Myocardial infarction refers to a dynamic process by which one or more regions of myocardium experience prolonged decrease in oxygen supply because of insufficient coronary blood flow causing necrosis of tissue.
Causes
* Occlusion of a coronary artery
* Streneous physical activity
* Emotional stress such as anger
* Exposure to cold
* Thrombus formation
Signs & Symptoms
* Chest pain radiating to one or both arms, neck and back
* Dyspnea or orthopnea
* Shortness of breath
* Anxiety
* Systolic blood pressure less than 80 mm of Hg
* Tachycardia or bradycardia
* Weakness, cold, sweat, pallor
* Palpitation
* Peripheral cyanosis
* Nausea or vomiting
Investigations
* 12 lead ECG
* Echocardiography
* Trop-I
* serum CPK-MP and (CPK)
* Lipid Profile
* ESR
Management
Medical Management
* Nitrates – help to relieve pain
* Calcium channel blockers – prevents vasodilation
* Beta-blockers
* Morphine-act as analgesics and sedatives
* Oxygen supply
* Heparin therapy
* Antiplatelet therapy
Sugical Management
* Angioplasty
* CABG
Nursing Management
* Provide proper rest
* Assess for previous health history regarding allergic medications, trauma etc
* Reassure the patient
* Monitor the vital signs
* Administer thrombolytic therapy
* Administer oxygen as required
* Assess the characteristic of chest pain including location, duration, and quality.
* Maintain intake output chart
* Instruct to avoid alcohol, smoking and physical activity
* Educate the patient to change life style and rehabilitation
Complication
* Pulmonary embolism
* Pericarditis
* Shock
* Mitral incompetence
* Heart failure
* Rupture of the heart
* Phlebothrombosis
* Angina pectoris