#ECG :
12 Leads ECG shows ST-segment elevation on lead V1 to V6.
#Dx: Extensive Anterior MI ( STEMI Anterior)
#C/F:
Chest pain : sudden so severe
central chest pain
which is crushing, constricting,
chocking, heaviness, tightness
Radiate to left arm or jaw
Associated with nausea & vomiting,
sweating
Aggravated by exertion
Not relieved by rest / GTN
O/E:
pulse : Raised(due to symp. activity)
BP: low ( if cardiogenic shock)
#Diagnostic criteria :
1.Typical ischaemic type chest pain
2.ECG change :
ST - elevation
T- invertion
Pathological -Q
3.Troponin -I positive
( Any two from above 3 criteria)
#Inv:
ECG :12 Lead
Troponin -I
Echocardiography
CBC
RBS
Lipid profile
S. creatinine
##Rx:
#Acute MI :
*Hospitalization
*Propped up position
*O2 inhalation :4-6L/min
*Asperin :300mg Stat then 75mg 0+1+0
*Clopidogrel : if asperin not tolerated
*GTN : S/L spray
*Atorvastatin: 40 mg stat then 20mg 0+0+1
*B- blocker : ( prevent Arrhythmia)
Metoprolol
Bisoprolol
*Pain killer : Morphin/ pethidine
1 ampule I/V stat & sos
*Surgical re-cannalization of vessel :By
PCI( Per-cutaneus coronary intervention)
if present within 6h of pain onset
*Medical re-cannalization of vessel : By
Streptokinase:1.5 Million Unit( if within
12h of presentation)
*LMWH : Enoxaparin :1mg/kg body Wt
BD for 5 days ( if present after
12 h of pain onset)
#Long term Rx / Rx on discharge :
*Asperin :75mg (0+1+0...Continued)
*Atorvastatin :10mg (0+0+1...Continued)
*B-blocker: Metoprolol :25mg (1+0+1...cont..)
*ACEi: To prevent cardiac remodelling
*Rx of co-morbidities : HTN, DM