ST elevation myocardial infarction initial care
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| Myocardial infarction Classification and external resources | |
 | |
|---|---|
| Diagram of a myocardial infarction (2) of the tip of the anterior wall of the heart (an apical infarct) after occlusion (1) of a branch of the left coronary artery (LCA, right coronary artery = RCA). | |
| ICD-10 | I21.-I22. |
| ICD-9 | 410 |
| DiseasesDB | 8664 |
| MedlinePlus | 000195 |
| eMedicine | med/1567 emerg/327 ped/2520 |
| Cardiology Network |
 Discuss ST elevation myocardial infarction initial care further in the WikiDoc Cardiology Network |
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The goal of initial care is to restore epicardial artery patency as rapidly and fully as possible, and to reduce the risk of early vessel reocclusion. Other goals include reducing the risk of lethal ventricular arrhythmias and reducing myocardial oxygen demands.
Overview of Initial Therapies
Initial therapies include Oxygen, aspirin, glyceryl trinitrate (nitroglycerin) (excluding though those patients with a right ventricular myocardial infarction) and analgesia (usually morphine. Morphine is the preferred analgesic agent due to its ability to reduce adrenergic drive and reduce preload (it is a venodilator). The antiplatelet agent aspirin has been associated with a reduction in mortality.[1]
Once the diagnosis of myocardial infarction is confirmed, additional pharmacologic agents may then be administered. These include beta blockers[1][1] and anticoagulation therapy (typically with an antithrombin)[1]
Wikidoc cites here the ACC / AHA Guidelines Based Therapy for ST Elevation MI [1]
DO NOT EDIT THESE GUIDELINES. You can make comments regarding the guidelines in the discussion section.
Interpreting the ACC / AHA Guidelines
Oxygen
Nitrates
Analgesics
Aspirin
Beta Blockers
Reperfusion Therapy (Overview of Fibrinolysis and Primary PCI)
Fibrinolysis
Primary PCI
Adjunctive and Rescue PCI
CABG
Management of Patients Who Were Not Reperfused
Assessing Success of Reperfusion
Antithrombin Therapy (Overview)
Unfractionated Heparin (UFH) Therapy
Low Molecular Weight Heparinoid Therapy
Direct Thrombin Inhibitor Therapy
Antiplatelet Agents
Aspirin
Thienopyridine Therapy
Glycoprotein IIbIIIa Inhibition
Inhibition of the Renin-Angiotensin-Aldosterone System
Magnesium Therapy
Glucose Control
Calcium Channel Blocker Therapy
See also
- acute coronary syndrome
- angina
- Cardiac arrest
- coronary thrombosis
- Hibernating myocardium
- Stunned myocardium
- Ventricular remodeling
References
External links
- The MD TV: Comments on Hot Topics, State of the Art Presentations in Cardiovascular Medicine, Expert Reviews on Cardiovascular Research
- Clinical Trial Results: An up to dated resource of Cardiovascular Research
- Risk Assessment Tool for Estimating Your 10-year Risk of Having a Heart Attack - based on information of the Framingham Heart Study, from the United States National Heart, Lung and Blood Institute
- Heart Attack - overview of resources from MedlinePlus.
- Heart Attack Warning Signals from the Heart and Stroke Foundation of Canada
- Regional PCI for STEMI Resource Center - Evidence based online resource center for the development of regional PCI networks for acute STEMI
- STEMI Systems - Articles, profiles, and reviews of the latest publications involved in STEMI care. Quarterly newsletter.
- American College of Cardiology (ACC) Door to Balloon (D2B) Initiative.
- American Heart Association's Heart Attack web site - Information and resources for preventing, recognizing and treating heart attack.
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
