MYOCARDIAL

INFRACTION
BY PRERNA YADAV
NIDHI YADAV
(B.Sc NURSING 4TH YR)
 INTRODUCTION

• Meaning Myo means Muscle , Cardiac means

Heart, Infraction Means Death of tissue due to lack
of blood supply.
• It is also called Heart attack.
• It occurs when Coronary artery become blocked and
the part of myocardial muscle become dead due to
prolonged lack of oxygen supply to the muscles.
 INCIDENCE
• Incidence is highly in older age people.
• About 5% Occurs in people under age
40yr.
• Mails are at higher risk compare to
female .
• Women during reproductive period
have low risk.
• Over last 30year the rate of disease
increased from 2-6 % in rural
population and 4-12 % in urban
population.
• In 2021 total 2541 death occur in India
due to MI.
 DEFINITION

It is defined as a disease condition which is caused by reduced blood

flow in the coronary artery due to any obstruction in the coronary
artery .

It is the irreversible damage of myocardial tissue caused by prolonged

ischemia and hypoxia.
 CAUSES
• Coronary artery thrombosis.
• Coronary atherosclerosis.
• Coronary Spasm.
• Coronary artery infection.
• Trauma causing rupture in the coronary arteries.
 RISK FACTOR

• Tobacco.
• Diabetes.
• High blood pressure.
• High blood cholesterol level.
• High blood triglyceride level.
• Obesity.
• Lack of physical activity.
• Stress.
 CLASSIFICATION

• Acc to Degree of damage

Zone of
Zone of injury
infraction

Zone of
ischemia
 Zone of infraction

• Death of heart muscles.

• Complete oxygen deprivation.
• Irreversible.
 Zone of Injury

• Muscle surrounding area of nacrosis _

• Inflamed and injured but viable.
 Zone of Ischemia

• Full recovery is possible.

 CLINICAL MANIFESTATIONS
 CHEST PAIN- NOT RELIEVED BY TAKING NITROGLYCERIN AND LAST LONGER THAN 30 MINUTES
 ANXIETY AND RESTLESSNESS
 DIAPHORESIS, COOL AND CLAMMY, MOIST SKIN, FASTER THAN NORMAL HEART RATE AND
RESPIRATORY RATE
 DECREASED CARDIAC CONTRACTILITY AND INCREASED HEART RATE
 EXTREME FATIGUE
 NAUSEA AND VOMITING
 DISORIENTATION, CONFUSION, FAINTING
 DECREASED URINE OUTPUT
 FEVER
 PERIPHERAL VASOCONSTRICTION
 DIAGNOSTIC EVALUATION

• DETAILED MEDICAL HISTORY

• PHYSICAL EXAMINATION
• ELECTROCARDIOGRAM (ECG OR EKG)
• ECHOCARDIOGRAM
• ANGIOGRAPHY
• STRESS TEST
• POSITRON EMISSION TOMOGRAPHY
• CT SCAN AND MRI
• BLOOD TEST- FAT, CHOLESTEROL LEVEL
• CARDIAC BIO MALSAR – TROPONIN, CK – MB, MYOGLOBIN, C-REACTIVE,
HOMOCYSTEINE
 MANAGEMENT

MEDICAL MANAGEMENT :
•OXYGEN THERAPY- 3 LITRE BY NASAL CANNULA
•THROMBOLYTIC THERAPY – UROKINASE, STREPTOKINASE AND TISSUE PLASMINOGEN
ACTIVATORS
•ANALGESIC- MORPHINE, MEPRIDINE
•VASODILATOR DRUG - NITROGLYCERIN GTN
•ACE INHIBITOR – CAPTOPRIL
•B-BLOCKER PROPRANOLOL, ATENOLOL
•CALCIUM – NIFEDIPINE
•ANTICOAGULANT – HEPARIN, ASPIRIN
•CHOLESTEROL LOWERING AGENTS STATINS
 MANAGEMENT
SURGICAL MANAGEMENT :

•CORONARY ARTERY BYPASS SURGERY CABG

•PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY PTCA
•ATHERECTOMY