Skip to Main Content

++

Condition/Disorder Synonyms

++

  • Non-ST elevation myocardial infarction (NSTEMI)

  • ST elevation myocardial infarction (STEMI)

  • Subendocardial myocardial infarction (SEMI)

  • Non-Q wave myocardial infarction

  • Acute coronary syndrome (ACS)

++

ICD-9-CM Codes

++

  • 410 Acute myocardial infarction

    • See entire list under 410

  • 412 Old myocardial infarction

    • See entire list under 412

++

ICD-10-CM Codes

++

  • I21.09 ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall

  • I21.11 ST elevation (STEMI) myocardial infarction involving right coronary artery

  • I21.19 ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall

  • I21.29 ST elevation (STEMI) myocardial infarction involving other sites

  • I21.4 Non-ST elevation (NSTEMI) myocardial infarction

  • I21.3 ST elevation (STEMI) myocardial infarction of unspecified site

  • I25.2 Old myocardial infarction

++

Preferred Practice Patterns1

++
++

Key Features

++

Description

++

  • Blood flow to a region of the heart is blocked

  • Supply does not equal demand, resulting in myocardial ischemia

  • Coronary arteries supply oxygen2

  • Without oxygen, heart cells die

  • Chest pain with or without left shoulder, jaw, neck, and teeth pain

++

Essentials of Diagnosis

++

  • Acute MI

    • Amount and time of blockage

      • Within 18 to 24 hours after MI: inflammatory response occurs because of necrosis

      • Visible necrosis is present in 2 to 4 days

    • EKG/ECG3

    • Cardiac enzymes

  • Old MI

    • EKG/ECG3

    • Echocardiogram to assess left ventricular function and ejection fraction

    • Cardiolite to assess for myocardial perfusion

    • Cardiac catheterization to assess for ejection fraction

++

General Considerations

++

  • MI can result in

    • Sudden death

    • Permanent myocardium damage

    • Valve dysfunction

    • Cardiac arrhythmias

    • Respiratory failure

    • Heart failure

    • Cardiogenic shock

    • Minimal to no myocardium damage

  • Stratification for risk of event (not specific solely to exercise)

  • Patients may have an MI without experiencing signs or symptoms (silent MI may be seen in patients who have diabetes)

  • Vital signs should be monitored before, during, and after exercise

  • Greater emphasis has been placed on wellness and prevention

++

Demographics

++

  • Heart disease is the number one cause of death in both women and men

  • Women are more likely to present with atypical symptoms compared to men

++

Clinical Findings

++

Signs and Symptoms

++

  • Acute MI

    • Chest pain, discomfort, pressure, tightness, or squeezing

    • Radiating pain, discomfort, pressure, tightness, or squeezing to the neck, throat, jaw, back, or right or left upper extremity

    • Shortness of breath

    • Excessive fatigue

    • Diaphoresis

    • Nausea/vomiting

    • Anxiety

    • Fainting

    • Wheezing

    • Abdominal ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.