Myocardial Infarction

Presented by:
Kinza Batool
Presented to:
Ma’am Sameen
 Content

 Definition
 Etiology
 Pathogenesis
 Clinical menifestation
 Complications
 Diagnosis
 Treatment
MYOCARDIAL INFARCTION

“MI or heart attack is the

irreversible damage of myocardial
tissue caused by prolonged
ischaemia and hypoxia”
 Etiology

 Tobacco smoking
 Hypertension
 Drug abuse
 Obesity, stress, alcohol,
 Diabetes, hyperlipoproteinaemia
 Chronic kidney disease
 Hyperhomocysteinemia
 Family history.
 PATHOGENESIS
 Acute plaque change

 Formation of microthrombi

 Vasospasm

 Activation of the coagulation

pathway
 Pathogenesis
1. Acute plaque 2. Formation of
change microthrombi
Erosion/Ulceration, Rupture, Exposure of thrombogenic
fissuring of plaque subendothelial Collagen

Exposes highly Platelets adhere to the site

thrombogenic plaque
Platelet activation and
aggregation
Sudden thrombus
formation
Formation of
microthrombi on the
Sudden occlusion of atheromatous plaque
lumen

Partial or complete
Ishemia and necrosis occlusion of affected
coronary artery
 Pathogenesis
4. Activation of
3. Vasospasm the coagulation
pathway

Release of tissue factor at the

Release of mediators by site of rupture
activated platelets, endothelial
cell and inflammatory cells
Activates coagulation
system
Vasospasm at the sites of
atheroma Increase the size of
the thrombus

Further narrowing of
the lumen Occlusion of blood
vessel

Necrosis
CLINICAL MENIFESTATIONS
 Chest pain
 Dyspnea
 Fatigue
 Increased sweating, weakness
 Nausea, vomiting
 Palpitation, hypertension,
hypotension, arrhythmia.
 Anxiety,
 Sleeplessness,
COMPLICATIONS
 Arrhythmias
 Cardiogenic shocks
 CHF,
 Thromboembolism,
 rupture,
 Cardiac aneurism,
 Pericarditis.
 DIAGNOSIS
Clinical manifestation ECG changes
 Pain, indigestion, apprehension,  ST segment elevation
shock, low grade fever.  T wave inversion
 Appearance of wide deep Q waves
Serum cardiac makers
 Creatinine phosphokinase(CK)
 Lactic dehydrogenase(LDH)
 Cardiac specific troponins ( cTn)
 TREATMENT

PHARMACOLOGICAL CORONARY ARTER BYPASS

ANGIOPLASTY
GRAFT

 Thrombolytic agent

 Anticoagulants

 Antiplatelet agents

 Antihypertensive agents

 Lipids lowering drugs

 Vasodilators
THANK YOU