Define | Etiology | Risk Factor | Pathophysiology | Sign and Symptoms | Diagnostic Evaluation | Early Management | Late Management | Nursing Management |
Myocardial Infarction or Heart Attack
*What is the definition of myocardial infarction?
M.I. is defined as Damage or Death of myocardial muscle due to Abrupt blood flow to the Heart. the blockage may be caused by the formation of thrombus in the coronary artery, a sudden progression of atherosclerosis, prolong narrowing of arteries.
*What is the Etiology of myocardial infarction?
- arteries prolong narrowing
*What are the risk factors of myocardial infarction?
- genetic cardiac disorder
- alcohol consumption
- diet – like high cholesterol, high fat
- activity – low physical exercise
*Explain the pathophysiology or what is the pathophysiology of myocardial infarction?
- due to etiological factor
- myocardial ischemia
- decrease myocardial oxygen supply
- increase cellular hypoxia
- decrease myocardial contractility
- decrease arterial pressure
- stimulation of baroreceptor and chemo-receptor sympathetic response
- increase myocardial contractility
- increase heart rate
- increase myocardial oxygen demand further myocardial ischemia
- necrosis of myocardial cells
- myocardial infarction or Heart Attack
*what are the clinical manifestation of myocardial infarction?
- severe chest pain(more than angina pectoris )
- pain may radiant to the chest, shoulder, neck, jaw, back
- unexplained anxiety
*Write the diagnostic evaluation of myocardial infarction?
ECG (elevated S & T segment)
laboratory test: serum creatinine kinase, myoglobin, cardiac troponin, ESR, (all level is increased)
*Write the complete management of myocardial infarction?
- morphine sulfate
- Anti-hematic: Domperidone, Alizapride
- Acute de perfusion therapy
- Primary percutaneous coronary intervention
- Maintaining vessel potassium
- Adjunctive therapy
- lifestyle modification: Diet control, stop smoking, regular exercise
- Secondary prevention: Anti-platelets, beta-blocker
The probable nursing diagnosis will be :
- pain related to an imbalance in oxygen supply and demand.
- Anxiety-related to chest pain, fear of death, threatening environment.
- Decrease cardiac output related to impaired contractility.
- Activity intolerance related to insufficient oxygenation to perform ADL and deconditioning effect of bed-rest.
- The risk for injury related to the dissolution of the protective clot.