Diagnostic Criteria for Acute Myocardial Infarction: Cardiac troponins, ECG & Symptoms

Diagnostic Criteria for Acute Myocardial Infarction: Cardiac troponins, ECG & Symptoms
Acute Myocardial Infarction: Definition & Criteria Acute myocardial infarction is the most severe complication of  coronary artery disease . The most common initiating mechanism is rupture or erosion of a vulnerable (unstable) atherosclerotic coronary plaque. Upon such damage, the plaque exposes highly thrombogenic materials which activate circulating platelets and coagulation factors, which results in thrombus formation (Figure 1). Disruption of an atherosclerotic plaque may also release atherosclerotic debris downstream, causing microvascular embolization (i.e occluding smaller vessels downstream). The thrombosis causes occlusion of the artery; blood flow may be partially or completely obstructed. Consequently, the myocardium supplied by the occluded artery becomes ischemic. Ultimately this results in myocardial necrosis (death of myocytes) which can be detected by elevated levels of cardiac proteins in the blood. Figure 1. Acute myocardial infarction is usually initiated by rupture…

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