Science Quiz / Myocardial Infarction

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Can you name the Myocardial Infarction

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HintAnswer
Almost always the result of an __
With the development of __
And total __ of the artery
Most common presenting feature
Unlike angina it occurs at __, is more severe and last for several hours
The pain is often associated with __ (name 2)
The patient often appears __ (name 2)
About __ of patients have no pain
These can either go unnoticed or present with __ (name 2)
This occurs most commonly in elderly patients or those with __
The diagnosis is made on the basis of the clinical history & early __ appearances
Serial changes (over __) in the ECG & serum levels of cardiac markers confirm the diagnosis & allow an assessment of infarct size
A normal __ in the early stages does not exclude the diagnosis
ECG - within hours there is __
Followed by __
Pathological Q waves are __ & __ negative deflections that start the QPR complex
They develop because the infarcted muscle is __ so that the recording leads 'look through' the infarcted area
This means that the electrical activity being recorded (on the opposite ventricular wall) is moving away from the electrode & s therefore __
New __ is also an indicator of acute MI
Typically ECG changed are confined to the leads that __ the infarct
Leads __ are involved in inferior infarcts
Leads __ are involved in lateral infarcts
Leads __ are involved in anterior infarcts
As there are no posterior leads, a posterior wall infarct is diagnosed by the appearance of reciprocal changes in __
i.e. the development of tall initial __ waves
__ depression
And tall upright __ waves
__ are regulatory proteins, highly specific & sensitive for cardiac muscle damage
They are released within __ of even onset
And persist for several __
HintAnswer
They are more sensitive & cardiac specific than __
CK is also produced by damaged __
They myocardial-bound (MB) isoenzyme fraction of CK is specific for __
The size of the enzyme rise is broadly proportional to the __
Other investigations include __
Lipids taken within the first __ reflect preinfarction levels
But after this time they stay altered for up to __
__ is common & treatment is that of the underlying cause, particularly pain, anxiety & HF
Sinus bradycardia is especially associated with __
AF occurs in about __ of cases & is usually a transient rhythm disturbance
__ are common and may precede the development of ventricular tachycardia (VT) or fibrillation (VF)
VT may degenerate into __ or itself produce shock or HF
__ occurring with inferior infarction is common & usually resolves spontaneously
__ occurring with anterior wall infarction indicates the involvement of both bundle branches by extensive myocardial necrosis
This has a very __
Heart failure in a mild form occurs in up to __ of patients following MI
Entensive infarction may cause acute HF, which may also occur following rupture of the __ or mitral valve papillary muscle
Both conditions present with worsening HR, a systolic __ & a loud __
Mortality is high & urgernt __ is needed
Hypertension with a raised JVP is usually a complication of __
But may also occur with __
Patients with severe left ventricular dysfunction, persistent AF or mural thrombosis on echo are at risk of __ from __
They should be anticoagulated with warfarin to achieve a target INR of __
__ is characterised by sharp chest pain & a pericardial rub
Late pericarditis is after how long?
Late pericarditis with fever & pericardial effusion is known as __
__ of patients die during the acute event
A further __ die in hospital
Of the survivors a further __ die in the next 2 years

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