A 55-year-old white woman presented to the emergency department with symptoms of dull aching shoulder and chest pain. [ncbi.nlm.nih.gov]

Clinical Presentation Patients who are experiencing an acute STEMI are classically described as presenting with pressure or crushing chest pain associated with shortness of breath, nausea/vomiting or diaphoresis. [cdemcurriculum.com]

The clinical presentation can be similar to an inferior wall MI (that is, GI symptoms can predominate). On an ECG, you see ST depression in the anterior leads (V1 and V2 big time). [dummies.com]

A 12-lead ECG should be performed on all patients presenting with the previously mentioned symptoms. [cathlabdigest.com]

Pathology of cardiac conduction as seen in 3-lead and 12-lead monitoring systems are presented in a practical manner to build confidence in this valuable diagnostic tool. [books.google.com]

• Weakness

  […] modifiable and non-modifiable risk factors 1. chest pain lasts for 20 min or more described as pain, pressure, tightness, heaviness, burning, squeezing, or crushing at the central chest or starts in or radiates to arms, shoulders, neck, jaw, or back 2. weakness [quizlet.com]

  Signs and symptoms of myocardial ischemia: Crushing pain on the chest (angina pectoris), behind the sternum, often radiating to the lower jaw or the left arm Fear of dying Nausea Shock (manifesting as paleness, low blood pressure, fast weak pulse) shock [en.ecgpedia.org]

  Women may also experience weakness, cold sweating, dizziness, pain or pressure in the back or high chest, pain or discomfort in one or both arms, irregular heart rate, and nausea. [americannursetoday.com]

  OF RVI Aside from questions about area of infarct, any patient who presents with chest pain, shortness of breath, unexplained hypotension, abdominal pain, back pain in the scapular or subscapular region, epigastric pain, neck or jaw pain, generalized weakness [emsworld.com]

• Fatigue

  Patients may make statements such as “my bra is too tight” or compare the discomfort to a “burning sensation, toothache, or an elephant sitting on one’s chest.”3 Nausea and vomiting, or simply fatigue, may be the only complaint. [cathlabdigest.com]

  In women, common signs and symptoms include unusual fatigue, sleep disturbances, shortness of breath, indigestion, and anxiety. Many women describe chest discomfort as aching, tightness, pressure, sharpness, burning, fullness, or tingling. [americannursetoday.com]

  […] remember as noted in “The Approach to Chest Pain” module that many patients with a STEMI or acute coronary syndrome (ACS) including: elderly, diabetic and female patients may present more typically with an anginal equivalents such as nausea and vomiting, fatigue [cdemcurriculum.com]

  Women can also commonly experience back or neck pain, indigestion, heartburn, lightheadedness, shortness of breath, fatigue, nausea, or pain in the back of the jaw. [en.wikipedia.org]

• Asymptomatic

  The ECG was recorded when the patient was asymptomatic. Observation of Q waves in leads II, III and aVF show OLD inferior wall myocadial infarction. [metealpaslan.com]

  The patient was asymptomatic, blood pressure was 120 × 80 mm Hg, and there were no signs of hemodynamic instability. [cardiovascularultrasound.biomedcentral.com]

  Small aneurysms are often asymptomatic but the presence of an aneurysm should be suspected in those with a history of MI who present with heart failure, ventricular arrhythmias or thromboembolism, particularly if the ECG has persistent ST elevation in [bsecho.org]

  […] switch operation大血管転換術 arteriography動脈造影［法］ arteriovenous (AV) anastomosis動静脈吻合［術］ arteriovenous (AV) fistula動静脈痩 arteritis動脈炎 artery 動脈 artificial heart人工心［臓］［装置］ artificial valve人工弁 ascites腹水 aspirinアスピリン asymmetric septal hypertrophy (ASH)非対称性心室中隔肥大 asymptomatic [tokyo-med.ac.jp]

• Coronary Atherosclerosis

  Associations of coronary heart disease risk factors with the intermediate lesion of atherosclerosis in youth. The Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. [emedicine.medscape.com]

• Malaise

  Patients present one to eight weeks post infarct with fever, malaise and pericardial sounding chest pain. There is an elevation of inflammatory markers and white cell count on blood tests and usually a pericardial effusion is present. [bsecho.org]

• Epigastric Pain

  Because epigastric pain became worst, a new electrocardiogram was undertaken, revealing an 1 mm ST segment elevation in leads V2 to V5. [cardiovascularultrasound.biomedcentral.com]

  Because symptoms of MI can be subtle, an ECG should be performed on any patient older than age 45 who is experiencing new epigastric pain or discomfort. The location of an MI depends on which coronary artery is occluded. [americannursetoday.com]

  FIELD DIAGNOSIS OF RVI Aside from questions about area of infarct, any patient who presents with chest pain, shortness of breath, unexplained hypotension, abdominal pain, back pain in the scapular or subscapular region, epigastric pain, neck or jaw pain [emsworld.com]

• Chest Pain

  A 55-year-old white woman presented to the emergency department with symptoms of dull aching shoulder and chest pain. [ncbi.nlm.nih.gov]

  The chest pain might be described as radiating into the patient’s neck, left arm or jaw. Oftentimes, they will appear visibly uncomfortable and may have a fist clutching the center of their chest. [cdemcurriculum.com]

  Chest. 125 (4): 1561–76. doi : 10.1378/chest.125.4.1561. PMID 15078775. [en.wikipedia.org]

  With QRS Fragmentation SUBTLE ST CHANGES This ECG was obtained from an 87-year-old man who was experiencing chest pain. [ecgguru.com]

  The 15-lead ECG in emergency department chest pain patients: Comparison to the 12-lead ECG. Ann Emerg Med Abstract. Publication pending. 3. Pollack M, et al. [ahcmedia.com]

• Heart Disease

  […] ischaemic heart disease, unspecified Ischaemic heart disease (chronic) NOS Processed on 29.10.2004 M.S. [apps.who.int]

  ICD 9 CM Field Value Diagnosis Code: 410.50 Long Description: Acute myocardial infarction of other lateral wall, episode of care unspecified Short Description: AMI lateral NEC, unspec Chapter: Diseases Of The Circulatory System Block: Ischemic Heart Disease [emedcodes.com]

  Ischemic heart diseases Use Additional code to identify presence of hypertension ( I10-I16 ) Ischemic heart diseases I21 ICD-10-CM Diagnosis Code I21 Acute myocardial infarction 2016 2017 2018 - Revised Code 2019 Non-Billable/Non-Specific Code Includes [icd10data.com]

  ICD-9 code 410.5 for Acute myocardial infarction of other lateral wall is a medical classification as listed by WHO under the range -ISCHEMIC HEART DISEASE (410-414). [coder.aapc.com]

• Hypotension

  Hypotension : Hypotension may occur in various settings following acute MI. [brown.edu]

  Mechanical Complications Hypotension and Ventricular Function Hypotension can occur for a number of reasons following an MI. [bsecho.org]

  If they are treated with nitroglycerin, they may experience sudden and dramatic hypotension from vasodilation. [emsworld.com]

  Nitrates should also be avoided because they can produce profound hypotension. [cathlabdigest.com]

  Here are some other key points concerning an inferior wall MI: If you see a test question in which a person with an inferior wall MI presents with hypotension, there may be extension of the inferior wall MI to affect the right ventricle. [dummies.com]

• Sweating

  You may break out in a cold sweat. Sometimes women will have different symptoms then men. For example, they are more likely to feel tired for no reason. The most common cause of heart attacks is coronary artery disease (CAD). [icdlist.com]

  Women may also experience weakness, cold sweating, dizziness, pain or pressure in the back or high chest, pain or discomfort in one or both arms, irregular heart rate, and nausea. [americannursetoday.com]

  […] with chest pain, shortness of breath, unexplained hypotension, abdominal pain, back pain in the scapular or subscapular region, epigastric pain, neck or jaw pain, generalized weakness, syncope, complaint of tightness in the chest, nausea, vomiting, sweating [emsworld.com]

  Specialty Cardiology, emergency medicine Symptoms Chest pain, shortness of breath, nausea, feeling faint, cold sweat, feeling tired ; arm, neck, back, jaw, or stomach pain [1] [2] Complications Heart failure, irregular heartbeat, cardiogenic shock, cardiac [en.wikipedia.org]

• Irritability

  There are premature atrial complexes (beat 4 on the rhythm strip) and multifocal ventricular ectopy (PVCs of two different types), indicating an “irritable” myocardium at risk of ventricular fibrillation. [lifeinthefastlane.com]

Electrocardiograms (ECGs) are a series of leads placed on a person's chest that measure electrical activity associated with contraction of heart muscle. [77] The taking of an ECG is an important part in the workup of an AMI, [23] and ECGs are often not [en.wikipedia.org]

• Right Axis Deviation

  Axis Deviation: Use Lead I, II, and aVF to diagnois Axis Deviation Vectors and Axis Vector: A quantity of electrical force that has a known magnitude and direction. [publicsafety.net]

  Note pathologic Q-waves in V1-4, late R wave in V1, wide S waves in lead I, and left axis deviation (-80 degrees). [ecg.utah.edu]

• Hypercholesterolemia

  As shown in the figure, the most important risk factors for myocardial infarction are: Male sex Smoking Hypertension Diabetes Mellitus Hypercholesterolemia Risk assessment of ischemia An exercise test such as a bicycle or treadmill test, may be useful [en.ecgpedia.org]

  上大静脈右肺動脈吻合術 gold standardゴールドスタンダード h heart rate (HR)心拍数 hemiblock束枝（ヘミ、片）ブロック hemodynamics 血行動態、血行力学 high-density lipoprotein (HDL) cholesterolＨＤＬコレステロール、高比重リポたんぱく[質]コレステロール high-output heart failure高拍出性心不全 hilar shadow肺門陰影 Holter monitoringホルターモニタ hypercholesterolemia [tokyo-med.ac.jp]

• T Wave Inversion

  These feature are suggestive of posterior wall infarction, being the inverse of Q wave, ST elevation and T wave inversion which would have been recorded in a posterior lead. [cardiophile.org]

  UZMA ANSARI ST depression, peaked T-waves, then T-wave inversion ST elevation & appearance of Q-waves ST segments and T-waves return to normal, but Q-waves persist Ischemia ST depression & T-wave inversion ST depression & T-wave inversion ST returns to [slideshare.net]

  In 8 of these 22 patients, the infarct was silent in the sense that no ST segment elevation or Q waves were seen, although ST depressions or T wave inversions, or both, in all but one patient were compatible with subendocardial infarction. [ncbi.nlm.nih.gov]

  Within a few hours, you can begin to see negative T waves or T wave inversion as the MI evolves. The T wave inversion can persist for months after the MI. [dummies.com]

  ST segment depression and T wave inversion 5 components of Pain Assessment P - precipitating Q - quality R - radiation S - severity T - timing 1. [quizlet.com]

The emphasis on cardiac care in the field has evolved from dysrhythmia recognition and treatment only to recognition and treatment of an evolving MI. [emsworld.com]

[…] for a myocardial infarction that has received initial treatment, but is still less than 8 weeks old. [coder.aapc.com]

Final message Inferior STEMI generally lacks the vigor to cause extensive damage to myocardium in most situations .Further they respond better to treatment. [drsvenkatesan.com]

Treatments may include medicines and medical procedures such as coronary angioplasty. After a heart attack, cardiac rehabilitation and lifestyle changes can help you recover. [icdlist.com]

With proper diagnosis of the origin of the infarct and proper treatment, many co-morbidities and possibly mortality may be avoided. [cathlabdigest.com]

Anterior myocardial infarction carries the worst prognosis of all infarct locations, mostly due to larger infarct size. [lifeinthefastlane.com]

By definition, patients in quadrant 4 are in "cardiogenic shock" and have a poor prognosis, unless they have a correctable mechanical complication, or unless they are early into the course of their MI, and some of the ischemic myocardium is recovered [brown.edu]

FACTORS THAT DETERMINE PROGNOSIS IN ACUTE MYOCARDIAL INFARCTION (BOX 1) The immediate prognosis in patients with acute myocardial infarction is inversely related to the amount of myocardial reserves (total myocardial mass less the myocardium involved [pmj.bmj.com]

St-segment - elevation (> 1mm or more abouve baseline) is an indication of occlusive thrombus with poorer prognosis 14. reciprocal ST segment depression may occur in the leads facing the area opposite the site of injury 15. [quizlet.com]

Differential diagnosis of ST elevations The most serious cause of ST elevations on ECG is a ST elevation MI, however there are other possible etiologies. As usual always consider the “worst first”. [cdemcurriculum.com]

"Epidemiology of heart failure and left ventricular systolic dysfunction after acute myocardial infarction: prevalence, clinical characteristics, and prognostic importance". [en.wikipedia.org]

It is important to appreciate that the ECG provides information about a totally different aspect of pathophysiology in acute myocardial infarction than does the coronary angiogram. [pmj.bmj.com]

Pathophysiology of Heart Disease: A Collaborative Project of Medical Students and Faculty. Lippincott Williams & Wilkins. p. 172. ISBN 9781469816685. [en.wikipedia.org]

"Vitamin and mineral supplements in the primary prevention of cardiovascular disease and cancer: An updated systematic evidence review for the U.S. Preventive Services Task Force". [en.wikipedia.org]

FDA approves Amgen's Repatha (evolocumab) to prevent heart attack and stroke [press release]. Available at https://www.amgen.com/media/news-releases/2017/12/fda-approves-amgens-repatha-evolocumab-to-prevent-heart-attack-and-stroke/. [emedicine.medscape.com]

For secondary prevention, beta-blocker therapy will continue after discharge because it decreases mortality after MI by 30%. [americannursetoday.com]

What they ... [ Read Full Story ] May 10, 2019 If your provider is ordering nebulizers and the drugs used in them for their patients, here are things in the documentation that will help prevent a resubmission to Medicare and ease medical codi... [ Read [coder.aapc.com]

But if you do get quick treatment, you may be able to prevent or limit damage to the heart muscle. That's why it's important to know the symptoms of a heart attack and call 9-1-1 if you or someone else is having them. [icdlist.com]