Question

what can we see on ECG with this condition OR what dysrhythemia correspond with following condition and what medication or action should be taken how do we diagnose

1) AMI

2) complication r/t MI

3) STEMI

4) Nonstemi

please type the answers and don't guess the answer

Answer 1

1) Acute Myocardial infarction:

Myocardial infarction is a condition where the myocardial cells are deprived of oxygen and destroyed.

Diagnose:

Diagnosis of MI is done based on the presence of signs and systems, ECG changes, and laboratory findings of elevated cardiac enzyme level.

ECG changes:

T wave inversion: As soon as the myocardial cell injury, the T wave becomes enlarged. The area of myocardial injury becomes ischemic, the repolarization becomes delayed causes T wave inversion.

ST segment changes: The myocardial cells repolarize more rapidly resulting in elevation of ST segment at least 1mm. If the myocardial injury occurs at the endocardial surface results in ST depression of about 1mm.

Abnormal Q waves: If there is no depolarization in the ischemic tissues, then Q wave developed within 1 to 3 days of injury.

Medication:

• Minimize the injury and preserve the myocardial function.
• Thrombolytics is administered to dissolve or lyze the thrombus.
• Morphine sulfate to decrease the workload of the heart.
• Emergency PCI if needed to notify the occluded artery.

2) Complications related to Myocardial Infarction:

Acute pulmonary edema, Heart failure, Cardiogenic shock, Ventricular dysarrythmias, cardiac arrest, pericardial perfusion are the complications. Ecg changes show ST segment become sharp angled and U wave inversion followed by T wave. No reciprocal changes can be seen. In ventricular Fibrillation The QRS shape becomes irregular and rate greater than 300 beats per minute.

3) STEMI

ST-elevated myocardial infarction is a clinical syndrome associated with myocardial infarction, ST elevation, and elevated troponin levels. It is the complete occlusion of coronary blood flow.

ECG changes:

ST elevation > 1mm is seen at the J point and it continues for two leads either V1 and V2 or V3 and V4. ST elevation in V3 and V4 refers to anterior ischemia, and ST elevation in aVF and II refers to inferior ischemia. ST elevation in I, aVL, aVF refers to lateral wall ischemia.

Medication:

Anti thrombolytic therapy, anti-ischemic therapy, reperfusion is done in the emergency department. Oxygen, NSAIDS, Beta blockers, Nitrates, Analgesics are administered to manage the condition.

4) NSTEMI

Non-ST-elevated Myocardial ischemia is also called as Unstable angina. It is the partial occlusion of the coronary artery. Both STEMI and NSTEMI are at risk of developing ventricular tachycardia, and ventricular fibrillation.

ECG changes:

Mostly the ECG shows ST depression or T wave inversion. ST depression of greater than or equal to 0.5mm is usually horizontal or downward sloping and is seen in two contiguous leads and T wave inversion of greater than or equal to 1mm in two contiguous leads. But NSTEMI does not specify the areas of infarction.

Medication:

Antithrombotic therapy and antiischemic therapy in the emergency department. Coronary angiography is done to determine the risk of myocardial infarction. Oxygen, Nitrates, Beta blockers are given to support the condition.