Risk Factors MYOCARDIAL INFARCTION Potential Complications

<40 years old or male

Signs and Symptoms Arrhythmias: depolarization due to lack of
Diabetes mellitus Intense and heavy chest pain oxygen
Dyslipidemia Pain unrelieved by nitroglycerine or resting Cardiogenic Shock: Tissue granulation due to
Hypertension Radiating pain to the left arm, jaw, neck macrophages causing tissue to become unstable
Family history of MIs Shortness of breath Pericarditis: Accumulation of the neutrophils at
Tobacco Smoking Nausea and vomiting the site.
Obesity Pale, cool, clammy skin and sweating Heart Failure
Sedentary lifestyle (diaphoresis) Papillary Muscle Rupture
High Fat Diet Increase HR and BP due to SNS stimulation. Pulmonary Edema
Women: May not feel heaviness on the chest Sudden Cardiac Death

Disease Process: MI is cardiac muscle tissue death due to the lack of blood flow because of the complete occlusion in the coronary artery. The most
common cause of MI is atherosclerosis, which occurs when plaque, which is the accumulation of lipids over time, forms in the coronary artery. When plaque
accumulates in the coronary arteries, the flow of blood and oxygen to the myocardium is reduced. If the occlusion continues for an extended period of time, it
will cause chest pain and ischemia in the cardiac muscle, which will cause them to die (necrosis) if not treated within 20-40 minutes. Because of the ischemia,
muscle contractility decreases and cardiac output decreases, which stimulates the SNS and causes an increase in HR and BP.

Medical Intervention, Labs and Diagnostics Nursing Nursing Interventions

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Myoglobin ( 1-3 hr post injury): Heme protein that helps transport oxygen. Found
Diagnosis
in cardiac and skeletal muscle. Early marker but is not very specific in indicating MI. Administration of Oxygen: flow rate of
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Troponin ( 2-4 hrs post injury): Protein found in Myocardial Cells. Tropins I and T 2-4 L/min by nasal cannula. Given to
are specific for cardiac muscle making it recognized as a reliable and critical Decreased increase the circulation oxygen level.
markers for myocardial injury. Cardiac Output Monitor the Vital signs, ECG, LOC,
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CK-MB ( 4-6 hrs post injury): A cardiac-specific isoenzyme that increases when r/t blockage in heart and lung sounds: This is to be
there has been damage to the cardiac cells. the coronary able to notify the physician
EKG artery immediately if there are changes in
T-wave inversion: Because of ischemia Ineffective these datas to manage the
ST-segment elevation or depression: Sign of injury Tissue Perfusion complications
Abnormal Q wave: Absence of depolarization current r/t reduced blood Bed rest, head elevated for no >45
Morphine: To reduce pain and anxiety flow degrees: To reduce oxygen demand and
Aspirin: To slow clotting Acute Pain r/t ⬇️
chest discomfort. Also Preload,
Nitroglycerin: To dilate artery, increasing blood flow myocardial reducing heart workload.
Emergent PCI: Procedure to open the occluded artery and promote reperfusion ischemia Deep breathing exercises and position
⬇️ ⬇️
Beta Blockers: workload of the heart, slows heart rate, blood pressure. change: To maintain effective
Calcium Channel Blockers: Stops the transport of calcium into the cardiac muscle ventilation throughout the Lungs.
which dilates the coronary arteries.