医学传媒iology--英文教学3AMI1.pptVIP

ST Segment Elevated Acute Myocardial Infarction Definition myocardial necrosis because of sustaining myocardial ischemia. Ischemia Sustaining Acute myocardial infarction Ischemia: Narrowing is the predominant reason for ischemia. Sometimes ischemia is caused by coronary spasm. Acute myocardial infarction Sustaining: last for 20 minutes at least. Acute myocardial infarction AMI is a life-threatening medical emergency which demands immediate activation of the emergency medical services. Immediate transport by ambulance to a hospital where advanced cardiac life support (ACLS) is available. The more time that passes before medical attention is sought, the more severe the permanent heart damage is likely to be, and the less likely survival will be. pathology Myocardium change coronary occlusion 20mim myocardium pathologic changes 1-12h myocardium necrosis 1-2w infarcted area fibrosis 6-8w scar formation Diagnosis History (present history, past history) Physical Examination ECG Enzymes Other Methods Present History Pain is the most commonly complaint, with following features: Persistent central chest pain which is present in about 2/3 of all cases. It is sometimes described as “intense pressure” Usually, the patient will tell you he is dying, or some uncomfortable sensation beyond description. Present History 2. Associated symptoms: such as dyspnea, shortness of breath, palpitation, dizziness, nausea, and diaphoresis. The sweat may be heavy or slight. It may wet the shirt, or just be on the forehead. Present History 3. Referred pain: The chest pain often radiated to the shoulder and/or arms (usually the left side), the neck, jaw or abdomen. Actua