acute myocardial infarction

(redirected from Arm pain)

acute myocardial infarction (AMI)

Etymology: L, acutus, + Gk, mys, muscle, kardia, heart; L, infarcire, to stuff
the early critical stage of necrosis of heart muscle tissue caused by blockage of a coronary artery. It is characterized by elevated S-T segments in the reflecting leads and elevated levels of cardiac enzymes. See also myocardial infarction.

acute myocardial infarction

Cardiology The abrupt death of heart muscle due to acute occlusion or spasm of the coronary arteries Epidemiology ±1.5 million MIs/yr–US, 75,000 AMI follow strenuous physical activity, of whom13 die; ±14 of all deaths in the US are due to AMIs; > 60% of the AMI-related deaths occur within 1 hr of the event; most are due to arrhythmias, in particular ventricular fibrillation Triggers Heavy exertion in ±5% of Pts, which is inversely related to Pt's habitual physical activity Etiology Occlusion of major coronary artery–CA, in a background of ASHD, due primarily to the plugging of the vessel with debris from an unstable plaque–see Uncomplicated plaque Clinical Main presenting symptom–retrosternal chest pain accompanied by tightness, discomfort, & SOB; cardiac pain often radiates to the arm & neck, and less commonly to the jaw; the pain of AMI generally is. not relieved with nitroglycerin, in contrast to esophageal pain, which is often identical in presentation, and may respond, albeit slowly, to nitroglycerin; the characteristic clinical picture notwithstanding, there is a high rate of false negative diagnoses of AMIs Diagnosis Clinical presentation, physical examination, EKG–sensitivity in diagnosing AMI is 50–70%, and is lower in lateral MIs than in anterior and inferior MIs; CXR may demonstrate left ventricular failure, cardiomegaly Echocardiography M-mode, 2-D & Doppler Radioisotopic studies Radionuclide angiography, perfusion scintigraphy, infarct-avid scintigraphy, & PET can be used to detect an AMI, determine size & effects on ventricular function, and establish prognosis; a radiopharmaceutical, 99mTc-sestamibi, has become the perfusion imaging agent of choice, given its usefulness for measuring the area of the myocardium at risk for AMI, and for recognizing the myocardium salvaged after thrombolytic therapy Other imaging techniques–eg, CT, and MRI Lab CK-MB, troponin I DiffDx AMI is the most common cause of acute chest pain in older adults, other conditions must be excluded–Prevention ↓ Smoking, ↓ cholesterol, ↓ HTN; ↑ aerobic exercise; influence of other factors-eg maintaining normal body weight, euglycemic state in diabetes, estrogen-replacement therapy, mild-to-moderate alcohol consumption, effect of prophylactic low-dose aspirin-on incidence of AMI is less clear. See AIMS, ASSET, EMERAS, EMIP, GISSI, GISSI-2, GUSTO-1, INJECT, ISIS-2, ISIS-3, LATE, MITI-1, MITI-2, RAPID, TAMI-5, TAMI-7, TEAM-2, TIMI-2, TIMI-4, Trial.
Differential diagnosis of acute myocardial infarction
Arm pain
Myocardial ischemia, cervical/thoracic vertebral pain, thoracic outlet syndrome
Epigastric pain
Myocardial ischemia, GI tract–esophagus, peptic ulcers, pancreas, liver disease–cholecystitis, hepatic distension, pericardial pain, pneumonia
Retrosternal pain
Myocardial ischemia, aortic dissection, esophageal pain, mediastinal lesions, pericardial pain, PTE
Shoulder pain
Myocardial ischemia, cervical vertebra, acute musculoskeletal lesions, pericardial pain, pleuritis, subdiaphragmatic abscess, thoracic outlet syndrome
.

a·cute cor·o·nar·y syn·drome

(ACS) (ă-kyūt' kōr'ŏ-nar-ē sin'drōm)
A general term for clinical syndromes due to reduction of blood flow in coronary arteries (e.g., unstable angina, acute myocardial infarction).
Synonym(s): acute myocardial infarction, preinfarction angina, unstable angina.

acute myocardial infarction (·kyōōtˑ mī·ō·karˑ·dē·l in·farkˑ·shn),

n early stage of heart muscle mortification caused by blockage in a coronary artery.

a·cute cor·o·nar·y syn·drome

(ACS) (ă-kyūt' kōr'ŏ-nar-ē sin'drōm)
A general term for clinical syndromes due to reduction of blood flow in coronary arteries.
Synonym(s): preinfarction angina, unstable angina.
References in periodicals archive ?
Shortly afterwards she started to experience left arm pain that eventually spread to other areas of her body.
No weapon was found and Williams was arrested for violation of the curfew and taken to the hospital after complaining of arm pain.
5,6,2 Greater level of disability is experienced by those patients who suffer from arm pain combined with neck pain as compared to those patients who suffer only from neck pain.
Dr Catherine Ryan, the project co-ordinator of Medical-Surgical Nursing at the University of Illinois, said, "The typical heart attack symptoms include chest pain, shoulder and arm pain, and neck and jaw discomfort.
The signs and symptoms of DSN neuropathy bear a striking resemblance to several other diagnoses or findings in the cervicothoracic, scapular and posterolateral arm areas including cervicogenic dorsalgia (CD), notalgia paresthetica (NP), SICK scapula and a posterolateral arm pain pattern.
These can range from crushing central chest pain, to a mild heaviness in the chest, and can be coupled with left arm pain or neck and jaw pain, or a mixed of all of these.
Vomiting, sweating, and left arm pain are common symptoms, but they're not ones that people immediately associate with a heart attack," says Leslie Cho, MD, co-section head of Preventive Cardiology and Rehabilitation at Cleveland Clinic.
Food and Drug Administration for reconstruction of the cervical disc at both one and two levels to treat arm pain and/or neurological deficit caused by various spine disorders or injuries.
Injured crew members were Marc Castro, who bumped his head into the ceiling of the aircraft; Joan Ratunil, 29, who had to wear a neck brace and undergo spinal CT scan; Raquel Cruz, 25, who complained of arm pain and had to undergo X-ray; and Katrina Angeles, 26, whose right arm was hurt after bumping into the aircraft's wall.
Contrary to general perception, a heart attack does not always manifest itself through chest and arm pain," stressed Dr Raza Seddiqi, CEO Arabian Healthcare Group and executive director of RAK Hospital.
In an ongoing ANA survey, 42 percent of nurses said they are at a "significant level of risk" to their safety from lifting or repositioning patients, and more than half said they experienced shoulder, back, neck or arm pain at work.