Myocardial Infarction (MI)

Myocardial Infarction (MI)

A heart attack is a life-threatening condition that occurs when blood flow to the heart muscle is abruptly cut off, causing tissue damage. This is usually the result of a blockage in one or more of the coronary arteries. It occurs as a result of sustained ischemia, causing irreversible myocardial cell death (necrosis). 80% to 90% of all acute Myocardial Infarctions (MIs) are secondary to thrombus formation. Acute myocardial infarction is the medical name for a heart attack.

Definition

Myocardial infraction refers to a dynamic process by which one or more regions of the heart experience a severe and prolonged decrease in oxygen supply because of insufficient coronary blood flow, subsequently necrosis or death to the myocardial tissue occurs.

Types

1. Non-ST segment elevation myocardial infarction or heart attack (NSTEMI)

2. ST segment elevation myocardial infarction or heart attack (STEMI).

Causes And Risk Factors

·               Bad cholesterol, Saturated fats, Trans fat - intake

·              Obesity - cause of 20% cases

·              Genetics

·              High Blood Pressure (hypertension)

·              High Triglyceride level

·              Diabetes and high blood sugar level

·              Smoking causes above 36% cases

·              Lack of exercise linked 7 to 12% cases

·              The use of certain illegal drugs including cocaine and amphetamines

·              A history of preeclampsia or high Blood pressure during pregnancy

Signs and Symptoms

The classic symptoms of a heart attack are chest pain and shortness of breath, the symptoms can be quite varied.

The most common symptoms of a heart attack include:

·              Prolonged cardiac pain (severe, sharp stabbing, radiating to neck, shoulders and back)

·              Breathlessness

·              Collapse / Syncope / Fainting

·              Pallor

·              Hypotension (or) Hypertension

·              Disorientation

·              Sweating

·              Anxiety

·              Tachycardia

·              Nausea and Vomiting

Diagnosis

·               ECG (Electro Cardio Gram)

·              X-ray Chest.

·              Serum Cardiac Markers Blood tests such as Troponin and Creatine KinaseMB (CK-MB).

·              Angiogram with coronary catheterization to look for areas of blockage in the arteries.

·              Echocardiography

·              Coagulation Studies

·              Nuclear imaging

Medical Management

·              Made the patient in a comfortable bed and provide complete bed rest

·              Administration of oxygen

·              Starting IV line

·              Monitoring ECG

·              Administration of analgesics (opiates)

·              Oral antianginal drug.

·              Thrombolytic therapy.

·              Anti-coagulants.

·              B-adrenergic receptor antagonist.

·              Anti-arrhythmic.

·              Antiplatelet.

Surgical Management

·              Percutaneous Transluminal Coronary Angioplasty (PTCA)

·              Coronary Artery Bypass Grafting (CABG)

Nursing Management

·              Vital Signs

·               Provide comfortable bed.

·              Oxygen administration

·              Start Intra Venous (IV) line

·              Intake and output chart

Complications

·              Thromboembolism

·              Dysrhythmias

·              Heart failure

·              Cardiogenic shock

·              Papillary muscle dysfunction leads to mitral regurgitation

·              Ventricular Aneurysm

·              Pericarditis

·               Acute Circulatory failure