Myocardial infarction

• Myocardial infarction (MI) is the irreversible death (necrosis) of

heart muscle secondary to prolonged lack of oxygen supply
(ischemia).
Signs and symptoms

The patient’s vital signs

• The patient’s heart rate is often increased secondary to a high
sympathoadrenal discharge.
• The patient's blood pressure is initially elevated.
• The pulse may be irregular because of ventricular ectopy, an accelerated
idioventricular rhythm, ventricular tachycardia, atrial fibrillation or flutter
Typical chest pain in acute MI has the following characteristics:
• Intense and unremitting for 30-60 minutes
• Substernal, and often radiates up to the neck, shoulder, and jaw, and down
the left arm
• Usually described as a substernal pressure sensation that also may be
characterized as squeezing, aching, burning, or even sharp
• In some patients, the symptom is epigastric, with a feeling of indigestion
or of fullness and gas
 Biochemical tests in myocardial infarction

In laboratory:
1. Troponin T Test
2. Creatine Kinase (CK), MB
3. Complete Blood Count (CBC)
Troponin T Test
 CLINICAL INFORMATION
• A blood sample drawn from a vein
• Troponin levels: Troponin is a contractile protein that normally is not
found in serum; it is released only when myocardial necrosis occurs
• Troponin Test to find out the levels of Troponin in your blood
• Troponin T levels get elevated when you suffer a heart attack. The
elevation is detectable from 3-4 hours after a heart attack. The levels
remain elevated for up to 2 weeks after you suffer a heart attack.
• Normal (hs Troponin T < 14ng/l)
• Possible MI (hs Troponin T 14-30 ng/l)

Troponin T Positive result Troponin T negative result

HEART DAMAGE NOT HEART DAMAGE

angina (chest pain related to
heart trouble) is worsening
 Creatine Kinase (CK), MB

• Creatine kinase (CK) is an enzyme, found primarily in muscle

and brain tissue. Including CK-MM (CK-3), CK-MB (CK-2), and
CK-BB (CK-1)
• CK-MB is one of the most important myocardial markers.
• A blood sample drawn from a vein.
Higher levels of CK-MB may heart attack
or have other heart problems :
Myocarditis, Pericarditis, Cardiac
defibrillation