Inf MI with RVMI by Dr. Jahangir Alam (1).pptx

Inferior mi with rvi

1. Acute Myocardial Infarction Dr. Md.Jahangir Alam Medical Officer Zia Heart Foundation Hospital And Research Institute,Dinajpur

2. Myocardial infarction Myocardial infarction is defined as a clinical event caused by myocardial ischemia in which there is evidence of myocardial injury or necrosis. MI occurs as a result of complete occlusion of a coronary artery due to the formation of occlusive thrombosis.

3. Clinical Findings of AMI

4. Ecg of inf MI

5. Investigagions ECG:-St elevation(With upward convexity) , Pathological Q wave,T Inversion Cardiac biomarkers(most specific Troponin I) Echocardiogram Coronary Angiogram

6. Inf MI with Rv infarction

7. Treatment Strategy

8. Treatment- <6 hours-PCI= Thrombolysis <6 hours with cardiogenic shock,hypotension -PCI <6 hours with hypotension,no pci center -iv crystalloids(fluid challenge) then thrombolysis with cardiac monitoring If there is no response with fluid challenge then- Dobutamine (improves rv stroke volume,promotes lv function) In presence of bradycardia-inj atropine In presence of CHB-Emergency TPM

9. Drugs should be avoided in RVMI:- Diuretics Nitrates Narcotics Beta blockers (Due to they decrease intravascular volume or produce vesodilatation)

10. Complications Early:-Arrhythmia (Vt,vf,AV block) Cardiogenic shock Acute pericarditis Mitral regurgitation Rupture of intervenricular septum Late:-Ventricular Aneurysm Dressler’s syndrome Post infarct

11. Ventricular Tachycardia

12. Inf MI with Sinus Bradycardia

13. Inf MI with Complete Heart Block