Acute & emergency · UKMLA & AKT

Myocardial infarction

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise myocardial infarction — the full SA Note notes add investigations, management, complications and 10 practice questions.

Key high-yield points

  • Central crushing chest pain - severe, radiating to left arm/jaw/back; not relieved by GTN
  • Diaphoresis, nausea and vomiting - particularly with inferior MI (vagal activation)
  • Atypical presentations - epigastric pain, fatigue, syncope, or silent MI - more common in diabetics and elderly

A normal resting 12-lead ECG does NOT exclude ACS - up to 30% of patients with ACS have a normal or non-diagnostic ECG at presentation. Serial ECGs and troponin are essential.

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