What are typical versus an atypical Myocardial infarction. Please reference.

What are typical versus an atypical Myocardial infarction. Please reference.

Non-ST segment elevation myocardial infarction and ST segment elevation myocardial infarction

 Typical Myocardial Infarction:

 Presentation:

 Symptoms: Some of the signs are severe, ‘squeezing’ chest pain or discomfort which may be aggravated in the left arm, neck or jaw. This is usually a throbbing discomfort that does not go for less than five minutes, although it can be constant; it may be associated with breathlessness, excessive sweating, vomiting, or fainting.

 Pain Description: Chest pain is usually characterised as a pressure, a squeezing, weight on the chest.

 Risk Factors:

 Some of the potential risks are; coronary artery disease, hypertension, hyperlipidemia, diabetes, smoking, and history of cardiac disorder in the family.

 Diagnostic Criteria:

 Electrocardiogram (ECG): Elevation of the ST-segment greater than 1 mm in > 2 contiguous leads or changes in leads V1-V4 or ST-segment deviation greater than 0. 5 mm in XII, III and aVF.

 Biomarkers: Abnormal troponins (e. g. , troponin I or T), creatine kinase-MB (CK-MB).

 Reference:

 American Heart Association (AHA). (2020). The Guideline for the Management of Patients With ST-Elevation Myocardial Infarction That Incorporates Professional Society and Society for Cardiovascular Angiography and Interventions AACV Recommendations Published in 2020 by the American College of Cardiology and the American Heart Association.

 Atypical Myocardial Infarction:

 Presentation:

 Symptoms: Symptoms may be less classical and comprise atypical or less typical pain or discomfort such as, epigastric pain, generalized discomfort in the back or any kind of abdominal pain. It can be more amorphous, less severe and express in the form of weak signs or symptoms that may not be typical for the particular disease.

 Pain Description: May include pleuritic pain, sternal or epigastric pain, This pain may be sharp or stabbing in nature or else the pain may be located in locations that are atypical to MI.

 Risk Factors:

 This may be explained by the fact that atypical MI may present in those with less traditional risk factors or with atypical gender and age or with some coexisting conditions. For example, the manifestations of malaria in women, the elderly and diabetic patients are different from those of other patients.

 Diagnostic Criteria:

 Electrocardiogram (ECG): May not have the classical ST-segment elevation; the ST segment may be depressed or it may not be changed at all.

 Biomarkers: There could be ongoing elevation of cardiac biomarkers, although patients may not present the classical symptoms of MI.

 Reference:

 Kotecha, D. , S. Panwar, and J. Wang. “Adolescents’ Social Media Use: Where Are We?” Journal of Adolescent Health 63, no. 4 (2018): 377–9. Out of all the articles reviewed in this paper, only one is specifically focused on the prevalence and the prognostic impact of atypical symptoms in myocardial infarction.

 Summary:

 The most usual Clinical manifestation of Typical MI is chest pain that is usually severe and is coupled with demonstrative changes in the ECG and elevated cardiac biomarkers.

 AMI has mild manifestations compared to STEMI, may occur in special groups of patients (women, the elderly) and may require a more step-by-step assessment as indicated despite ambiguous features.