What is the prognosis of acute myocardial infarction?
The outcomes of patients suffering from acute myocardial infarction are contingent on the time taken to deliver definitive treatment. Evidence has shown that the extent of myocardial salvage is greatest if patients are reperfused in the first 3 h from the onset of symptoms [1].
What is the prehospital role in the management of acute myocardial infarction?
Importantly, the prehospital role in the management of acute myocardial infarction also involves the initiation of therapy, the upstream of the hospital-delivered treatment.
Is early thrombolysis effective in the management of acute myocardial infarction?
Keywords: acute myocardial infarction (AMI), ambulance care, paramedic, pre‐hospital thrombolysis, reperfusion therapy The effectiveness of early thrombolysis in the management of acute myocardial infarction (AMI) is well established, particularly with regard to its positive effect on mortality rates.
Why is rapid diagnosis of myocardial infarction so important in reperfusion?
The rapid patient assessment and field diagnosis of myocardial infarction has become a crucial factor in time to reperfusion as it dictates the decision on the most appropriate form of reperfusion treatment accounting for geographical factors and available facilities.
Which delay to ACS treatment is usually the longest?
The pre-hospital delays include patient, doctor and emergency medical transport (EMT) delay. Patient delay is among the longest in the pre-hospital chain of ACS patients.
Why is it important to receive treatment as early as possible after a myocardial infarction?
Early treatment aims to reduce the extent of myocardial damage. As the myocardium is damaged by a diminished oxygen supply due to the obstructed coronary artery, infarct size can be reduced in two ways: dissolution of the thrombus to restore coronary blood flow.
What is the most common complication of a myocardial infarction in the first 24 hours after it occurs?
Pericarditis. This is often acute and usually occurs 24-72 hours post-MI.
What is the immediate treatment for a patient with a myocardial infarction?
Although the immediate priority in managing acute myocardial infarction is thrombolysis and reperfusion of the myocardium, a variety of other drug therapies such as heparin, β-adrenoceptor blockers, magnesium and insulin might also be considered in the early hours.
When is the best time to mobilize patients after myocardial infarction an issue that merits further research?
Despite differences in the time of bed rest and mobilization after MI, several studies have reported that the early mobilization could reduce mortality, depression, and HR variations (5) and help in an early return to work (2) after MI. In contrast, early mobilization may adversely affect MI patient outcomes.
What are common complications after an MI?
With the above anatomical correlates in mind, the various complications of acute MI are easier to explain:Arrhythmias / Heart block:Hypotension:Ventricular septal rupture:Left ventricular free wall rupture:Left ventricular aneurysm formation:Right ventricular infarction:
What happens if myocardial infarction is not treated?
If a person does not receive immediate treatment, this lack of blood flow can cause damage to the heart. Complications arising from this situation include: Arrhythmias: These are abnormal heartbeats. Cardiogenic shock: This refers to severe damage to the heart muscle.
What is the first intervention for a client experiencing MI?
The first goal for healthcare professionals in management of acute myocardial infarction (MI) is to diagnose the condition in a very rapid manner. As a general rule, initial therapy for acute MI is directed toward restoration of perfusion as soon as possible to salvage as much of the jeopardized myocardium as possible.
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.
What is patient delay?
Patient delay is a complex, multifaceted problem, and the time between symptom onset and seeking definitive treatment is often divided into phases to gain a better understanding of the issue. The process of evaluating an illness may be different based on a number of factors, including timing of the symptoms (i.e., early or late in the process), their potential seriousness, and the amount of discomfort experienced. Researchers have labeled the stages of patient delay slightly differently; however, there is general agreement that it is helpful to divide them into the following three stages.
Why is delay in treatment important?
Treatment delay is an important phenomenon in health care because it affects the ability of clinicians to deliver appropriate treatment in a timely manner. Delay in treatment can result in increased morbidity and mortality. For example, if a person is experiencing symptoms of a heart attack, delay in seeking care prevents the application of proven treatments such as thrombolysis or angioplasty that minimize or prevent the heart attack. Delay results in greater destruction of heart muscle, leading to a poorer prognosis and reduced quality of life.
Why is delay important in healthcare?
Because delay in providing care causes increased morbidity and mortality, health care providers must understand the reasons for delay so that they can intervene in an appropriate and effective manner. For example, if patients state that they delay seeking treatment for symptoms because they will be embarrassed if the symptoms are nothing, then an appropriate intervention might be for the health care provider to focus on this issue, acknowledging that embarrassment is a normal response. A cost/benefit argument might be made that given the benefit of early treatment, being wrong on occasion is less important than avoiding the potential disability and loss of personal productive capacity. Lastly, it is important to note that most factors influencing patient delay are often modifiable, and therefore and efforts to reduce patient delay have direct benefits to patients in terms of decreased morbidity and mortality.
How does delay affect treatment?
There are a number of psychosocial factors that influence treatment-seeking behavior. These factors may change somewhat depending on different disease states. People vary greatly in how they experience or perceive symptoms. Delay may increase if symptoms do not match a patient’s expectation or are different than what she or he experienced previously in the same illness. Delay time can be increased if symptoms are vague, confusing, intermittent, or come on gradually. In the case of heart attack symptoms, patients often delay if they believe that the symptoms are not cardiac related. Severity of pain or other symptoms has not been shown to consistently affect delay time.