Myocardial Infraction

Subject: Medical and Surgical Nursing I (Theory)

Overview

Myocardial infarction, another name for a heart attack, can be fatal. A blood clot in a coronary artery, a blood vessel that supplies blood to a portion of the heart muscle, frequently causes a heart attack. Its causes include low blood pressure, coronary artery vasospasm, abrupt blood loss, anemia, and prinzmentals variant angina. Fullness, nauseousness, heartburn, shortness of breath, perspiration or a cold sweat, dizziness, and other sensations are some of its signs and symptoms. Some of its treatments include high flow oxygen, IV access, IV analgesia, and antiemetics. The patient may experience complications like pericarditis, left ventricular failure, and ventricular arrhythmia.

Myocardial infarction

Definition

A blood clot in a coronary artery, a blood vessel that supplies blood to a portion of the heart muscle, frequently causes a heart attack. A portion of the heart muscle may be harmed or even destroyed by the interruption in blood flow that takes place during a heart attack.

Myocardial infarction, another name for a heart attack, can be fatal. Over time, there has been a significant improvement in heart attack treatment. If you believe you may be having a heart attack, it's critical to recognize symptoms as soon as possible and seek emergency medical attention by dialing 911.

Causes

  • Vasospasm of coronary artery _ prinzmentals variant angina
  • Decreased oxygen supply _ acute blood loss anemia,low BP
  • Increased demand for oxygen _ rapid heart rate, thyrotoxicosis,ingestion of cocaine.

Risk factor

  • Non modifiable : Family history, increasing age, sex ( 3 times more in men )
  • Modifiable: High blood cholesterol level,smoking, tobacco,DM, HTN, obesity

Symptoms

Common heart attack symptoms include:

  • Fullness, nauseousness, indigestion, and heartburn
  • Breathing difficulty
  • A cold sweat or perspiration
  • Anxiety or a sense of impending disaster
  • Fatigue
  • Difficulty sleeping
  • Dizziness or lightheadedness

Diagnosis

  • ECG
  • Troponin
  • Myoglobin
  • LHD
  • Increased CPK - MB
  • Leukocytosis: appears on the second day after MI and disappear in 1 week.

Management 

  • High flow oxygen.
  • IV access
  • IV analgesia and antiemetics
  • Serial ECG Monitoring
  • IV analgesia : 5-10 mg morphine with metaoclopramide 10 mg.
  • Avoid intramuscular injection.
  • It has been demonstrated that thrombolytic treatment increases MI survival rates.
  • Angiography is crucial for determining the severity of coronary disease.
  • Anti-coagulants include oral aspirin and subcutaneous heparin (12,500 units twice daily).
  • Angiography is crucial for understanding the severity of coronory disorders.
  • Beta blocker: Intravenous beta blockers enhance short-term mortality and lower arrhythmias. Avoid if you have heart block, bradycardia, or failure.

Nursing intetvention

  • To find ischemia, injury new or prolonged infarction, arrhythmia, and conduction problems, monitor the ECG results.
  • To track treatment response and spot issues, keep track of your vital signs and hemodynamic variables.
  • To increase the heart's ability to receive oxygen, administer oxygen as directed.
  • When experiencing severe pain, get an ECG reading to rule out myocardial ischemia, injury, or infraction.
  • Maintain the patient's recommended diet to lower cholesterol levels and fluid retention.
  • Relieve the patient's anxiousness because it raises oxygen consumption.
  • If postoperative care is required, do so to prevent complications and aid in the patient's full recovery.

Nursing diagnosis

  • Chest discomfort brought on by an imbalance in oxygen supply and demand.
  • possible arrhythmias caused by a drop in cardiac output.
  • respiratory problems brought on by a drop in CO.
  • His illness is exacerbated by anxiety and fear of dying.
  • intolerance for activity under restrictions.
  • Risks associated with thrombolytic treatment.

Complications

  • Left ventricular failure
  • Ventricular arrhythmia
  • Papillary miscle rupture
  • Pericarditis
  • Post MI angina
  • Ventricular aneurism

References

  • Mandal, G. (August 2013). A Textbook of Adult Health Nursing (2nd ed.). Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013
  • https://prezi.com/_jivuexnkr0l/coagulation-heart-attack/
  • http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/cardiology/complications-of-acute-myocardial-infarction/
  • patient.info/doctor/complications-of-acute-myocardial-infarction
  • www.gla.ac.uk/media/media_115009_en.pdf
Things to remember
  • Known also as a myocardial infarction, a heart attack
  • A portion of the heart muscle may be harmed or even destroyed by the interruption in blood flow that takes place during a heart attack.
  • Increased oxygen consumption due to a fast heartbeat, thyrotoxicosis, and cocaine use.
  • Fullness, nauseousness, indigestion, and heartburn
  • It has been demonstrated that thrombolytic treatment increases MI survival rates.
  • Family history, advancing age, and sex are non-modifiable factors ( 3 times more in men )
  • Beta blocker: Intravenous beta blockers enhance short-term mortality and lower arrhythmias.
Questions and Answers

A blood clot that is blocking the flow of blood via a coronary artery, a blood vessel that supplies blood to a portion of the heart muscle, is what often causes a heart attack. A portion of the heart muscle may be damaged or even destroyed by the interruption in blood flow that takes place during a heart attack.

Myocardial infarction, another name for a heart attack, can be deadly. Over time, there has been a significant improvement in heart attack treatment. If you believe you may be having a heart attack, it's critical to recognize symptoms as soon as possible and seek emergency medical attention by dialing 911.

 

Causes

  • A coronary artery spasm,
  • Angina prinzmentals variation,
  • Lower oxygen levels,
  • Low BP, anemia, and abrupt blood loss,
  • A rise in the need for oxygen,
  • Rapid heartbeat, thyrotoxicosis, and cocaine consumption.

Symptoms

Common heart attack symptoms include:

  • A feeling of fullness, nausea, indigestion, heartburn,
  • Shortness of breath,
  • Sweating or a cold sweat,
  • Feelings of anxiety or an impending sense of doom,
  • Fatigue,
  • Trouble sleeping,
  • Lightheadedness or dizziness.

 

Nursing Intetvention

  • To find ischemia, damage new or prolonged infarction, arrhythmia, and conduction problems, monitor the ECG results.
  • To track treatment response and spot issues, keep track of your vital signs and hemodynamic variables.
  • To increase the heart's ability to receive oxygen, provide oxygen as directed.
  • When experiencing severe discomfort, get an ECG reading to rule out myocardial ischemia, injury, or infraction.
  • Maintain the patient's recommended diet to lower cholesterol levels and fluid retention.
  • Relieve the patient's anxiousness since it raises oxygen consumption.
  • If postoperative care is required, do so to prevent problems and aid in the patient's full recovery.

Nursing Diagnosis

  • Chest pain brought on by an imbalance in oxygen supply and demand.
  • Possible arrhythmias caused by a drop in cardiac output.
  • Respiratory problems brought on by a drop in CO.
  • Fear of dying and anxiety contributed to his condition.
  • Activity intolerance linked to enforced restrictions.
  • The possibility of thrombolytic treatment problems.

Complications

  • Failed left ventricle,
  • Arrhythmia ventricular,
  • Rupture of the papillary muscle,
  • The pericarditis.
  • After MI, angina,
  • Aneurism in the ventricle.

Myocardial Infarction

Definition

A blood clot that is blocking the flow of blood via a coronary artery, a blood vessel that supplies blood to a portion of the heart muscle, is what often causes a heart attack. A portion of the heart muscle may be damaged or even destroyed by the interruption in blood flow that takes place during a heart attack.

Myocardial infarction, another name for a heart attack, can be deadly. Over time, there has been a significant improvement in heart attack treatment. If you believe you may be having a heart attack, it's critical to recognize symptoms as soon as possible and seek emergency medical attention by dialing 911.

Causes

  • Vasospasm of coronary artery,
  • Prinzmentals variant angina,
  • Decreased oxygen supply,
  • Acute blood loss anemia,low BP,
  • Increased demand for oxygen,
  • Rapid heart rate, thyrotoxicosis,ingestion of cocaine.

Risk Factor

  • Non Modifiable: Family history, increasing age, sex ( 3 times more in men )
  • Modifiable: High blood cholesterol level,smoking, tobacco,DM, HTN, obesity

Symptoms

Common heart attack symptoms include:

  • A feeling of fullness, nausea, indigestion, heartburn.
  • Shortness of breath.
  • Sweating or a cold sweat.
  • Feelings of anxiety or an impending sense of doom.
  • Fatigue.
  • Trouble sleeping.
  • Lightheadedness or dizziness.

Diagnosis

  • ECG,
  • Troponin,
  • Myoglobin,
  • LHD,
  • Increased CPK - MB,
  • Leukocytosis: appears on the second day after MI and disappear in 1 week.

Management

  • High flow oxygen.
  • IV access.
  • IV analgesia and antiemetics.
  • Serial ECG Monitoring.
  • IV analgesia : 5-10 mg morphine with metaoclopramide 10 mg.
  • Avoid intramuscular injection.
  • Thrombolytic therapy has been shown to improve survival rates in MI.
  • Angiography provides essential knowledge of the extent of coronary disease.
  • Anti coagulants : subcutaneous heparin 12500 units twice daily with addition to oral aspirine.
  • Angiography provides essential knowledge of the extent of coronory diseases.
  • Beta blocker; intravenous beta blockers reduce arrhythmias and improve short term mortality. Avoided if heart failure, bradycardia or heart block.

Nursing Intetvention

  • To find ischemia, damage new or prolonged infarction, arrhythmia, and conduction problems, monitor the ECG results.
  • To track treatment response and spot issues, keep track of your vital signs and hemodynamic variables.
  • To increase the heart's ability to receive oxygen, provide oxygen as directed.
  • When experiencing severe discomfort, get an ECG reading to rule out myocardial ischemia, injury, or infraction.
  • Maintain the patient's recommended diet to lower cholesterol levels and fluid retention.
  • Relieve the patient's anxiety because it raises oxygen consumption.
  • If postoperative care is required, do so to prevent complications and aid in the patient's full recovery.

Nursing Diagnosis

  • Chest pain brought on by an imbalance in oxygen supply and demand.
  • Possible arrhythmias caused by a decrease in cardiac output.
  • Eespiratory problems brought on by a drop in CO.
  • His illness is exacerbated by anxiety and dread of dying.
  • Intolerance for activity under restrictions.
  • Risks associated with thrombolytic treatment.

Complications

  • Left ventricular failure,
  • Ventricular arrhythmia,
  • Papillary miscle rupture,
  • Pericarditis,
  • Post MI angina,
  • Ventricular aneurism.

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