ST elevation myocardial infarction causes

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Overview

Pathophysiology

Pathophysiology of Vessel Occlusion
Pathophysiology of Reperfusion
Gross Pathology
Histopathology

Causes

Differentiating ST elevation myocardial infarction from other Diseases

Epidemiology and Demographics

Risk Factors

Triggers

Natural History and Complications

Risk Stratification and Prognosis

Pregnancy

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

EKG Examples

Chest X Ray

Cardiac MRI

Echocardiography

Coronary Angiography

Treatment

Pre-Hospital Care

Initial Care

Oxygen
Nitrates
Analgesics
Aspirin
Beta Blockers
Antithrombins
The coronary care unit
The step down unit
STEMI and Out-of-Hospital Cardiac Arrest
Pharmacologic Reperfusion
Reperfusion Therapy (Overview of Fibrinolysis and Primary PCI)
Fibrinolysis
Reperfusion at a Non–PCI-Capable Hospital:Recommendations
Mechanical Reperfusion
The importance of reducing Door-to-Balloon times
Primary PCI
Adjunctive and Rescue PCI
Rescue PCI
Facilitated PCI
Adjunctive PCI
CABG
Management of Patients Who Were Not Reperfused
Assessing Success of Reperfusion
Antithrombin Therapy
Antithrombin therapy
Unfractionated heparin
Low Molecular Weight Heparinoid Therapy
Direct Thrombin Inhibitor Therapy
Factor Xa Inhibition
DVT prophylaxis
Long term anticoagulation
Antiplatelet Agents
Aspirin
Thienopyridine Therapy
Glycoprotein IIbIIIa Inhibition
Other Initial Therapy
Inhibition of the Renin-Angiotensin-Aldosterone System
Magnesium Therapy
Glucose Control
Calcium Channel Blocker Therapy
Lipid Management

Pre-Discharge Care

Recommendations for Perioperative Management–Timing of Elective Noncardiac Surgery in Patients Treated With PCI and DAPT

Post Hospitalization Plan of Care

Long-Term Medical Therapy and Secondary Prevention

Overview
Inhibition of the Renin-Angiotensin-Aldosterone System
Cardiac Rehabilitation
Pacemaker Implantation
Long Term Anticoagulation
Implantable Cardioverter Defibrillator
ICD implantation within 40 days of myocardial infarction
ICD within 90 days of revascularization

Case Studies

Case #1

Case #2

Case #3

Case #4

Case #5

ST elevation myocardial infarction causes On the Web

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ST elevation myocardial infarction causes in the news

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Risk calculators and risk factors for ST elevation myocardial infarction causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]

Overview

The most common proximate cause of ST elevation myocardial infarction is plaque rupture. There are risk factors for plaque rupture and triggers of plaque rupture. A full discussion regarding the chronic risk factors and acute triggers of ST elevation MI can be found in other chapters. While plaque rupture is the most common cause of ST segment elevation MI, other conditions can cause ST elevation and myocardial necrosis. In order to expeditiously treat an alternate underlying cause of myonecrosis, it is important to rapidly identify conditions other than plaque rupture that may also cause ST elevation and myonecrosis. Indeed, the management of some of these conditions might differ substantially from that of plaque rupture: cocaine induced STEMI would not be treated with beta-blockers, and myocardial contusion would not be treated with an antithrombin.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Acute coronary syndrome, amyloidosis, anaphylactic shock, aortic dissection, aortic stenosis, arrhythmias, atherosclerosis, bradyarrhythmias, broken heart syndrome, commotio cordis, coronary artery aneurysm, coronary artery dissection, coronary artery vasospasm, coronary heart disease, coronary stent thrombosis, coronary thrombosis, dissecting aortic aneurysm, dyslipidemia, Hurler disease hypertension, hypotension, idiopathic hypertrophic subaortic stenosis, infectious endocarditis, Kawasaki disease, malignant hypertension, myocardial contusion,plaque rupture, prinzmetal angina, Progesterone, pseudoxanthoma elasticum, stress cardiomyopathy, tachyarrhythmias, Takayasu arteritis, Takotsubo cardiomyopathy
Chemical / poisoning Carbon monoxide poisoning
Dermatologic Kawasaki disease, pseudoxanthoma elasticum
Drug Side Effect Aldesleukin, almotriptan, alvimopan, Amlodipine besylate and Valsartan, amphetamines, anabolic steroids, cocaine, combined oral contraceptive pill, caspofungin acetate, desmopressin, desogestrel and ethinyl estradiol, diclofenac (patch), diflunisal, disulfiram, eletriptan, ephedrine, Estropipate, erythropoietin, ergonovine, estramustine, ethynodiol diacetate and ethinyl estradiol, etravirine, etonogestrel, fibrinogen,goserelin, idarubicin hydrochloride, indinavir, interferon alfacon-1, interferon gamma, letrozole, leuprolide, levothyroxine, marijuana, sudden withdrawal of beta blockers, meclofenamate, medroxyprogesterone, mefenamic acid, meloxicam, meropenem, methoxy polyethylene glycol-epoetin beta, naratriptan, niacin, Norgestimate and Ethinyl estradiol, Norgestrel and Ethinyl estradiol, sudden withdrawal of nitrates, nitroglycerin, oxaprozin, pegylated interferon alfa-2b, pergolide, piroxicam, pramipexole, ramucirumab, Repaglinide and Metformin hydrochloride, Rubidium Rb 82, sertraline, sumatriptan, testosterone, thalidomide, tiagabine, toremifene
Ear Nose Throat Thyrotoxicosis
Endocrine Amyloidosis, diabetes mellitus, pheochromocytoma, thyrotoxicosis
Environmental Air pollution, earthquakes, fine particulate matter
Gastroenterologic Hurler disease, pseudoxanthoma elasticum
Genetic Fabry's disease, familial hypercholesterolemia, homocystinuria, Hurler disease, mucopolysaccharidoses
Hematologic Disseminated intravascular coagulation, hypercoagulable states, polycythemia vera, thrombocytosis
Iatrogenic Coronary stent thrombosis, sudden withdrawal of beta blockers, sudden withdrawal of nitrates, transluminal percutaneous coronary angioplasty
Infectious Disease Infectious endocarditis
Musculoskeletal / Ortho Homocystinuria
Neurologic No underlying causes
Nutritional / Metabolic Amyloidosis, dyslipidemia, electrolyte imbalance, Fabry's disease, familial hypercholesterolemia, heavy meal, homocystinuria, Hurler disease, mucopolysaccharidoses, thiamine deficiency
Obstetric/Gynecologic Combined oral contraceptive pill, nuvaring
Oncologic Pheochromocytoma
Opthalmologic Homocystinuria
Overdose / Toxicity Cocaine, epinephrine overdose, marijuana
Psychiatric Anxiety, bereavement, broken heart syndrome, Hurler disease, psychological stress, stress cardiomyopathy,
Pulmonary Anaphylactic shock, respiratory failure, upper respiratory tract infection
Renal / Electrolyte Electrolyte imbalance
Rheum / Immune / Allergy Amyloidosis, anaphylactic shock, polyarteritis nodosa
Sexual Sexual activity
Trauma Electrocution, myocardial contusion, sports injury, trauma
Urologic No underlying causes
Miscellaneous Anger, electrocution, physical exertion, wartime bombing/missile attacks

Causes in Alphabetical Order


References

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