MYOCARDIAL INFARCTION

PRESENTED BY : RITIKA VERMA

BSc. Nursing (III YEAR)
SIHER College Of Nursing
Baghpat
Presentation Title
Subtitle goes here
 DEFINITION

 Myocardial Infarction is defined as diseased

condition which is caused by reduced blood
flow in a coronary artery due to atherosclerosis
[hardning of arteries] and occulsion of an artery
by an embolus or thrombus.
 Myocardial Infarction or heart attack is the
irreversible damage of myocardial tissue caused
by prolonged ischemia (reduced blood flow) and
hypoxia (absence of enough oxygen in the
tissues).
 Causes
 Tobacco , smoking
 Hypertension
 Drug abuse
 Obesity
 Stress
 Alcohol
 Age
 Gender
 Diabetes
 Hyperlipoproteinaemia
 Family history of Ischaemia Heart Disease
 Hyperhomocysteinemia
 PATHOPHYSIOLOGY
• Due to etiological factors

Obstruction in Coronary Artery

Decrease blood supply to heart

Increased demand of oxygen in heart

Difficulty in survival of cells and tissue in myocardium

Necrosis of myocardial tissue

Myocardial infarction
 Clinical Manifestation
• Chest pain/ chest discomfort
• Dyspnea
• Fatigue
 Others symptoms include :
• Increased sweating
• Weakness
• Nausea
• Vomiting
• Light headedness
• Palpitation
• Anxiety
• Sleeplessness
• Hypertension
• Hypotension
• Arrhythmia
• Chest pain in less in women their common
symptoms are weakness, fatigue and dyspnea
 SITE OF MI(MYOCARDIAL
INFARCTION)
 Most common anterior wall of left
ventricle due to thrombus in left arm.
 Posterior wall of heart due to blockage in
right coronary artery.
 Inferior wall of heart due to right coronary
artery blockage
 COMPLICATION
• Arrhythmia
• Cardiogenic shock (10%)
• Congestive heart failure
• Rupture (5%)
• Cardiac aneurism (5%)
• Pericarditis
 DIAGNOSIS
•1.Clinical features:
Pain
Indigestion
Apprehension
Shock
Low grade fever
2.Serum cardiac markers:
Creatinine phosphokinase
(CK)
Lactic dehydrogenase
(LDH)
Cardiac specific troponins
(cTn
•3.ECG changes:

ST segment elevation

 T wave inversion

appearance of wide deep Q waves.

MAGNETIC RESONANCE
IMAGING (MRI)

ANGIOGRAPHY

CHEST X- RAY
 MANAGEMENT
•1.NON-PHARMACOLOGICAL:

 Counselling and education of patients

 Life style measures

 Smoking cessation

 Avoid Alcohol intake

 Diet and nutrition

 Salt restriction
2.PHARMACOLOGICAL:
 Thrombolytic agents
 Anticoagulants
 Antiplatelet agents
 Antihypertensive agents
 Lipid lowering drugs
 Vasodialators
 Others
i) Analgesics
ii) Antiulcer drugs
iii) Antidepressants
SURGICAL MANAGEMENT

I. CABG – Coronary Artery Bypass

Grafting
II. PTCA - Percutaneous
Transluminal Coronary
Angioplasty
III. ATHERCTOMY
DIETARY MANAGEMENT
 Low fat/ cholesterol diet
 Low sodium diet
 Avoid caffeine intake
 Avoid alcohol use
 Nursing management -
ASSESSMENT-
Collect information about chest pain from
the patient.
Observe patient’s symptoms.
Take a medical history
Assess anxiety level of patient .
Assess side effect and drug effects.
 NURSING DIAGNOSIS
• Pain related to decrease blood supply to
heart .
• Anxiety related to chest pain and fear of
death.
• Decrease cardiac output related to
dysrhythmias.
• Activity intolerance related to disease
conditions.
• Altered tissue perfusion related to
infarction.
Thank you