Transcript Myocardial infarction

Myocardial infarction
My objectives are:
• Define MI or heart attack
• Identify people at risk
• Know pathophysiology of MI
• Know the sign & symptom
• Learn the way that diagnoses MI
• Identify treatment that given to person who has
MI
What is heart attack or MI
……???
• Its the death of apportion of heart muscle
in an area where there is sudden loss of
blood supply.
Introduction
• Myocardial infarction is the most common
disease which spread in this world it must
take more important as subject to know
about it
Myocardial Infarction
Causes
• Chest pain
• resulting in rapid& disorganized heart beat
(ventricular fibrillation(
• electrical instability of heart muscle tissue
Pathophysiology
• Caused by a complete block of a coronary
artery by a blood clot forming This block
related to accumulation of fat on the wall
of the blood vessel
• Increase demand for O2
• Decrease oxygen supply
• Sudden constriction of coronary artery
Signs & symptoms
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Severe chest pain
Increase B.P or decrease B.P
Tachycardia,bradycardia ,dyshythmia
Shortness of breathing
,dyspnea,tachypnea,pulmonary edema
• Decrease U .O
• Nausea and vomiting
Signs & symptoms
• Anxiety , fear, headache, visual
disturbances, altered speech
• Skin cool, clammy, pale ,diaphoresis,
moist skin
Classification of M.I
• The location of the injury mostly to the left
ventricular wall
• Anterior v3, v4
• Inferior L2 ,L3, AVF
• Posterior or lateral wall L1,AVL.V 6,or V5
Diagnoses of M.I
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ECG (electrocardiogram)
Laboratory test : cardiac enzyme
Creatinine kinase (ck) isoenzymes
CK_MB(heart muscle)
Troponin : regulate the myocardial
contractility
• LDH
Risk factor
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Smoking
Lack of exercise
Hyper lipidemia
Obesity
Diabetes
Stress
Hypertension
Medical management for
M.I
• M.I can treat by open the blocked artery &
restore blood flow to the affected area of
the heart muscle by :
• Reperfusion : established in the first 4_6
hrs of heart attack by using (percutanous
transluminal coronary angioplasty (PTCA)
or thrombolytic medication:
Pharmacological Treatment
• Streptokinase
• Increase amount of plasminogen activator
clump & clot
• Increase amount of blood circulation
• ATP
• ACE Inhibitor
Pharmacological Treatment
Antiplatelets medicine like aspirin to reduce
tendency of platelets in the blood to
clump&clot.
Nitroglycerine: vasodilator.
Complications
Heart block.
Acute pulmonary edema.
Cardiogenic shock
Congestive heart failure (CHF).
Myocardial rupture.
Pericardial effusion & cardiac temponade.
Nsg process for pt with MI
assessment
A systemic assessment include careful
history , particularly as it related to
symptom. Each symptom must be
evaluated with regard to time , duration ,
factors that precipitate the symptom and
relieve it
Nsg diagnosis
1. Ineffective cardiopulmonary perfusion
related to reduced coronary blood flow
2. Potential impaired gas exchange related
to fluid overload from L.V
3. Potential altered peripheral tissue
perfusion related to decreased cardiac
output
4. Anxiety related to fear of death
Nsg diagnosis
The major goals of the pt include relief the
pain , prevention of further myocardial
damage , absence of respiratory
dysfunction , reducing anxiety and
absence of recognition of complications
Nsg interventions
1. Relieve pain and other symptom of
ischemia : collaboration among the pt ,
nurse and physician is critical in assessing
the pts response to therapy
2. Improving respiratory function :
encouraging the pt to breathe deeply and
change position frequently helps keep fluid
from pooling in the bases of the lungs.
Nsg interventions
3. Promoting adequate tissue perfusion
checking skin temp and peripheral pul
frequently is important to ensure adeq
tissue perfusion
Evaluation
Expected pt outcomes may include
1. Relief of angina
2. No signs of respiratory difficulties
3. Adequate tissue perfusion
4. Decreased anxiety
5. Absence of complications
Summary
Myocardial infarction is the process by which
area of myocardial cells in the heart are
permanently destroy and death due to
sudden loss of blood supply
MI maybe was: 1- anterior :V3,V4
2- inferior II III AVF
3-lateral: V6.V5.AVL
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Summary
MI caused sever chest pain radiation in Lt
arm and lower jaw ,short of breathing,
nausea, vomiting , tachy-bradycardia
diaphoresis , anxiety , pale , dysrhythmia ,
fear .
The key of tools for diagnosis MI was ECG
which indicate may change in waves and
cardiac enzyme and history
Summary
Medical treatment was try to open blocked
artery and restore blood flow to affected
area and preventing future damage and
complication.
The thrombolytic medication : streptokinase
, morphine , aspirin , nitroglycerine.
NSG intervention to relief chest pain give
good care put him in semi sitting position
Summary
• O2 mask apply if necessary
MI cause fatal disease which should b
treated immediately to prevent any
complication may be happened such a
heart block ,acute pulmonary edema ,
CHF