Cocaine Induced Myocardial Infarction

The American Heart Association (AHA) early this month (April 2008) has just came out with a guidelines on the management of cocaine induced myocardial infarction.Cocaine can cause myocardial ischemia because it blocks the reuptake of norepinephrine and dopamine at the presynaptic adrenergic terminals, thus results in an accumulation of catecholamines at the postsynaptic receptor (powerful

Posterior MI Changes

The above ECG strips were taken from a 58 years old was admitted two days ago with history of chest pain that started about 30 minutes prior to admission to Emergency Department. (Click on each ECG strip to get a clearer, larger view.)The ECF obviously show ST elevations in leads II, III and aVF, indicating that he has acute inferior wall MI.However, leads V1 and V2 also show ST depression, and

Q&A based on Malaysian MOH CPG Management of Acute STEMI

I have compiled a series of Q&A notes based on the latest CPG on STEMI. If there is any mistake, please email me at cksheng74@yahoo.com. Cheers,K.S. ChewManagement of Acute Myocardial InfarctionIn some cases of early MI, the ECG can be normal or equivocal. In such cases, serial ECG is advocated. What is the time interval recommended for the repeat ECG? Which cardiac biomarkers are

Prognostic Value of ST Elevations in Myocardial Infarction

Anterior location of STE (anterior AMI) compared with inferior or lateral, correlates with much worse prognosis and greater benefit of reperfusion therapyPatients with anterior infarction demonstrated a lower left ventricular ejection fraction on admission and after 10 days than did patients with inferior infarction, even after adjustment for infarct size, as well as a higher incidence of

ST Score

Greater height of ST segments and greater number of leads involved correlate with higher mortality and greater benefits from reperfusion therapy.ST Score refers to the total millimeters of STE in all leads combined. High ST Score correlates with higher mortalityMeasured at J point, a score greater than 12 to 13 mm for anterior AMI and greater than 6 – 9 mm for inferior AMI correlates with high

When Is Creatine Kinase and CKMB considered significant in Acute Myocardial Infarction?

I read two interesting articles that mentioned about the biochemical markers in AMI.Question 1: When Is Creatine Kinase and CKMB considered significant in Acute Myocardial Infarction?Creatinine Kinase (CK) and Creatine Kinas-MB (CK-MB) is significant when [in the presence of other supportive criteria like typical chest pain, etc] 1. CK elevated ≥ 2x upper laboratory normal and/or2. CK-MB