Acute Myocardial Infarction CLINICAL PRESENTATION
Acute Myocardial Infarction is precipitated by exertion, exercise, emotional stress, medical and surgical disease and interventions. Circadian variation – AMI is more common in early morning hours due to increase in sympathetic tone and increased thrombolytic tendency from 4 to 12 AM.
Acute Myocardial Infarction Pain:
- Pain is the most common and typical symptom of AMI. There is very severe pain.
- It radiates to Arms; Abdomen; Jaw; Back and Neck. Pain may be present up to occiput or to umbilicus in front but not lower than umbilicus.
- It is a deep pain. It may be a severe discomfort, heaviness, squeezing, crushing pain. It is located in central portion of chest and sometimes epigastrium.
Acute Myocardial Infarction Chest pain is accompanied by :
- Sense of doom.
- Pain occurs during exertion – is not relieved with rest. Pain may occur during rest.
- Painless MI – occurs in:
- Vomiting Anxiety
- Diabetes mellitus –
- old age
- In Old age – Acute MI may present with acute dyspnea (pulmonary oedema).
Acute Myocardial Infarction Less Common presentations
- Loss of consciousness Confusion
- Extreme weakness Arrhythmia
- Pulmonary embolism Falling Blood pressure.