Cardiology · Overview · 2 min read
Acute Myocardial Infarction
Acute MI is cardiomyocyte necrosis from sustained ischemia, almost always due to atherosclerotic plaque rupture. Rapid reperfusion within 90 minutes of first medical contact is the single most important determinant of survival.
Key points
- Crushing chest pain at rest unrelieved by nitroglycerin and lasting at least 20 minutes is the classic presentation.
- Diagnosis requires troponin elevation plus one of: symptoms, ECG changes, imaging, or angiographic thrombus.
- STEMI: door-to-balloon ≤ 90 minutes for primary PCI; fibrinolytic ≤ 30 minutes if PCI is not available.
- Mechanical complications cluster between days 2 and 7 post-infarct.
- Lifelong aspirin 81 mg, high-intensity statin, and beta-blockers ≥ 12 months for reduced EF.
Exam relevance
USMLE Step 2USMLE Step 3PLAB 2MRCP
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