《心肌梗死英文》课件.ppt

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ACUTEMYOCARDIALINFARCTION〔AMI〕

DefinitionPrevalenceCauseSymptomsandsignsAuxiliaryexaminations

。ContentsDiagnosisThedifferentialdiagnosiscomplicationsTherapy

。

DefinitionDeathornecrosisofmyocardialcells.

DefinitionFromananatomicormorphologicstandpoint----transmural----nontransmural.

DefinitionFromECGfinding--STelevationSTEMI--non-STelevationNSTEMI

PrevalenceTheWorldHealthOrganizationestimatedin2004,that12.2%ofworldwidedeathswerefromischemicheartdisease.

Leadingcauseofdeathinhigh-ormiddle-incomecountries.Secondonlytolowerrespiratoryinfectionsinlower-incomecountries.

Worldwide,morethan3millionpeoplehaveSTEMIsand4millionhaveNSTEMIsayear.STEMIsoccurabouttwiceasofteninmenaswomen.

Ingeneral，MIcanoccuratanyage，butitsincidentriseswithage.Approximately50%ofallMI’sintheUSoccurinpeopleyoungerthan65yearsofage.

MortalityThemortalityis50%in24hours.

CauseCoronaryatherosclerosisFormationofthrombusObstructionofbloodflowMuscledeathincardiacmuscle

Plaquerupture→adventitialipidcoreCholesterolnuclearthrombosis

Rupturedplaques

RiskfactorsAgeHyperlipidemiaDiabetesmellitusHypertensionSmokingMalegenderFamilyhistoryofatheroscleroticarterialdisease(inheritance)

Inducingfactors

EarlyhoursofthemorningOvereatingHeavyphysicalactivityAgitationRapidriseofbloodpressureDefecatinghardlyShockDehydrationSurgerySeverearrhythmia

SymptomsProdromalsymptoms:PainofinfarctionAssociatedsymptomsPainlessinfarctionsuddendeathandEarlyarrhythmias

Prodromalsymptoms

Occuratrestorwithlessactivitythanusual.Approximatelyonethirdhavehadsymptomsfrom1to4weeksbefore.

Painofinfarction

AtrestIntheearlymorningSimilartoanginainlocationandradiationbutmoresevere.Nitroglycerinhaslittleeffect,evenopioidmaynotrelieve

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