by Carlo Raj, MD

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    We have arrived at acute myocardial infarction. If you remember, we had discussed the two different types of myocardial infarctions and I need to make sure that we are clear about where we are heading next. There were the transmural type and you tell me if it is transmural, entire wall has been affected and so, therefore, you would find your obstruction where exactly? Is it an artery or arteriole? If you remember that functional anatomical picture that I showed you of the left ventricular wall and that is what we called it then the coronary artery was on the superficial aspect of the wall, on the surface by the pericardium. Thus, if the coronary artery was to be affected, then entire wall underneath was, so, therefore, you then refer to this as being a transmural infarct. So, as you move forward here and when you see NSTEMI this refers to what the actual patient is suffering from? A non-ST elevation myocardial infarction and by that we are referring to an ST depression. Or if it is an ST elevation myocardial infarction and if it is transmural of any type and I walked you through the three major blood vessels in our earlier discussion with left anterior descending, with left circumflex, and also right coronary artery, those will then result in an ST-elevation myocardial infarction. Now we are at a point where you need to make sure that you put all of this together, please. As we had discussed earlier, if the atherosclerotic plaque becomes large enough and as you see in the illustration here, there will be rupture. And if there is rupture, then understand that the central necrotic material including LDL and such escapes into and embolizes distally into the coronary artery, resulting in complete occlusion, and may...

    About the Lecture

    The lecture STEMI and NSTEMI by Carlo Raj, MD is from the course Ischemic Heart Disease. It contains the following chapters:

    • Pathogenesis
    • Signs & Symptoms
    • Localizing AMI by EKG
    • Special Inferior Wall MI's

    Author of lecture STEMI and NSTEMI

     Carlo Raj, MD

    Carlo Raj, MD

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