الفهرس | Only 14 pages are availabe for public view |
Abstract Introduction: Clinical diagnosis of acute myocardial infarction (AMI) is defined as a rise in cardiac biomarker values [preferably cardiac troponin (cTn)] together with at least one of the following: symptoms of ischemia, electrocardiogram (ECG) changes indicative of new ischemia (new ST-T changes or new left bundle branch block), development of pathologic Q waves in the ECG, or imaging evidence of new loss of viable myocardium or new regional wall motion abnormality. Aims: The aim of the essay is to discuss arrhythmias following acute myocardial infarction, their pathophysiology, diagnosis and management. Summary: The indications for treatment of cardiac arrhythmia may be considered in the following situations; (1) when the arrhythmia produces immediate deterioration in cardiovascular function (as in VF and VT and sometimes in AF) or (2) when the arrhythmia gives no immediate deterioration in cardiac function, but when its persistent presence may be expected to give rise to such deterioration or (3) when the arrhythmia carries a risk of giving rise to a subsequent more serious arrhythmia. Conclusion: Patients who present to the emergency department with an AMI will usually be diagnosed and treated before admission to the ICU. Treatment includes; oxygen supplementation if oxygen saturation is less than 90%, morphine for analgesia, beta blockers, nitrates, aspirin, inhibitors of the platelet p2y12 receptor, anticoagulation therapy and PCI if accessible or fibrinolysis. |