Imminent myocardial infarction

Introduction Near-force myocardial infarction is one of the symptoms of premature myocardial infarction syndrome.

Cause

The underlying lesion of this syndrome is coronary atherosclerosis. Certain factors can affect the blood oxygen supply of the heart muscle, such as arrhythmia, hypotension, persistent emotional agitation, hyperthyroidism, and anemia.

an examination

Related inspection

Dynamic electrocardiogram (Holter monitoring) selective cardiovascular angiography serum alpha hydroxybutyrate dehydrogenase determination of motion imaging effusion lactate dehydrogenase

There are a variety of clinical manifestations from angina to myocardial infarction. Before the occurrence of myocardial infarction, there may be no angina prodromal symptoms, or there may be different degrees of angina. About 40 to 60% of patients have pre-existing symptoms before myocardial infarction.

Characteristics of premature myocardial infarction syndrome:

First, the pain in the precordial area lasts for more than 15 minutes.

Second, the electrocardiogram and enzyme examination have no basis for myocardial infarction.

Third, without shock, blood pressure changes and cardiac insufficiency.

Fifth, the direction of myocardial infarction.

Patients generally have more severe precordial pain, which lasts longer than normal angina, and can even be more than one hour. Colic is not relieved by nitroglycerin, and even an analgesic agent must be used. Angina can occur at rest, and even the patient can wake up during sleep. At the time of the attack, atrial and ventricular galloping, abnormal signs of myocardial ischemia such as second heart sound splitting can be heard. Electrocardiogram occasionally showed ST segment and T wave changes in subendocardial ischemia, and there was no change in QRS. If the myocardial necrosis area is small, there can be no ECG changes.

The outcome of this syndrome is as follows:

1. After a long period of time, the ischemic attack gradually improves, possibly due to the formation of collateral circulation.

Second, a small number of patients may suddenly die due to ventricular fibrillation or arrest.

Third, usually after a few days or weeks, myocardial infarction can occur, no pain recurrence after rest and exertion.

Differential diagnosis

Myocardial infarction refers to the interruption of blood flow in the coronary arteries based on coronary artery lesions, causing severe and persistent acute ischemia in the corresponding myocardium, eventually leading to ischemic necrosis of the myocardium.

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