antidepressant
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A 55 year old Caucassian male is brought to the ER with sudden onset severe substernal chest pain, as well as sweating and mild dyspnea. The pain does not respond to aspirin or sublingual nitroglycerin. His pas medical history is significant for hypertension, diabetes, and hyperlipidemia. ECG demonstrates ST segment elevation in leads I, aVL and V1-V3 with Q wave development over the next several hours. Cardiac catheterization in this patient would most likely show which of the following?
why is the answer acute transmural myocardial infarction. why not unstable angina?
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| silver
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i think the ECG changes are what you need to focus on. they say Q waves develop over the next few hours is one hallmark of transmural MI. furthermore, ST elevation is a sign of MI, not unstable angina.
this is what i think.....anyone else?
pg. 174 Goljan RR
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| pr20
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Diagnosis of MI requires at least two of the following:
1.a history of ischemic-type chest pain
2.evolving ECG changes
3.a rise in cardiac enzymes or troponins
Clinically,unstable angina can mimic MI but ECG usually does not show ST elevation in unstable angina.Some cases of unstable angina may show transient ST elevation,ST depression and inverted T waves on ECG.Remember that unstable angina may also cause the release of specific intracellular cardiac enzymes(Troponin T and I),and raised levels of such enzymes indicates an adverse prognosis.
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| antidepressant
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thank you silver and pr20, ECG is a big change, shouldnt have ignored it.
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