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Cardiology

Question
22 out of 67
 

Universal definition of MI all except (AIIMS Nov 2011)



A Sudden death can be due to MI

B Wall motion abnormalities on echo with raised biochemical markers indicate MI

C Post CABG MI tropo should rise >3times

D Troponin rise by 5-6% indicates re infarction.

Ans. C

Post CABG MI troponin should rise >3times

(Ref: Journal of the American College of Cardiology and AHA)

Table 1 Clinical classification of different types of myocardial infarction.

Type 1

Spontaneous myocardial infarction related to ischaemia due to a primary coronary event such as plaque erosion and/or rupture, fissuring or dissection

Type 2

Myocardial infarction secondary to ischemia due to either increased oxygen demand or decreased supply, e.g. coronary artery spasm, coronary embolism, anemia, arrhythmias, hypertension, or hypotension

Type 3

Sudden unexpected cardiac death, including cardiac arrest, often with symptoms suggestive of myocardial ischemia, accompanied by presumably new ST elevation, or new LBBB, evidence of fresh thrombus in a coronary artery by angiography and/or at autopsy, but death occurring before blood samples could be obtained, or at a time before the appearance of cardiac biomarkers in the blood.

Type 4a

Myocardial infarction associated with PCI

Type 4b

Myocardial infarction associated with stent thrombosis as documented by angiography or at autopsy

Type 5

Myocardial infarction associated with CABG

The new ACC/ESC definition of myocardial infarction (MI)1

Definition of reinfarction

The definition of MI in patients undergo-ing CABG, The CK-MB threshold should be 5times the upper limit of normal and the CK-MB threshold for PCI should be 3 times the upper limit of normal.

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