Myocardial infarction

Myocardial infarction occurs when there is an area of myocardial necrosis resulting from an interruption to the blood supply of one or more coronary arteries or their branches.

There is a sudden onset of severe, crushing, central chest pain that usually lasts for more than 30 minutes (in contrast to angina) and is not relieved by rest or anti-anginal medications. Often
there is a past medical history of angina pectoris, as thrombosis is more likely to occur in narrowed coronary arteries and the two
conditions share the same risk factors.
The pain may radiate to the arms or lower jaw. It is often associated with sweating, nausea and vomiting, and may cause shortness of breath.
On examination the patient looks shocked and unwell, with an ashen complexion, sweating, and a cold, clammy skin. They usually have a fast, weak pulse and may
have a reduced blood pressure and signs of left ventricular failure.

diagnosis ::

ECG and cardiac enzymes like CK and others ...

Treatment ::
Adequate pain relief
Patients with myocardial infarction usually require opiate analgesics such as morphine (10–20 mg) or diamorphine (5–10 mg) intravenously, given together with an anti- emetic such as cyclizine (50 mg) to counteract the nausea and vomiting that opiates can induce. The patient should be given oxygen to breathe, and any complications that arise should be quickly identified and treated...

Thrombolytic therapy
In the absence of any contraindication, all patients with acute
myocardial infarction should be given thrombolytic therapy. The drugs used are either steptokinase or tissue plasminogen activator....