Question

Why patients with diabetes frequently experience atypical or silent MI? o Describe symptoms of MI that a patient with diabetes most likely to experience. • 2. What is the difference between stable and unstable angina? • 3. What changes in glucose level are expected after MI? Why? • 4. What acronym MONA stands for? • 5. Can patient take Ibuprofen instead of Aspirin when she or he experiences chest pain? • 6. How fast the patient with STEMI should undergo coronary angiography or receive thrombolytic therapy in agencies without PCI capability?

Answer 1

Why patients with diabetes frequently experience atypical or silent MI?	Due to diabetic neuropathy, which can damage nerves that control the heart
Describe symptoms of MI that a patient with diabetes most likely to experience.	Chest pain that radiates to lower jaw, neck and left arm, Nausea Vomiting Breathlessness Anxiety
What is the difference between stable and unstable angina?	Stable angina a. Occurs during physical excretion b. Chest pain starts and goes on increases / repeated in nature c. Usually short term pain less than 5 min d.Relived by medicine e. Feels like acidity or regurgitation f. Pain spreads to arms and back	Unstable angina a. Occurs when at rest, sleep and less physical excertion b. Comes as a surprise c. More severe and lasts longer d. No relief by medicine or rest e. Sudden increase in pain and spreads to arms lower jaw, back of chest, under the arm
What changes in glucose level are expected after MI? Why?	Autonomic neuropathy may predispose to infarction and result in atypical presenting symptoms in the diabetic patient, making diagnosis difficult and delaying treatment. The glucose levels increase as there is increase in corticosteroids Pro-inflammatory mechanisms may contribute to hyper-glycaemia-in acute myocardial infarction
What acronym MONA stands for?	M- morphine O- oxygen N- Nitrates A- aspirin
Can patient take Ibuprofen instead of Aspirin when she or he experiences chest pain?	No, if the chest pain is because of underlying heart disease, Ibuprofen may cause arrhythmias.
How fast the patient with STEMI should undergo coronary angiography or receive thrombolytic therapy in agencies without PCI capability?	90 minutes of first medical contact should be treated with thrombolytic therapy.