Myocardial

infarction
Rle 2 - burhan, cabanilla, corres, de jose, delos
reyes
 Myocardial infarction

Description Etiology
● Reduces myocardial ● Coronary artery disease
perfusion and death of heart common cause with
tissue caused by lack of plaque formation
oxygenated blood flow narrowing vessels and
● Mi is treated in er, inpatient pieces breaking off,
hospital, ccu, icu, or creating emboli.
medical unit

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 pathophysiology

“
1. Marked reduction or loss of blood flow through
one or more of the coronary arteries, resulting
cardiac muscle ischemia, and over a finite period,
resulting in necrosis.
2. Occurs most often due to CAD
3. Cellular ischemia and necrosis can affect the
heart’s rhytm, pumping action and blood
circulation
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pathophysiology

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pathophysiology

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pathophysiology

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pathophysiology

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 Signs and symptoms

● Pressure or tightness in the chest ● Nausea

● Pain in the chest, back, jaw, and ● Vomiting

other areas of the upper body that
lasts more than a few minutes or ● Anxiety
that goes away and comes back
● A cough
● Shortness of breath
● Dizziness
● Sweating
● A fast heart rate

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 Diagnostic tests
Cardiac enzymes & isoenzymes: 1. Critical & reliable marker of myocardial injury
1. Troponin 1 & troponin 2. Helps determine extent & timing of muscle
2. Creatinine kinase & isoenzyme damage
CK-MB 3. If negative, rule out MI
3. Myoglobin

Electrolytes Imbalances of sodium and potassium can alter

conduction and compromise contractility

Complete blood count Leukocytosis usually appears on the 2nd day after
acute MI due to inflammatory process

Chest x-ray Show enlarged cardiac shadow

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 Diagnostic tests

Electrocardiogram ST segment elevation

Echocardiography Reveals abnormalities in chambers, seotal, and

ventricular wall motion, blood flow, and valve
function
Magnetic resonance Abnormalities of the heart

Cardiac angiography Patency of coronary arteries, reveals abnormal

heart & valve shape, measures pressures within
each chamber of heart. Identifies location of MI.
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 “
medications

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● Aspirin
● Thrombolytics
● Antiplatelet Agents
● Other blood-thinning medications
● Pain relievers
● Nitroglycerin
● Beta blockers
● ACE inhibitors
● Statins

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 Nursing diagnosis
Activity Intolerance
Encourage bedrest to chair rest initially. Reduces myocardial workload and oxygen
Thereafter, limit activity on basis of pain or consumption, reducing risk of complication,
adverse cardiac response. such as extension of MI.
Review signs and symptoms reflecting palpitations, pulse irregularities, development
intolerance of present activity level or of chest pain, or dyspnea may indicate need
requiring notification of nurse . for changes in exercise regimen or
medication.
Record and document heart rate and rhythm To determine client’s response to activity and
and BP changes before, during and after may indicate myocardial oxygen deprivation
activity. that may require decrease in activity level.

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 Nursing diagnosis
Acute Pain
Monitor and document characteristics of Variation of appearance and behavior of
pain, noting verbal reports, nonverbal cues. clients in pain may present a challenge in
assessment. As most clients in with an acute
MI appear ill.
Instruct client to report pain immediately Delays in reporting pain hinders pain relief
and may necessitate increased dosage of
medication to achieve relief.

Administer supplemental oxygen by means Increases amount of oxygen available for

of nasal cannula or face mask myocardial uptake and thereby may relieve
discomfort associated with tissue ischemia.

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 Nursing diagnosis
Ineffective Tissue Perfusion
Inspect for pallor, cyanosis and cool or Cerebral perfusion is directly related to
clammy skin. cardiac output and is influenced by
electrolyte and acid base variations.

Encourage active or assist with passive leg Enhances venous return, reduces venous
exercises stasis and decreases risk of
thrombophlebitis.

Apply elastic compression stockings May be desired to prevent DVT.

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