1. Non-ST Segment Elevation Myocardial Infarction (NSTEMI)
   1. Pathophysiology
      1. Complete occlusion of minor coronary artery
      2. Partial occlusion of major coronary artery
      3. Result is partial thickness damage of the myocardium/heart muscle
   2. Symptoms
      1. Presents clinically the same as STEMI
      2. Chest pain
      3. Nausea
      4. Vomiting
      5. Diaphoresis
      6. Dyspnea
   3. ECG Findings
      1. ST-segment depression or T-wave inversion
      2. DOES NOT show ST segment elevation in ECG (due to partial thickness injury of heart muscle)
      3. DOES NOT progress to a Q-wave
   4. Cardiac Markers
      1. Often mild elevation compared to STEMI
      2. Elevated CK-MB
      3. Elevated Trop I and Trop T
   5. Diagnosis
      1. History
      2. No ST segment elevation on ECG
      3. Elevated serum cardiac markers
   6. Complications
      1. Cardiogenic shock
      2. Left ventricular failure
      3. Mitral regurgitation
      4. Cardiac tamponade
   7. Treatment
      1. Antiplatelets
      2. Anticoagulants
      3. Beta-blockers
      4. Statins
      5. ACE Inhibitors
      6. ARBs
      7. PCI or Coronary Artery Bypass Grafting (CABG) (medium-high risk patients)
      8. Drug treatment for those with low risk
      9. FYI - thrombolytic therapy is harmful in NSTEMI patients (increased risk for reinfarction)
2. ST Segment Elevation Myocardial Infarction (STEMI)
   1. Pathophysiology
      1. Full thickness damage to myocardium/heart muscle
      2. Complete occlusion of major coronary artery
   2. Symptoms
      1. Presents clinically the same as NSTEMI
      2. Chest pain
      3. Nausea
      4. Vomiting
      5. Diaphoresis
      6. Dyspnea
   3. ECG Findings
      1. ST segment elevation in ECG (due to full thickness injury of heart muscle)
      2. later progress to a Q-wave
      3. ST-segment elevation, pathological Q-wave formation and T-wave inversion
   4. Cardiac Markers
      1. Often more elevated compared to STEMI
      2. Elevated CK-MB
      3. Elevated Trop I and Trop T
   5. Diagnosis
      1. History
      2. ST segment elevation on ECG
      3. and elevated serum cardiac markers
   6. Complications
      1. Cardiogenic shock
      2. Left ventricular failure
      3. Mitral regurgitation
      4. Cardiac tamponade
   7. Treatment
      1. Antiplatelets
      2. Anticoagulants
      3. Beta-blockers
      4. Statins
      5. ACE Inhibitors
      6. ARBs
      7. Percutaneous Coronary Intervention (PCI)
         1. Goal is within 120 minutes of diagnosis
         2. Thrombolytic therapy if beyond 120 minutes