Heart Attacks: Basic Facts

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+Heart problems are not just due to myocardial infarction. Acute Coronary Syndrome includes 3 things: Unstable Angina, Non-ST elevation Myocardial Infarction and ST elevation myocardial infarction.

+Most common cause of Acute Coronary Syndrome: Plaque Rupture. Thrombus develops on the top of disrupted plaque.

+Medications: Statins, ACE inhibitors stabilize fibrous cap of a coronary atheroma.

+Stop smoking, reduce stress.

+Stop Cocaine (in case if you are abusing it)

+Tests: Troponin is detected 3-6 hours after the onset of ischemia and remains elevated for 7-14 days after Myocardial infarction.

Myoglobin Test: detected 2 hours after heart attack. Peaks at 8 hours, remains elevated for less than 24 hours.

+Fibrinolysis – Dissolving the clot – should be considered in ST Elevation Myocardial Infarction.

+Stenting: Bare Metal Stent; Drug-Eluting Stent.

-After stenting: Consider aspirin, Clopidogrel

-Coronary Bypass surgery: useful especially in Left vessel disease.

+ST Elevation Myocardial Infarction: look for ST elevation on EKG.

+Pericarditis; Diffuse ST Elevation.

+After MI: ACE inhibitor, Beta Blocker, Statins, Aspirin improve survival.

+Statins lower cardiovascular events. Atorvastatin, rosuvastatin, Atorvastatin etc.

+Prevent Metabolic Syndrome: Decrease cholesterol; prevent obesity.



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