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Myocardial Infarction | Pathology USMLE Step 1
Explore the intricate pathology of myocardial infarction (MI) in this comprehensive overview tailored for USMLE Step 1 preparation. MI, commonly known as a heart attack, occurs due to the occlusion of a coronary artery, leading to ischemia and subsequent necrosis of myocardial tissue. The process typically begins with the rupture or erosion of an atherosclerotic plaque, followed by the formation of a thrombus that obstructs blood flow to a portion of the heart. Clinically, MI presents with chest pain or discomfort, diaphoresis, dyspnea, nausea, and other signs of sympathetic activation. Diagnostic evaluation includes electrocardiography (ECG) showing characteristic ST-segment elevation or depression, cardiac biomarkers such as troponin, and imaging modalities like echocardiography or coronary angiography to assess myocardial function and coronary anatomy. Management involves prompt reperfusion therapy with thrombolytics or percutaneous coronary intervention (PCI) to restore blood flow and limit infarct size, along with adjunctive pharmacotherapy including antiplatelet agents, beta-blockers, ACE inhibitors, and statins to reduce ischemic injury and prevent recurrent events. Understanding the pathophysiology, clinical manifestations, diagnostic criteria, and management principles of MI is essential for medical students preparing for board exams and future clinical practice.๐
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