Myocardial Infarction (MI)

Etiology

  • Type 1: Plaque rupture event with coronary occlusion (common cause of STEMI)
  • Type 2: Supply demand mismatch, where physiologic stress (e.g. sepsis, tachycardia, anemia, hypoxemia, etc) causes increased myocardial O2 demand that can't be met; can be superimposed on pre-existing CAD
  • Type 3: Sudden cardiac death related to MI
  • Type 4: MI during percutaneous procedure
  • Type 5: MI during by-pass surgery

Risk Factors

  • Dm, Hypertension, Smoking, Age > ~50, M>F, Hyperlpidemia, Family hx, Known atherosclerosis

Symptoms

  • Acute chest pressure @ rest, can radiate to arm/neck, back
  • Pressure (or pain) can sometimes present in epigastric area/upper abdomen
  • Often associated with N, V, SOB, diaphoresis, feeling poorly

Physical Exam Findings

  • Sometimes tachycardia, htn, diaphoresis, uncomfortable appearance, clutching chest
  • Can have elevated jvp, rales, other CHF findings