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Myocardial Infarction: Seminar On

Ms. Jayashree presented on myocardial infarction (MI), also known as a heart attack. Key points included: 1. MI occurs when blood flow to the heart is blocked, causing damage to heart muscle. 2. Risk factors include coronary artery atherosclerosis and plaque rupture, which can lead to thrombus formation and occlusion. 3. Prompt treatment is important to minimize myocardial damage, as necrosis spreads throughout the heart wall over time. 4. Complications can impact the heart mechanically, electrically, and lead to further vascular issues if left untreated.

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Suhas Ingale
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327 views

Myocardial Infarction: Seminar On

Ms. Jayashree presented on myocardial infarction (MI), also known as a heart attack. Key points included: 1. MI occurs when blood flow to the heart is blocked, causing damage to heart muscle. 2. Risk factors include coronary artery atherosclerosis and plaque rupture, which can lead to thrombus formation and occlusion. 3. Prompt treatment is important to minimize myocardial damage, as necrosis spreads throughout the heart wall over time. 4. Complications can impact the heart mechanically, electrically, and lead to further vascular issues if left untreated.

Uploaded by

Suhas Ingale
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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Seminar On

Myocardial Infarction
 Presented By –
Ms. Bhagat Jayashree
 Internship

Guided By
Dr. Dapse

Ahmednagar Homoeopathic Medical College & Hospital


Ahmednagar
Definition
 Myocardial infarction is an ischemic
necrosis of the myocardium, caused by
occlusion of coronary artery and
prolonged myocardial ischemia.
 MI is an extreme consequence of acute
coronary syndromes – the spectrum of
clinical states caused by instability of
coronary artery lumen due to plaque
instability and (athero)thrombosis
Epidemilogy
 >50 000 cases annually in Ukraine,
the number is largely
underestimated
 Mortality is high – up to 15%. Up to
60% of deaths occur before hospital
admission
 >1.5 million cases in the US
annually(60 cases per 100 000
people)
 Either
one of the following criteria satisfies the
diagnosis for an acute, evolving, or recent
myocardial infarction:

1. Typical rise and gradual fall (troponin) or


more rapid rise and fall (CK-MB) of
biochemical markers of myocardial necrosis
with at least one of the following:
a. Ischemic symptoms
b. Development of pathologic Q waves on
the electrocardiogram
c. Electrocardiographic changes indicative
of ischemia (ST segment elevation or
depression)
d. Coronary artery intervention (e.g.,
coronary angioplasty).
2. Pathological findings of an acute
myocardial infarction
 Most patients who sustain an MI have
coronary atherosclerosis.
 The thrombus formation occurs most
often at the site of an atherosclerotic
lesion, thus obstructing blood flow to the
myocardial tissues.
 Plaque rupture is believed to be the
triggering mechanism for the
development of the thrombus in most
patients with an MI.
 When the plaques rupture, a thrombus is
formed at the site that can occlude blood
flow, thus resulting in an MI.
 Irreversible damage to the myocardium can
begin as early as 20 to 40 minutes after
interruption of blood flow.
 The dynamic process of infarction may not
be completed, however, for several hours.
 Necrosis of tissue appears to occur in a
sequential fashion.
 Cellular death occurs first in the
subendocardial layer and spreads like a
“wavefront” throughout the thickness of the
wall of the heart.
 The shorter the time between coronary
occlusion and coronary reperfusion, the
greater the amount of myocardial tissue
that could be salvaged.
Time Is Myocardium and the
Wavefront of Necrosis

CM Gibson 2002
 The cellular changes associated with an MI can
be followed by:
1. the development of infarct extension (new
myocardial necrosis),
2. infarct expansion (a disproportionate thinning
and dilation of the infarct zone), or
3. Ventricular remodeling (a disproportionate
thinning and dilation of the ventricle).
 MIs most often result in damage to the left
ventricle, leading to an alteration in left
ventricular function.
 Infarctions can also occur in the right
ventricle or in both ventricles.
MI Classifications

MI’s can be subcategorized by


anatomy and clinical diagnostic
information.
Anatomic
 Transmural and Subendocardial

Diagnostic
 ST elevations (STEMI) and non ST
elevations (NSTEMI).
 MIs can be located
in the anterior,
septal, lateral,
posterior, or
inferior walls of
the left ventricle.
Vascular Complications Myocardial
 Recurrent ischemia Complications
 Recurrent infarction  Diastolic dysfunction
 Systolic dysfunction
Mechanical
 Congestive heart failure
Complications
 Hypotension/cardiogenic
 Left ventricular free wall
shock
rupture  Right ventricular
 Ventricular septal rupture
infarction
 Papillary muscle rupture  Ventricular cavity dilation
with acute mitral  Aneurysm formation
regurgitation (true, false)
Pericardial Electrical
Complications Complications
 Pericarditis
 Ventricular
 Dressler’s syndrome
tachycardia
 Pericardial effusion
 Ventricular fibrillation
Thromboembolic  Supraventricular
Complications
 Mural thrombosis
tachydysrhythmias
 Bradydysrhythmias
 Systemic
 Atrioventricular block
thromboembolism
 Deep venous thrombosis (first, second, or
 Pulmonary embolism third degree)
 ACONITE - Attacks of intense pain extending from the heart
down the left arm, with numbness and tingling of fingers and
fear and anxiety that he will drop dead in the street. Nervous
and confused in a crowd. Palpitations with anxiety, cardiac
oppression, and syncope. Palpitations < when walking,
lancinating stitches prevent the patient from assuming the
erect position or taking a deep breath. Panic attacks.
 ARNICA - Strain to the heart muscle, producing
uncomplicated hypertrophy, with swelling of hand from any
exertion, hands turn red when hanging down. Heart feels as if
tightly grasped by the hand the whole chest feels sore and
bruised and cannot bear the clothing to touch it. Pulse is full
and strong. Tells everyone he is fine and does not want to be
approached. Often the first remedy to use, especially if the
heart attack has been brought on by exertion.
 CACTUS - Sensation of constriction of the heart, feels as if it were
compressed or squeezed by an iron hand. Heart pains come on
slowly, gradually increase then gradually subside. Angina pectoris,
with suffocation, cold sweat and ever-present iron band feeling. Blood
clots. Pulse feeble, irregular quick, without strength. Melancholic,
taciturn, sad, and ill humored. Worse < about noon, lying on the left
side, walking, going upstairs. 11 a.m. and 11 p.m. Better > open air.
  
 DIGITALIS - Sudden sensation that the heart stood still. Pulse very
small, slow, feeble, intermitting every third, fifth and seventh beat.
Feels as if the heart would stop beating if she moved. Blueness,
coldness and suffocation. Despondency, fearful, anxious for the
future. Worse < when sitting erect, after meals, music.

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