short notes on myovardial infraction

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INTRODUCTION:- It is a type of acute coronary syndrome, which
describes a sudden or short-term change in symptoms related to blood flow to
the heart. Unlike other causes of acute coronary syndromes, such as unstable
angina, a myocardial infarction occurs when there is cell death When there is
evidence of an MI, it may be classified as an segment elevation myocardial
infarction (STEMI) or Non-segment elevation myocardial infarction (NSTEMI)
based on the results of an ECG.
DEFFINATION:- Myocardial infarction is also called a “heart attack”.
Myocardial infarction (MI) refers to tissue death (infarction) of the heart muscle
(myocardium).
CAUSES:- Mainly coronary artery disesase (cholesterol plaque buildup in
the arteries, known as atherosclerosis)
- Smoking
- High Blood Pressure (158/99)
- Diabetes Mellitus
- Male Sex
- Low Levels Of Physical Activity
- PastFamily History
- Obesity
- Alcohol Use
- Diet
- Family History Of Ischemic Heart Disease
- Women who use combined oral contraceptive pills have a
modestly increased risk of myocardial infarction, especially in the
presence of other risk factors.
SIGN AND SYMPTOMS:-
1. Chest pain
a. Severe, diffuse steady substernal pain of a crushing and squeezing
nature.

3. b. No relieved by rest or sublingual vasodilator therapy, but requires
opoids.
c. May radiate to the arms (usually the left ), shoulders,neck, back,
and /or jaw, continues for than 15 mins.
e. May produce anxiety and fear, resulting in an increase in heart
rate, BP, and respiratory rate.
2. Diaphoresis, cool clammy skin (Clammy skin refers to wet or sweaty skin),
facial pallor.
3. Hyperetension or hypotension.
4. Bradycardia or trachycardia.
5. Palpitations, severe anxiety, dyspnea.
7. Disorientation, confusion, restlessness.
8. Nausea, vomiting, weakness.
DIGNOSIS:- An electrocardiogram (EKG)
 A physical examination, with special attention to your heart and blood pressure
 Blood tests for serum cardiac markers — chemicals that are released into the
blood when the heart muscle is damaged. The blood test that doctors order
most frequently to diagnose a heart attack is called troponin.
Additional tests may be needed, including:

4.  An echocardiogram — A painless test that uses sound waves to look at the
heart muscle and heart valves.
 Radionuclide imaging — Scans that use special radioactive isotopes to detect
areas of poor blood flow in the hear.
MANAGEMENT:-
1. Oxygen therapy:-
a. Usually given by nasal cannula.
b. Improves oxygenation to ischemic heart muscle.
2. Pain control:-
a. Morphine is used to relieve pain, to improve cardiac hemodynamics by
reducing preload and afterload, and to provide anxiety relief.
b. Vasodilator therapy consist of nitroglycerin administered sublingually, via
I.V., or transdermally.
c. Benzodiazepines arew used with analgesiics when anxiety complicates chest
pain and its relief.
3. Surgicalmanagement:-Emergency CABG surgery can be performed within
6 hours of evolving infarction.
4. complications:-Rhytm disturbances,
-Heart failure(with 20% to 35% left ventricle damage )
-Cardiogemnic shock
-Cardiac rupture
-Pericarditis (2 to 3 days after MI)
-Psychiatric problems – depression, personality changes.
5. Nursing management:-
1.Gather information regarding the patients chest pain:
a. nature and intensity
b. onset and duration
c. Location and radiation
2. Gather information about presence or absence of cardiac risk factors.

5. 3. identify patients social supportsystem and potential care givers.
4. Evaluate cognitive, behavioural, and emotional status.
PREVENTION:-
You can help to prevent a heart attack by:
 Exercising regularly
 Eating healthfully
 Maintaining a healthy weight
 Not using tobacco products
 Controlling your blood pressure
 Lowering your LDL cholesterol.