The document summarizes the clinical features of a myocardial infarction (MI). Key symptoms include chest pain that is more severe and longer lasting than angina pain, often described as tightness, heaviness, or constriction. Many patients experience breathlessness as their primary or only symptom. Additional symptoms can include vomiting, sinus bradycardia from vagal stimulation, and infarction occurring without physical signs in some cases. Sudden death from ventricular fibrillation or asystole may occur immediately or within the first hour.

1. BY ABDULLAH BIN MOHD SUBRI

2. CLINICAL FEATURES

3.  Pain is cardinal feature.
Usually occur at same sites as
angina but more severe and
longer.
 Often describe as tightness,
heaviness or constriction.
 Most patients are breathless
and, in some, this is the only
symptom. Indeed, MI may pass
unrecognised
 Vomiting and sinus bradycardia
are often due to vagal
stimulation and are
particularly common in
patients with inferior MI.
 Sometimes infarction occurs in
the absence of physical signs.
 Sudden death, from ventricular
fibrillation or asystole, may
occur immediately and often
within the first hour.

4. Chest pain
 Site : central part of chest / epigastrium
 Onset : at rest, sudden
 Character : heavy, squeezing, crushing, stabbing
 Radiation : radiate to left arm
 Associated symptoms : sweating, nausea, breathlessness
 Duration : >10min

5. Examples: A patient has Killip class II, SBP of 99 mmHg, heart rate of 100 beats/min, is 65 years of
age, has a serum creatinine level of 76 µmol/L, did not have a cardiac arrest at admission but did have
ST-segment deviation and elevated enzyme levels. His score would be: 20 + 53 + 15 + 58 + 7 + 0 + 28 +
14 = 195. This gives about a 16% risk of having an in-hospital death.