It is retrosternal and often radiates up to the neck, shoulder, and jaws, and down to the left arm. 1998 Jul. 116 (7):e148-304. [Medline]. [Medline]. 1995 May 10. Medscape Medical News. Armstrong PW, Westerhout CM, Welsh RC. [Medline]. [Medline]. Patients frequently develop tricuspid incompetence; hepatojugular reflux may be elicited even when hepatomegaly is not marked. Montalescot G, Zeymer U, Silvain J, et al. Stone GW, McLaurin BT, Cox DA, et al, for the ACUITY Investigators. O'Riordan M. Positive EP test helps ID post-MI patients for ICDs. Diagnostic accuracy of a point-of-care troponin I assay for acute myocardial infarction within 3 hours after presentation in early presenters to the emergency department with chest pain. Myocardial perfusion imaging in emergency department patients with negative cardiac biomarkers: yield for detecting ischemia, short-term events, and impact of downstream revascularization on mortality. Am Heart J. [Medline]. Circulation. 2018 Mar. Enoxaparin is superior to unfractionated heparin in patients with ST elevation myocardial infarction undergoing fibrinolysis regardless of the choice of lytic: an ExTRACT-TIMI 25 analysis. Ann Intern Med. Colchicine a Case Study for What's Wrong With US Drug Pricing, Dec 4, 2020 This Week in Cardiology Podcast, Many Patients With Type 2 MI Don't Get Cardiologist Evaluation, Keys to Diagnosing Broken Heart Syndrome (Takotsubo Cardiomyopathy), Chili Pepper Consumption Linked to Better Midlife Survival, Pesco-Mediterranean Diet, Fasting 'Ideal' to Reduce CVD, SAMSON Pins Most Muscle Pain Experienced With Statins on the Nocebo Effect, Proinflammatory Dietary Pattern Linked to Higher CV Risk, Heart Failure With Preserved Ejection Fraction Management: 5 Things to Know, Young Women Have Worse MI Outcomes Than Men of Same Age, Diabetes Confers Greater Excess Risk of Myocardial Infarction in Women Than Men, Postinfarction Ventricular Septal Rupture, Aspirin Reduces Ischaemic Events in Patients With Pneumonia. Available at Important elements of the history, such as characteristics of the pain and important associated symptoms, and past hi… 70 (16):2048-90. Am J Cardiovasc Drugs. 36. Important elements of the history, such as characteristics of the pain and important associated symptoms, and past history of or risk factors for cardiovascular disease, are used to determine the likelihood that these symptoms represent acute coronary syndrome (ACS) and to predict the likelihood of clinical outcomes. 358 (9296):1855-63. A summary and critical assessment of the 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: filling the gaps. Am J Emerg Med. Xiang L, Zhong A, You T, Chen J, Xu W, Shi M. Prognostic significance of right bundle branch block for patients with acute myocardial infarction: a systematic review and meta-analysis. 32 (1):28-34. Circulation. Wallentin L, Goldstein P, Armstrong PW, et al. 29 (2):89-91. [Guideline] Smith SC Jr, Allen J, Blair SN, et al,. Kundi H, Kiziltunc E, Korkmaz A, Cicek G, Ornek E, Ileri M. A novel risk scoring system to predict cardiovascular death in patients with acute myocardial infarction: CHA2DS2-VASc-CF score. CPR = cardiopulmonary resuscitation; INR = international normalized ratio; STEMI = ST-elevation myocardial infarction; US = United States of America. DiNicolantonio JJ, Lavie CJ, Fares H, Menezes AR, O'Keefe JH. [Full Text]. [Medline]. [Guideline] Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC); Steg PG, James SK, Atar D, et al. Circulation. Am J Cardiol. Lancet. N Engl J Med. [Medline]. Anderson JL, Adams CD, Antman EM, et al, for the ACC, AHA Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the management of patients with unstable angina/NSTEMI, et al. 4. Effect of intracoronary delivery of autologous bone marrow mononuclear cells 2 to 3 weeks following acute myocardial infarction on left ventricular function: the LateTIME randomized trial. [Guideline] Wong GC, Welsford M, Ainsworth C, et al, for members of the Secondary Panel. In some patients, the symptom is epigastric, with a feeling of indigestion or of fullness and gas. Okrainec K, Banerjee DK, Eisenberg MJ. Reddy KS. B-type natriuretic peptide in the early diagnosis and risk stratification of acute chest pain. The patient’s history is critical in diagnosing myocardial infarction (MI) and sometimes may provide the only clues that lead to the diagnosis in the initial phases of the patient presentation. [Medline]. Daggett WM, Buckley MJ, Akins CW, Leinbach RC, Gold HK, Block PC, et al. JAMA. [Medline]. [Full Text]. Stone GW, Witzenbichler B, Guagliumi G, et al. [46]  In a retrospective study (2009-2016) comprising 4373 patients with acute MI (STEMI: n = 1427; NSTEMI: n = 2946) who presented to an emergency department and underwent cardiac catherization proceures, patients who experienced cardiac death in the follow-up period had significantly higher CHA2DS2-VASc and CHA2DS2-VASc-CF scores, and were more likely to have had major adverse cardiac events and hypertension, were older and current smokers, and have a family history of coronary artery disease; this group also had a significantly lower left ventricular ejection fraction and glomerular filtration rate than those who did not experience cardiovascular death. 428240-overview 2014 Jun 24. Arterioscler Thromb Vasc Biol. The purpose of this study was to correlate the clinical presentation of acute myocardial infarction with the patency rate and degree of residual stenosis of the infarct-related artery. Open-label, randomized, placebo-controlled evaluation of intracoronary adenosine or nitroprusside after thrombus aspiration during primary percutaneous coronary intervention for the prevention of microvascular obstruction in acute myocardial infarction: the REOPEN-AMI study (Intracoronary Nitroprusside Versus Adenosine in Acute Myocardial Infarction). [Medline]. 2000 Jul 5. 2004 Jul 20. 2007 Jun 26. ; ECG – ST elevations, ST depressions, T-wave inversions and pathological Q-waves may be used to diagnose myocardial … [Full Text]. N Engl J Med. [Medline]. Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology guidelines on the acute management of ST-elevation myocardial infarction: focused update on regionalization and reperfusion. 2014 Mar 5. Efficacy and safety of tenecteplase in combination with enoxaparin, abciximab, or unfractionated heparin: the ASSENT-3 randomised trial in acute myocardial infarction. [Medline]. Estimates of benefits and harms of prophylactic use of aspirin in the general population. Takakuwa KM, Ou FS, Peterson ED, et al. Clinical guideline [CG172] Published date: 13 November 2013. Goodman SG, Cohen M, Bigonzi F, et al. INTRODUCTION Myocardial infarction (MI) refers to the process by which areas of myocardial cells in the heart are permanently destroyed. 343 (8893):311-22. [Medline]. 48 (4-5):254-9. 2012 Oct 16. Time delay to treatment and mortality in primary angioplasty for acute myocardial infarction: every minute of delay counts. 2015 Mar. [Medline]. 2017 AHA/ACC clinical performance and quality measures for adults with ST-elevation and non-ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. 2016 Jan 14. In this age group, the clinical presentation of coronary heart disease can be quite atypical. Risk of death or reinfarction associated with the use of selective cyclooxygenase-2 inhibitors and nonselective nonsteroidal antiinflammatory drugs after acute myocardial infarction. [Medline]. McDaniel MC, Willis P, Walker B, et al. Eur Heart J. ... Clinical patterns of myocardial infarction in ambulant patients. [Medline]. [Medline]. [Full Text]. Circulation. Storrow AB, Christenson RH, Nowak RM, et al. 147 (4):E16. Pericardial friction rub. James SK, Lindahl B, Siegbahn A, et al. Medscape. 376 (18):1713-22. Bertolet BD, Hill JA. Am Heart J. Cardiovascular disease in non-Western countries. Patients with type 2 myocardial infarction or myocardial injury have poor clinical outcomes, worse than those patients with type 1 myocardial infarction, with one in three patients dead at 1 year.6 In a prospective study of patients with acute coronary syndrome (n=2818), Stein et al found an increased risk of death in those with an adjudicated diagnosis of type 2 versus type 1 myocardial … Rao KK, Enriquez JR, de Lemos JA, Alexander KP, Chen AY, McGuire DK, et al. [Full Text]. Clin Biochem. Warfarin, kidney dysfunction, and outcomes following acute myocardial infarction in patients with atrial fibrillation. Medscape [serial online]. Cuzick J, Thorat MA, Bosetti C, et al. The 2013 International Society for Heart and Lung Transplantation Guidelines for mechanical circulatory support: executive summary. [Medline]. 357 (11):1121-35. 2012 Oct. 33 (20):2569-619. 2015 Mar. 2002 39 (2):119-77. The patient may recall only an episode of indigestion as an indication of myocardial infarction (see Physical Examination). Myocardial infarction – macroscopic appearance (scar formation) Part 13 of 26 The picture below shows scar formation in the yellow circle on the posterior aspect of the left ventricle.
2020 clinical presentation of myocardial infarction