1、ACUTE MYOCARDIAL INFARCTION（AMI）Contents Definition Definition Definition Prevalence Mortality The mortality is 50%in 24 hours.Cause Coronary atherosclerosis Formation of thrombus Obstruction of blood flow Muscle death in cardiac muscle Plaque rupturePlaque rupture adventitialipid coreCholesterol nu
2、clearthrombosis Ruptured plaques Risk factors Inducing factors Symptoms Prodromal symptomsPain of infarction Associated symptomsPainless infarction sudden death and Early arrhythmias SignsSignsSigns,SignsSigns Auxiliary examinations ElectrocadiogramQ wave development T wave inversionLocation Inferio
3、r wall aVF Anterior wall V16 Anteroseptal wall V1-3 Apical or lateral wall V46 Posterior wall-V7-9 Right-sided -V4R-V5RLaboratory findings Marker Time to appearance Duration of elevation 6hr12hrSpecificity Troponin I 2-6hr 5-10d75%90%-100%98%Troponin T2-6hr 5-14d80%95%-100%95%CK-MB3-6hr 2-4d65%95%95
4、%myoglobin1-2hr 1d85%90%80%EchocardiographyBedside assessment of left ventricular global and regional function.Diagnosing postinfarction,mitral regurgitation or ventricular septal defect.WHO Definition Of MI Typical symptoms of chest pain 30 minutes Characteristic rise and fall of serum enzyme level
5、s Typical ECG changes with development of ST elevation or Q waves Diagnosis Chest pain History、examination and ECG Acute coronary syndrome（ACS）ST segment elevation Non-ST segment elevation NSTEMIUANo TnI(TnT)STEMITnI(TnT)TnI(TnT)The differential diagnosis Complications Therapy Prevention Definition Definition Mortality The mortality is 50%in 24 hours.Painless infarction SignsWHO Definition Of MI Typical symptoms of chest pain 30 minutes Characteristic rise and fall of serum enzyme levels Typical ECG changes with development of ST elevation or Q waves Diagnosis
