Some very basic cardiovascular questions...

[Stroganoff]

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How does one recognize a myocardial infarction vs. aortic dissection (or ruptured aortic aneurysm...is that the same thing?)? People are advised to take aspirin to "save themselves from a heart attack," but I've read that its blood thinning properties are counterproductive for a ruptured aorta (causing more bleeding, preventing clotting, etc.)

Same goes with recognizing the difference between an ischemic stroke vs. hemmorhagic stroke (or ruptured brain aneurysm...is that the same thing?).

Is prompt medical attention (along with imaging, EKG, etc.) the only real way to know what a pt. has?

Anyway, I am not a medical student yet but was just wondering about this. Thanks.

 

[NateatUC]

How does one recognize a myocardial infarction vs. aortic dissection (or ruptured aortic aneurysm...is that the same thing?)? People are advised to take aspirin to "save themselves from a heart attack," but I've read that its blood thinning properties are counterproductive for a ruptured aorta (causing more bleeding, preventing clotting, etc.).

This actually isn't THAT hard. The pain is different - crushing and radiating to the left arm/shoulder/jaw with MI vs. sharp, radiating to back with dissection. Not to mention the characteristic ECG changes, cardiac enzyme elevations, etc. Technically ruptured aortic aneurysm and aortic dissection are not the same thing. A ruptured aneurysm is basically the wall of the aorta weakening, ballooning out and eventually "popping". Aortic dissection is where the blood escapes through a tear in the wall and dissects between layers of the vessel wall. Lots of people still refer to dissections as "dissecting aneurysms" though, even though there really is no "ballooning" with the dissection.

As for the issue of aspirin, yes, its anticoagulant properties have been shown to help prevent heart attack. As far as complicating a ruptured aneurysm or dissection, its really not an issue since when one of those blows, the bleeding is so profuse anyway that the patient often bleeds out into their chest or abdomen. These things do NOT clot - they're under too much pressure. Think fire hose.

Same goes with recognizing the difference between an ischemic stroke vs. hemmorhagic stroke (or ruptured brain aneurysm...is that the same thing?)..

One word, OK 2 words: CT scan.

Is prompt medical attention (along with imaging, EKG, etc.) the only real way to know what a pt. has?.

In a word, yes.

 

[Seaglass]

Also, the risk of having an MI is much greater than the risk of having a ruptured aneurysm, and likewise the risk of having an ischemic stroke is much greater than having a hemorrhagic stroke. So if you are trying to change disease patterns in a large population, telling people to take an aspirin is going to prevent much more disease than it causes.

C