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Myocardial Infarction Notes

The document discusses myocardial infarction (MI) or heart attack, including its definition, types, causes, risk factors, pathophysiology, clinical manifestations, diagnostic examinations, management, complications, and nursing management. MI occurs when myocardial tissues are abruptly deprived of oxygen due to issues like atherosclerosis or artery blockage and results in cell death of the heart muscle.

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Ashutosh Bhalerao
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489 views6 pages

Myocardial Infarction Notes

The document discusses myocardial infarction (MI) or heart attack, including its definition, types, causes, risk factors, pathophysiology, clinical manifestations, diagnostic examinations, management, complications, and nursing management. MI occurs when myocardial tissues are abruptly deprived of oxygen due to issues like atherosclerosis or artery blockage and results in cell death of the heart muscle.

Uploaded by

Ashutosh Bhalerao
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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in

Myocardial infarction (MI)


Introduction
 Myocardial infarction is an emergency and life threatening condition and also known as heart attack.
 Myocardial infarction is an irreversible damage and necrosis of myocardial tissue due to prolonged ischemia
and hypoxia.

Definition
 Myocardial infarction (MI) is defined as a permanent destruction and necrosis of myocardial tissue Due to
insufficient blood supply of myocardial tissue.
 Male have higher risk.
 MI occurs when myocardial tissues are abruptly and severely deprived of oxygen due to atherosclerosis and
occlusion of an artery.

Types of MI
1. According to infarction -

 Trans mural infarction


 Subendocardial infarction

1. According to ECG

 ST elevation MI

 Non ST elevation MI

1. A/C to anatomy

 Anterior wall MI

 Posterior wall MI
 Anterior septal wall MI
 Lateral wall MI
 Posterior septal wall MI
 Interior wall MI.

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Cause
 Coronary artery thrombosis ( most common cause )
 Coronary artery embolism
 Coronary artery plaque formation
 Vasospasm
 Coronary artery atherosclerosis
 Cocaine abuse.

Risk Factors
 Atherosclerosis
 Hypertension
 Drug abuse
 Alcohol, stress
 Obesity
 Smoking
 Diabetes
 Age, Gender
 Chronic kidney Disease
 Physical in activity
 Sedentary lifestyle
 Family history.

Pathophysiology
Etiology / cause / risk factor
↓
Abrupt blood supply to myocardial tissue and cell
↓
Insufficient oxygen supply according to demand
↓
Necrosis and ischemia of tissue
↓
Myocardial cell death
↓
Irritation myocardial nerve fibre
↓
Anatomical and physiological changes of heart
↓
Ischemic chest pain.

Clinical Manifestation

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 Sever, crushing, unbearable chest pain.


 Pain may be radiated to the neck, jaw, left arm or back.
 Dysrhythmias
 Tachycardia
 Bradycardia
 Hypertension
 Dyspnoea
 GI disturbance
 Increased sweating
 Shortness of breath
 Cyanosis
 Cold extremities
 Anxiety
 Nausea, vomiting
 Dizziness
 Palpitation
 Sleeplessness, fatigue.

Diagnostic Examination
 History collection and physical examination.
 Chest x ray and MRI.
 Angiography
 ECHO - Assess anatomy
 ECG - check heart performance

 ST - segment elevated
 T - wave inversion
 "Q" wave abnormal.

 Positron emission tomography (PET - scan).


 Thallium scan - assess necrotic tissue.
 Cardiac marker assessment (myoglobin, troponin, CPK - MB test).
 CBC.

Management
Pharmacological
 Morphine sulphate ( drug of choice )
 Nitro-glycerine
 Anticoagulants
 Vasodilators
 Thrombolytic agents
 Antihypertensive drugs
 Antiemetic
 Antiplatelet

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 Heparin
 Oxygen administer.

Non pharmacological
 Lifestyle modification
 Smoking cessation
 Salt restriction
 Exercise and yoga ( Range of motion )
 Dietary modification
 Avoid alcohol intake
 Health education
 Maintain bed rest.

Surgical Management
 Percutaneous Trans luminal coronary angioplasty (PTCA).
 Coronary artery bypass grafting (CABG).
 Median Sternotomy (open heart surgery).

MI Complication
 Dysrhythmias
 Congestive cardiac failure
 Cardiogenic shock
 Pulmonary edema
 Dressler syndrome
 Deep vein thrombosis
 Pericarditis
 Thrombophlebitis.

Nursing Management
 Nurses assess the patient's general condition and intensity of chest pain.
 Provide semi Fowler position.
 Provide oxygen therapy.
 Maintain balance between oxygen supply and demand.
 Regularly monitor cardiac function.
 The Administrator prescribed medication (morphine sulphate).
 Examine the ECG findings continuously.
 Assess patient MI complications.
 Encourage bed rest and reduce stress.

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 Provide health education and emotional support.


 Educate about follow up care.

Key Points
1. Necrosis of myocardial tissue in case of - Myocardial infarction.

1. Most common cause of MI - Coronary artery thrombosis.

1. Duration of chest pain in myocardial infarction - More than 30 minute.

1. Common manifestation of MI - Chest pain.


2. "Q" wave abnormality in ECG, indicate - Permanent changes.

1. Common complication of MI - Dysrhythmia.

1. Common position During MI - Semi Fowler position.

1. Drug of choice of MI - Morphine sulphate.

1. ECG finding in MI patient - ST segment elevated.

1. Which coronary affect in lateral wall MI - Left coronary artery.

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