ECHO): Checks for heart
function & damage.
Coronary Angiography: Gold Standard to detect
blockages.
Mnemonic: "E.T.C.A." (ECG, Troponin, CK-MB, Angiography)
TREATMENT OF MI
1. IMMEDIATE
MANAGEMENT (DURING HEART ATTACK - FIRST 6 HOURS!)
M.O.N.A. Protocol:
- Morphine →
Pain relief & reduces heart stress.
- Oxygen → If
low oxygen levels.
- Nitroglycerin
→ Improves blood flow.
- Aspirin →
Prevents further clot formation.
Thrombolysis (Clot-Busting Drugs)
- Streptokinase, Urokinase, tPA
(Give within Golden Period = First 6 Hours!).
Emergency Angioplasty (PCI)
- Stent placed in the blocked artery to
restore blood flow.
2. LONG-TERM
MANAGEMENT (AFTER MI TO PREVENT ANOTHER ATTACK)
Lifestyle Changes:
- Quit Smoking, Healthy Diet, Regular
Exercise.
Medications:
- Beta-Blockers (Reduce Heart Workload).
- ACE Inhibitors (Prevent Heart
Failure).
- Aspirin & Clopidogrel (Prevent
Blood Clots).
- Statins (Lower Cholesterol).
Surgical Options:
- Angioplasty (Stent Placement) → Opens
Blocked Arteries.
- Coronary Artery Bypass Grafting (CABG)
→ Bypass Blocked Arteries.
Mnemonic: "N.L.M.S." (Nitroglycerin, Lifestyle, Medications, Surgery)
COMPLICATIONS OF
MI
• Heart Failure → Weak pumping heart.
• Arrhythmias → Irregular heartbeats, can cause sudden death.
• Cardiogenic Shock → Severe low BP & organ failure.
• Pericarditis → Inflammation of heart lining.
• Thromboembolism → Blood clots in lungs/brain.
Mnemonic: "H.A.C.P.T." (Heart Failure, Arrhythmia, Cardiogenic Shock, Pericarditis, Thrombosis)
PREVENTION OF MI
Control Risk Factors:
- Manage BP, Diabetes, Cholesterol.
- Quit Smoking & Reduce Stress.
Healthy Lifestyle:
- Eat More Fruits, Less Junk Food.
- Exercise Daily, Maintain Healthy
Weight.
Regular Check-ups:
- Annual ECG & Cholesterol Check.
Mnemonic: "R.H.C." (Risk Factor Control, Healthy Lifestyle, Check-ups)
FINAL REVISION WITH MNEMONICS
- Definition = "MI = Muscle Infarct" (Heart Muscle Death)
- Causes = "A-G-G" (Age, Gender, Genetics) & "S.U.G.A.R." (Smoking, Unhealthy Diet, Glucose, Activity Low, Raised BP)
- Types of MI = "STEMI = Severe, NSTEMI = Not So Total Blockage"
- Symptoms = "C.H.E.S.T." (Crushing Pain, Heaviness, Extended to Arm, Sweating, Tightness)
- Diagnosis = "E.T.C.A." (ECG, Troponin, CK-MB, Angiography)
- Immediate Treatment = "M.O.N.A." (Morphine, Oxygen, Nitroglycerin, Aspirin)
- Long-Term Treatment = "N.L.M.S." (Nitroglycerin, Lifestyle, Medications, Surgery)
- Complications = "H.A.C.P.T." (Heart Failure, Arrhythmia, Cardiogenic Shock, Pericarditis, Thrombosis)
- Prevention = "R.H.C." (Risk Factor Control, Healthy Lifestyle, Check-ups)
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