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Differential Diagnostic of ST Elevation Miocard Infarct

1. Unstable Angina :

>Most commonly presents with chest pain and/or shortness of breath, although typical symptoms

may be present.

>Initial risk stratification and management depends on the clinical features and ECG.>ECG typically shows ST segment depression and T-wave inversion, but may be normal.

>Acute management includes antiplatelet and antithrombotic therapy to reduce the extent of

myocardial damage and complications.

>Long-term management includes reduction of risk factors and medication to prevent recurrence.

2. Non STEMI :

Part of the acute coronary syndrome spectrum. Caused by a partial or near-complete

thrombosis or embolisation of a coronary artery resulting in compromised blood flow to

myocardium with subsequent myocardial injury.

Patients typically present with chest pressure/discomfort lasting at least several minutes,

accompanied by sweating, dyspnoea, nausea, and/or anxiety.

Symptoms are indistinguishable from those of unstable angina. However, non-ST-elevation

MI is differentiated from unstable angina by a rise of cardiac markers and/or ischaemic ECG

changes.

ECG is the first-line investigation in all patients and should not be delayed for history,

examination, or other tests.

Early stratification and treatment with anti-ischaemic (beta-blockers, nitrates), anti-

coagulant (heparin), and antiplatelet agents (aspirin and clopidogrel) is needed. Higher-risk

patients should be considered for an early invasive strategy (coronary angiography and

revascularisation in

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5. Pneumothorax

Patients present with sudden onset of pleuritic chest discomfort and SOB.

Tachycardia, hypotension, and cyanosis suggest a tension pneumothorax.

Known underlying medical conditions that predispose to pneumothorax, such as chronic

obstructive pulmonary disease, connective tissue disease, or recent chest trauma, may

support this diagnosis.

6. Myocarditis

Patients often have a recent history of influenza-like illness or underlying autoimmune

condition such as SLE.

They are likely to be young and often do not have risk factors for CAD.

Myocarditis is more likely to present with symptoms of cardiac failure than with chest pain.