Analgesia and anti-emetics The pain of myocardial infarction is usually severe and requires potent opiate analgesia. Intravenous diamorphine 2.5–5 mg (repeated as necessary) is the drug of choice and is not only a powerful analgesic but also has a useful anxiolytic effect.
What is myocardial infarction treatment?
Myocardial Infarction Treatment. Myocardial infarction treatment attempts to save as much myocardium as possible and to prevent further complications. Acute myocardial infarction (AMI), commonly known as a heart attack, is the interruption of blood supply to a part of the heart, causing heart cells to die.
Which medications should be avoided in the treatment of acute myocardial infarction?
If the final diagnosis of acute myocardial infarction is confirmed (or another acute coronary syndrome is suspected) the patient should continue to receive 150 mg aspirin daily. Aspirin should be avoided in patients who have had a previous serious allergic reaction, recent gastrointestinal bleeding or recent intracranial haemorrhage.
Which medications are used to treat left ventricular dysfunction after myocardial infarction?
Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003 Apr 3. 348 (14):1309-21.
What are the immediate management priorities for suspected myocardial infarction?
Immediate management priorities The immediate concerns for a patient with suspected myocardial infarction should be their safety and comfort. Intravenous access must be available for effective administration of emergency drug therapy followed by rapid transfer to an area with a high level of supervision and resuscitation facilities.
How to prevent repeat heart attack?
What is a minimally invasive procedure?
What happens after you leave the hospital?
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What is the standard treatment for an acute myocardial infarction?
Despite the absence of definitive outcome data, it is reasonable to treat the patient with acute MI and without hypotension, bradycardia, or excessive tachycardia with intravenous nitroglycerin for 24 to 48 hours after hospitalization.
How can you treat a patient with previous myocardial infarction?
How Can I Treat A Patient With Previous Myocardial Infarction (MI)?NSAIDs and ASA with Digoxin, Captopril, Propranolol: limit prescribing to 4 days or less.Antibiotics (e.g., erythromycin, tetracycline) with Digoxin, Propranolol.Barbiturates, benzodiazepines with Digoxin, Verapamil, Lovastatin.
What is the first step in treatment of myocardial infarction?
The early treatment of acute myocardial infarction consists of ensuring the patient is in an environment in which defibrillation is possible and then reducing the size of the potential infarct by re-opening the occluded coronary artery.
What treatment is indicated in the first 12 hours of myocardial infarction?
Alteplase, reteplase and streptokinase need to be given within 12 hours of symptom onset, ideally within one hour. Tenecteplase should be given as early as possible and usually within six hours of symptom onset. Bleeding complications are the main risks associated with thrombolysis.
What should be done in the late phase of myocardial infarction?
Myocardial infarction treatment in late phase: Patient leaving hospital should be diagnosed, prescribed by drugs and level of exercise and activities permitted at home and the expected date of returning to work should be given.
What causes a myocardial infarction?
The most frequent cause of myocardial infarction (MI) is rupture of an atherosclerotic plaque within a coronary artery with subsequent arterial spasm and thrombus formation. Other causes include the following: Coronary artery vasospasm. Ventricular hypertrophy.
What is the name of the heart attack that causes the heart to die?
Acute myocardial infarction (AMI), commonly known as a heart attack, is the interruption of blood supply to a part of the heart, causing heart cells to die. This is most commonly due to occlusion (blockage) of a coronary artery following the rupture of a vulnerable atherosclerotic plaque, which is an unstable collection of lipids (fatty acids) ...
What causes ventricular hypertrophy?
Ventricular hypertrophy. Hypoxia due to carbon monoxide poisoning or acute pulmonary diseases. Coronary artery emboli, secondary to cholesterol, air, or the products of sepsis. Cocaine, amphetamines. Arteritis ,aneurysms of the coronary arteries. Increased afterload which increase the demand on the myocardium.
How to improve patient morale after heart attack?
Regular exercise and altering the posture of patient help to overcome these problems and improve patient morale. Most patients able to sit up in chair and take a few steps within 24 hrs of heart attack. As the days in hospital pass, exercise increases but the patient must avoid undue tachycardia.
How does bed rest affect heart attack patients?
Bed rest reduces physical fitness and impairs the reflexes that prevent and undue fall of blood pressure when we assume the upright position. General weakness and dizziness leads to severity of heart attack. Regular exercise and altering the posture of patient help to overcome these problems and improve patient morale. Most patients able to sit up in chair and take a few steps within 24 hrs of heart attack. As the days in hospital pass, exercise increases but the patient must avoid undue tachycardia. Before discharge patient must climb stairs in hospital.
How many joules are passed through the chest during lethal arrhythmia?
Paddles are placed in front and back of the chest and a current is passed through the chest usually about 300 joules.
What is a heart attack called?
The type of heart attack (also called myocardial infarction, or MI) you experienced determines the treatments that your medical team will recommend. A heart attack occurs when a blockage in one or more coronary arteries reduces or stops blood flow to the heart, which starves part of the heart muscle of oxygen.
What is the ischemia guided strategy?
Both may involve a test called cardiac catheterization to examine the inside of your heart: The ischemia-guided strategy uses various drugs (antiplatelet agents and anticoagulants) to inhibit blood clot formation. The early invasive strategy will start with the use of various drugs (antiplatelet agents and anticoagulants) to inhibit blood clot ...
What is a stent used for?
Stent procedure: A stent is a wire mesh tube used to prop open an artery during angioplasty. Transmyocardial revascularization (TMR): A laser is used to drill a series of holes from the outside of the heart into the heart’s pumping chamber.
What is the alternative to bypass surgery?
Minimally invasive heart surgery: An alternative to standard bypass surgery. Radiofrequency ablation: A catheter with an electrode at its tip is guided through the veins to the heart muscle to destroy carefully selected heart muscle cells in a very small area.
What is the early invasive strategy?
The early invasive strategy will start with the use of various drugs (antiplatelet agents and anticoagulants) to inhibit blood clot formation, but might also proceed to a medical therapy, a PCI with stenting or coronary artery bypass grafting (CABG), followed by certain types of post-hospital care.
What is PCI in hospitals?
About 36 percent of hospitals in the U.S. are equipped to use a procedure called percutaneous coronary intervention (PCI), a mechanical means of treating heart attack. At a hospital equipped to administer PCI, you would likely be sent to a department that specializes in cardiac catheterization, sometimes called a “cath lab.”.
Can statins lower cholesterol?
Cholesterol-lowering medications: Various medications can lower blood cholesterol levels, but statins are the best first course of action. When statins prove ineffective, or if a patient experiences serious side effects from statin therapy, other drugs may be recommended.
Why is triage important for ACS?
Triage and evaluation. Because acute coronary syndrome (ACS) is a spectrum of conditions, initial evaluation to establish a working diagnosis is crucial, as this will dictate management owing to some differences in management steps and timelines for each component of the ACS spectrum.
Can beta blockers be given intravenously?
Beta blockers should not be given intravenously in patients with evidence of low cardiac output state (heart rate >110 beats/min or systolic blood pressure < 100 mmHg), and used with caution in elderly patients or in individuals with an unknown left ventricular ejection fraction. [ 96] .
What is a myocardial infarction?
A myocardial infarction, commonly called a heart attack, occurs when blood flow to a part of the heart is blocked. This is a health care emergency because, without fast repair, part of the heart muscle can completely die. In turn, this leads to long-term problems, such as congestive heart failure. In fact, in some severe cases, patients are ...
Which protocol should be followed first for suspected myocardial infarction?
However, the mnemonic never indicated exactly which protocol should be followed first. Plus, over the years, treatment recommendations from the American Heart Association changed. The only protocol that has remained the same over the years is aspirin, which has always been recommended as the first treatment for suspected myocardial infarction.
What is the best medicine for a heart attack?
The final step is morphine. This drug is recommended in two milligram doses only for severe chest, arm or jaw pain. Morphine can also help calm an anxious patient down, which can decrease the amount of oxygen that the body calls for during the heart attack.
What is the second recommendation for oxygen?
The second recommendation used to always be to apply oxygen to improve oxygen supplies in the blood. However, this is only the case these days if your patient is hypoxemic, which is usually described as have oxygen saturations below 90 percent.
What are the symptoms of a heart attack?
You’ll be able to catch symptoms in your patients that show that this could be happening, such as chest, arm or jaw pain, nausea and vomiting and shortness of breath.
Can a pacemaker cause cardiac death?
In turn, this leads to long-term problems, such as congestive heart failure. In fact, in some severe cases , patients are at risk of sudden cardiac death if the part of the heart with the natural pacemaker function fails. As a health care worker, you’re in a great position to limit the repercussions from a heart attack.
What is the primary goal of treatment for a blocked artery?
Cardiac surgery. The primary goal of treatment is to quickly open the blocked artery and restore blood flow to the heart muscle , a process called reperfusion.
What is the name of the death of a heart muscle?
Share Your Story. A heart attack (also known as a myocardial infarction or MI) is the death of heart muscle from the sudden blockage by a blood clot in a coronary artery that supplies blood to the heart. Blockage of a coronary artery deprives the heart muscle of blood and oxygen, causing injury to the heart muscle.
How do antiplatelets work?
Antiplatelet agents are medications that prevent blood clots from forming by inhibiting the aggregation of platelets. Platelets are fragments of cells that circulate in the blood. Platelets begin the formation of blood clots by clumping together (a process called aggregation). Platelet clumps are then strengthened and expanded by the action of clotting factors (coagulants) that result in the deposition of protein (fibrin) among the platelets. Aggregation of platelets occurs at the site of any injury or laceration, but it also occurs at the site of rupture of cholesterol plaques in the walls of coronary arteries. Formation of clots at the site of an injury or laceration is desirable because it prevents excessive loss of blood, but formation of clots inside coronary arteries blocks the arteries and causes heart attacks.
What are the different types of antiplatelet agents?
There are three types of antiplatelet agents -- aspirin, thienopyridines, and the glycoprotein IIb/IIIa inhibitors. These agents differ in their mode of action, antiplatelet potency, speed of onset of action, and cost. For more, please read the Aspirin and Antiplatelet Medications article.
How is nitroglycerin used in heart attacks?
Nitroglycerin is the most common nitrate used in the treatment of heart attacks. It can be given sublingually (under the tongue), as a spray, as a paste applied over skin, and intravenously. Intravenous nitroglycerine has a rapid onset of action and is commonly used in the initial (first 48 hours) treatment of heart attacks. Nitroglycerine is a vasodilator (blood vessel expander), that opens arteries by relaxing the muscular wall of the artery. Nitroglycerine dilates coronary arteries as well as other blood vessels throughout the body. By dilating blood vessels, nitroglycerine lowers blood pressure, decreases the work that the heart must do to pump blood, lowers the demand by the heart for oxygen, prevents coronary artery spasm, improves blood flow to the heart muscle, and potentially minimizes the size of the heart attack. Nitroglycerine is especially helpful in patients with heart attacks who also have heart failure or high blood pressure.
How long does it take for a heart muscle to die?
If blood flow is not restored within 20 to 40 minutes, irreversible death of the heart muscle will begin to occur. Muscle continues to die for 6 to 8 hours at which time ...
Is aspirin safe for heart attacks?
Numerous studies have shown that aspirin reduces mortality (by 25%) when given to patients with heart attacks. Aspirin is easy to use, safe at the low doses used for antiplatelet action, fast acting (with an onset of action within 30 minutes), and cheap.
How to prevent repeat heart attack?
You should talk with your doctor about an exercise plan that is safe for you. In some cases, your doctor may recommend that you take part in a formal cardiac rehabilitation program which provides exercise training and counseling.
What is a minimally invasive procedure?
In many cases, a minimally invasive procedure can be used to restore blood flow to the heart muscle (sometimes in combination with medication to dissolve clots). Examples of these procedures include:
What happens after you leave the hospital?
After you leave the hospital, you may feel weak or a little depressed or anxious. This is common and your medical team will work with you to help overcome these problems. Often, this involves lifestyle changes and medications aimed at reducing your risk of another heart attack.
