Myocardial Infarction

COMPLICATION (CAPS TRAP)

C→CHF T→Thromboembloism
A→Arrhythmias R→Rupture
P→Pericaditis A→Aneurysm
S→Shock P→Post MI Syndrome

Stable Angina
Atherosclerosis

Acute Rheumatic Fever

Cardiovascular

Ischemic Heart Disease

System

Endocarditis Congestive Heart Failure

Major Risk Factor Minor Risk Factors

CLINICAL FEATURES
Diabetes Mellitus Obesity
Chest Pain on exertion Hyperlipidemia Sedentary life style
Relieved with nitroglycerin Cigarette smoking Stress
Onset- gradual Age (Men>45, Women Alcohol
Diaphoresis >55Y

Unstable Angina

LEFT SIDED HEART FAILURE RIGHT SIDED HEART FAILURE

CAUSES: Ischemia, HTN, Dilated CAUSES: Most commonly due to left sided
Cardiomyopathy, Myocardial Infarction, HF and Cor pulmonale.
Restrictive Cardiomyopathy
CLINICAL FEATURES: CLINICAL FEATURES:
• Awakening at night with shortness • Fluid retention causing swelling, or
of breath. pitting edema, in the ankles, legs
• Shortness of breath during exercise and/or feet.
or when lying flat. • Jugular venous distention
• Chronic coughing or wheezing. • Painful Hepatosplenomegaly with CLINICAL FEATURES
• Difficulty concentrating.
characteristics ‘nutmeg’ liver Chest Pain on Rest.
• Fatigue.
• Lack of appetite and nausea. TREATMENT:
LABS: 1. Positive Blood Culture TREATMENT: Based on etiology and symptoms. The distinction b/w unstable angina (USA) and NSTEMI is based on Cardiac enzyme.
2. Anemia of chronic disease (↓Hb, ↓MCV, ↓TIBC, ↑Ferritin ACE inhibitor, Digoxin, Nitrates Normal in USA.
3. Transesophageal echocardiogram
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CARDIOMYOPATHY
2
DILATED HYPERTROPHIC RESTRICTIVE
CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY
Dilation of all 4 chamber of heart Massive hypertrophy of left Decrease compliance of the
ventricle ventricular endomyocardium
RESULT ↓
Hypertrophic cardiomyopathy Restrict filling during diastole
makes the heart valve more tight
Systolic Dysfuction ↓
Can’t fill heart anymore
↓
Mitral & Tricuspid
Heart Walls lose compliance
Reggurgitation CAUSE
↓
Can’t fill heart, Diastolic
Arrthmias
❖ Amyloidosis
dysfunction
❖ Sarcoidosis
↓
❖ Endocardial fibroelastosis
Decrease Cardiac output
❖ Loeffler Syndrome

CAUSE CAUSE
CLINICAL FEATURE
❖ Genetic Mutation ❖ Genetic Mutation
❖ Myocarditis
❖ Present as CHF features
❖ Alcohol abuse
CLINICAL FEATURE ❖ Diminished QRS amplitude
❖Drugs → Doxorubicin
❖Pregnancy (Late or after child birth)
❖Hemochromatosis ❖ Decrease Cardiac output
❖ Sudden death due to
TREATMENT: Ventricular Arrhythmias
❖Syncope with exercise
Heart Transplant ❖Common in Young Athletes