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    Myocardial Infarction

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    Anelle Umali
    Myocardial infarction, also known as a heart attack, occurs when blood flow to the heart is blocked, damaging heart muscle. It is usually caused by a blockage in the coronary arteries from atherosclerosis. Risk factors include high cholesterol, smoking, hypertension, obesity, stress, lack of exercise, and existing heart disease. Symptoms include chest pain, shortness of breath, nausea, and feelings of anxiety. Diagnosis involves electrocardiograms, blood tests of cardiac enzymes, and imaging tests. Treatment focuses on restoring blood flow, reducing risk factors, and rehabilitation to prevent further heart damage.

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    Myocardial Infarction

    Uploaded by

    Anelle Umali
    517 views23 pages
    Myocardial infarction, also known as a heart attack, occurs when blood flow to the heart is blocked, damaging heart muscle. It is usually caused by a blockage in the coronary arteries from atherosclerosis. Risk factors include high cholesterol, smoking, hypertension, obesity, stress, lack of exercise, and existing heart disease. Symptoms include chest pain, shortness of breath, nausea, and feelings of anxiety. Diagnosis involves electrocardiograms, blood tests of cardiac enzymes, and imaging tests. Treatment focuses on restoring blood flow, reducing risk factors, and rehabilitation to prevent further heart damage.

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    Myocardial infarction, also known as a heart attack, occurs when blood flow to the heart is blocked, damaging heart muscle. It is usually caused by a blockage in the coronary arteries from atherosclerosis. Risk factors include high cholesterol, smoking, hypertension, obesity, stress, lack of exercise, and existing heart disease. Symptoms include chest pain, shortness of breath, nausea, and feelings of anxiety. Diagnosis involves electrocardiograms, blood tests of cardiac enzymes, and imaging tests. Treatment focuses on restoring blood flow, reducing risk factors, and rehabilitation to prevent further heart damage.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    517 views23 pages

    Myocardial Infarction

    Uploaded by

    Anelle Umali
    Myocardial infarction, also known as a heart attack, occurs when blood flow to the heart is blocked, damaging heart muscle. It is usually caused by a blockage in the coronary arteries from atherosclerosis. Risk factors include high cholesterol, smoking, hypertension, obesity, stress, lack of exercise, and existing heart disease. Symptoms include chest pain, shortness of breath, nausea, and feelings of anxiety. Diagnosis involves electrocardiograms, blood tests of cardiac enzymes, and imaging tests. Treatment focuses on restoring blood flow, reducing risk factors, and rehabilitation to prevent further heart damage.

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    MYOCARDIAL INFARCTION

    MYOCARDIAL INFARCTION
    Death of myocardial tissue in regions of the heart with abrupt interruption of coronary blood supply brought about by inadequate oxygenation and is often caused by a sudden, complete blockage Characterized by localized formation of necrosis (tissue destruction) with subsequent healing by scar formation

    ETIOLOGY
    CAD Coronary vasospasm Coronary artery occlusion by embolus and thrombus Conditions decreasing perfusion such as hemorrhage and shock Hypertension Diabetes Mellitus

    RISK FACTORS
    Hypercholesterolemia Smoking Hypertension Obesity Stress Sedentary lifestyle Atherosclerotic coronary artery disease

    PATHOPHYSIOLOGY

    ASSESSMENT
    CHEST PAIN Described as severe, persistent, crushing substernal discomfort Radiates to the neck, arm, jaw and back Occurs without cause, primarily in the morning Not relieved by rest or nitroglycerin Lasts 30 mins or longer

    ASSESSMENT
    RESPIRATORY SYSTEM Dyspnea Occasional findings: rales or crackles

    ASSESSMENT
    CARDIOVASCULAR SYSTEM Initial increase in blood pressure and pulse with a gradual drop in blood pressure Occasional findings: presence of S4, pericardial friction rub, split S1 and S2 sounds

    ASSESSMENT
    OTHER MANIFESTATIONS Diaphoresis Cold clammy skin Nausea and vomiting Elevated temperature Restlessness and anxiety with s feeling of sense of doom

    DIAGNOSTIC TESTS
    ECG: ST segment elevattion, T wave inversion, and presence of Q wave Myocardial enzymes: increased Troponin T an I, CK-MB, LDH and myoglobin levels

    DIAGNOSTIC TESTS
    Blood tests: Elevated WBC count Elevated erythrocyte sedimentation rate (ESR) Elevated serum cholesterol Elevated AST (aspartate transaminase)

    Test after the acute stage: Exercise tolerance test Thalium scans Cardiac catheterization

    MANAGEMENT
    MI is a medical emergency which requires immediate medical attention. Treatment attempts to salvage as much myocardium as possible and to prevent further complications

    MEDICATIONS

    orphine xygen itroglycerin spirin

    NURSING INTERVENTIONS
    1. Monitor and improve clients cardiopulmonary state Monitor ECG and hemodynamic procedures Perform complete lung/cardiovascular assessment Monitor urinary output and report output of less than 30 ml/hr Monitor for complications especially dysrhythmias, since ventricular tachycardia can happen in the first few hours after MI

    NURSING INTERVENTIONS
    2. Minimize clients anxiety Provide information as to procedures and drug therapy Provide information as needed 3. Minimize metabolic demands Provide soft diet Provide a low sodium, low cholesterol and low fat diet

    NURSING INTERVENTIONS
    4. Provide oxygen at 2 L/min (or as ordered) to relive dyspnea and prevent arrhythmias 5. Advise bed rest in semi-Fowlers position 6. Provide other dependent nursing interventions: Assist in treatment modalities such as PTCA and CABG Administer medications Stool softener and hypolipidimics

    NURSING INTERVENTIONS
    Analgesic: Morphine sulfate (DOC) Relaxes bronchioles to enhance oxygenation Provides pain and anxiety relief Given IV (because after an infarction, there is poor peripheral perfusion and serum enzymes would be affected by IM injections) as ordered.

    NURSING INTERVENTIONS
    ACE inhibitors Prevents formation of Angiotensin II Limits the area of infarction Thrombolytics Streptokinase: reteplase and alteplase Dissolve clots in the coronary artery allowing blood to flow

    NURSING INTERVENTIONS
    7. Provide client health teaching Effects of MI, healing process and treatment regimen Medication regimen including name, pupose, schedule, dosage and side effects Risk factors with necessary life style modifications Dietary restrictions: low sodium, low cholesterol, avoidance of caffeine Importance of participation in a progressive activity program

    NURSING INTERVENTIONS
    Reporting of the following symptoms: Increase and persistent chest pain Dyspnea Weakness Fatigue Persistent palpitations Light headedness Enrollment of client in a cardiac rehabilitation program

    NURSING INTERVENTIONS
    8. After the acute episode Maintain bed rest for the first 3 days Provide passive range of motion exercises Progression of movement: Dangling of the feet at side of bed, sitting on the bed, then out on a chair for 30 minutes thrice daily Afterwards proceed with ambulation in the room, to the toilet, then to the hallway thrice a day

    NURSING INTERVENTIONS
    Cardiac rehabilatation: To extend and improve quality of life For physical conditioning

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