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Lateral Wall Myocardial Infarction

Myocardial Infarction (lateral Wall)


Presentation

  • A 55-year-old white woman presented to the emergency department with symptoms of dull aching shoulder and chest pain.[ncbi.nlm.nih.gov]
  • Inferior, posterior and lateral wall myocardial infarction Inferior, posterior and lateral wall myocardial infarction ST segment elevation and T wave inversion are present in II, III and aVF, the inferior leads.[cardiophile.org]
  • 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]
Coronary Artery Disease
  • The final diagnoses are listed as follows for each hospital stay: Hospital A (#1): AMI, Severe coronary artery disease Hospital B: Severe coronary artery disease, Recent MI Hospital A (#2): Recent MI, S/P coronary artery bypass graft, coronary artery[health-information.advanceweb.com]
  • artery disease and the acute coronary syndromes in the online merck manual which i have linked you into below for a better understanding of how mis are classified and for information about the different damage you are looking for. there is an article[allnurses.com]
  • The most common cause of heart attacks is coronary artery disease (CAD). With CAD, there is a buildup of cholesterol and other material, called plaque, on their inner walls or the arteries. This is atherosclerosis. It can build up for years.[icdlist.com]
  • This scoring system is based on cardiac risk factors as well as known coronary artery disease. You can use the TIMI score to risk-stratify patients being admitted to the hospital.[dummies.com]
  • Globally, acute myocardial infarction is the leading cause of death for both men and women.1 In the United States, one in five deaths is attributed to coronary artery disease.2 What are the signs and symptoms of a patient presenting with acute myocardial[cathlabdigest.com]
Weight Loss
  • However, some supplements taken for weight loss contain ingredients that have been associated with cardiovascular events.[ncbi.nlm.nih.gov]
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]
  • In the past, a new LBBB in a patient with ischemic chest pain was considered to be an indication for a patient to undergo cardiac catheterization.[cdemcurriculum.com]
  • With QRS Fragmentation SUBTLE ST CHANGES This ECG was obtained from an 87-year-old man who was experiencing chest pain.[ecgguru.com]
  • "Cause of ST segment abnormality in ED chest pain patients". Am J Emerg Med . 19 (1): 25–8. doi : 10.1053/ajem.2001.18029 . PMID 11146012 . a b Wang K, Asinger RW, Marriott HJ (November 2003).[en.wikipedia.org]
  • 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
  • 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]
  • 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]
  • Coronary: · failure · insufficiency I24.9 Acute ischaemic heart disease, unspecified Excludes: ischaemic heart disease (chronic) NOS ( I25.9 ) I25 Chronic ischaemic heart disease Excludes: cardiovascular disease NOS ( I51.6 ) I25.0 Atherosclerotic cardiovascular[apps.who.int]
  • 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 cardiac infarction[icd10data.com]
  • .- ) I20-I25 Ischemic heart diseases Use additional code to identify presence of hypertension ( I10-I15 ) I21 ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction Includes: • cardiac infarction • coronary (artery) embolism • coronary[coding-pro.com]
Sleep Disturbance
  • 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]
Renal Impairment
Social Isolation
  • isolation. [15] Anterior infarcts, persistent ventricular tachycardia or fibrillation, development of heart blocks , and left ventricular impairment are all associated with poorer prognosis. [15] Without treatment, about a quarter of those affected by[en.wikipedia.org]

Workup

  • Electrocardiograms (ECGs) are a series of leads placed on a person's chest that measure electrical activity associated with contraction of heart muscle. [74] The taking of an ECG is an important part in the workup of an AMI, [22] and ECGs are often not[en.wikipedia.org]
Right Axis Deviation
  • If the QRS is negative in Lead I, the heart is pointing more to the right than normal; hence, Right Axis Deviation. This is very complicated and difiicult to explain in this forum.[publicsafety.net]
  • axis deviation) Left anterior fascicular block (may see small q-waves in anterior chest leads) Acute pericarditis (the ST segment elevation may mimic acute transmural injury) Central nervous system disease (may mimic non-Q wave MI by causing diffuse[ecg.utah.edu]
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]
  • 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]
  • There is also a loss of general R wave progression across the precordial leads and there may be symmetric T wave inversion as well.[meds.queensu.ca]

Treatment

  • […] for a myocardial infarction that has received initial treatment, but is still less than 8 weeks old.[coder.aapc.com]
  • In emergency clinic the ECG findings was compatible with acute myocardial infarction and was admit to CCU for treatment. 在急诊室检查心电图,所见符合急性心肌梗塞,收入冠心病监护病房抢救。[hujiang.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]
  • The myocardial injury may have been averted due to early treatment intervention.[health-information.advanceweb.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]

Prognosis

  • 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]
  • Lateral extension of an anterior, inferior or posterior MI indicates a larger territory of myocardium at risk with consequent worse prognosis. How to recognise a lateral STEMI ST elevation in the lateral leads (I, aVL, V5-6).[lifeinthefastlane.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]

Etiology

  • 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

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

Pathophysiology

  • 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 . Archived from the original on 2017-07-28.[en.wikipedia.org]

Prevention

  • "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]
  • For secondary prevention, beta-blocker therapy will continue after discharge because it decreases mortality after MI by 30%.[americannursetoday.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]
  • Initial management The initial management of the overall management plan for patients with acute MI has the following aims: Restoration of the balance between oxygen supply and demand to prevent further ischemia Pain relief Prevention and treatment of[emedicine.medscape.com]
  • Early recanalization prevented development of Q waves in inferior leads. Only the negative T waves in leads III and aVF can be the evidence of an OLD inferior myocardial infarction. Leads III and aVF have rS complex.[metealpaslan.com]

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