AL

INFARCTIO
N
 General Objective

At the end of the class students will be able to gain knowledge

about myocardial infarction and its management.
 SPECIFIC OBJECTIVES
At the end of the class students will be able to:
1. Define Myocardial Infarction

2. Enlist the causative and risk factors for MI

3. Discuss about the pathophysiology of myocardial infarction
4. Enlist the various clinical manifestations of MI
5. Discuss about the different assessment and diagnostic methods for MI
6. Enlist about the medical and surgical management of MI
7. List the nursing diagnoses.
8. Explain about the nursing management and discharge planning for
patients with MI
 Definition
Myocardial Infarction is the
death of heart tissue caused by
the lack of oxygenated blood
flow
 CAUSES OF MI
Rupture of Vasospasm of
atherosclerotic coronary artery
1 plaque 2

Decreased oxygen Increased demand

supply for oxygen
3 4
 RISK FACTORS FOR MI

1 2 3
AGE TOBACCO USE HIGH BP

4 5 6
HIGH DIABETES FAMILY HISTORY
CHOLESTEROL, MELLITUS
OBESITY
PATHOPHYSIOLOGY
 CLINICAL MANIFESTATIONS
Cool,
pale and
Anxiety
moist
skin

Shortening of Chest Pain,

breath, Tachycardia
Tachypnea

Nausea Indigestion
Diagnostic Methods
Electrocardiogram (ECG)
A recording of the electrical activity
of the heart using leads attached in
the body
 LAB TESTS
Troponin T
Protein found in myocardial cells,
Remains elevated for as long as 2 weeks

Creatine Kinase MB
It’s a cardiac specific isoenzyme,
It begins to increase within a few hours and peaks
within 24 hours of infarction

Myoglobin
It’s a heme protein,
It starts to increase within 1 to 3 hours and peaks within 12 hours
Angiography
Imaging studies
 Medical Management
1. Rapid transit to hospital
2. 12 lead ECG within 10 minutes
3. Lab blood specimen of biomarkers
4. Other diagnoses
5. Routine medical interventions
• Relief of acute ischemic pain –MONA (morphine, oxygen, nitrates,
Aspirin)
• Prevent coronary artery clot formation (antiplatelet drugs,
antithrombin drugs etc.
• Decrease myocardial workload – beta blockers,calcium channel
blockers
• Prevention recognition and treatment of dysthymia- beta blockers
Percutaneous transluminal
coronary angioplasty (PTCA)
CORONARY ARTERY BYPASS GRAFT
(CABG)
 NURSING DIAGNOSIS
1. Acute pain related to increased myocardial oxygen
demand and decreased myocardial oxygen supply
2. Risk for decreased cardiac tissue perfusion related to
reduced coronary blood flow
3. Risk for imbalanced fluid volume
4. Risk for ineffective tissue perfusion related to
decreased cardiac output from left ventricular
dysfunction
5. Anxiety related to cardiac event and possible death
6.Deficient knowledge about self care
Nursing Management

1. Initial management
2. In patient management
3. Long term management
Long term Management
(Cardiac rehabilitation)

1. Physical activity
2. Body weight
3. Nutrition
4.Psychosocial
5. Smoking cessation
6.Adherance to medication
and follow up
THANKYOU