Peer Reviewed
Feature Article Cardiovascular medicine

Diagnosis of acute myocardial infarction and patient risk stratification

Mohsen (mawson) Habibian, Atifur Rahman
Abstract
A 12-lead ECG is crucial in identifying patients with ST-elevation myocardial infarction (STEMI), who require rapid reperfusion therapy. Measurement of cardiac enzymes contributes to risk stratification in those with non-STEMI acute coronary syndrome to help determine appropriate management.
Key Points
  • Acute myocardial infarction (MI) can be grouped into ST-elevation and non ST-elevation MI.
  • Diagnosis of MI requires review of the patient’s symptoms and signs, ECG patterns and troponin levels.
  • Some patients do not present with the chest pain characteristic of MI; in these patients, angina-equivalent criteria need to be considered.
  • Simple risk scores such as the TIMI and HEART scores can help risk-stratify patients and determine the most appropriate treatment strategy; these scores may be useful for GPs as well as in the emergency department.

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