What to do if you have an mi?
Access to the correct care in the first few minutes and hours after the onset of symptoms is crucial as sudden death after an MI is often the result of a disturbance of heart rhythm. Giving thrombolytics (clot-dissolving drugs) as soon as possible after an acute MI reduces the risk of death and disability.
Is it easy to make a diagnosis of mi?
A diagnosis of MI is usually easy to make, although some patients do not have the classic symptoms and may present as silent MIs. Groups of people more likely to have atypical presentation include women, individuals with diabetes, older people and people from minority ethnic groups (Department of Health, 2000).
What are the most important aspects of care for mi?
One of the most important aspects of care of the patient with MI is the assessment. Assess for chest pain not relieved by rest or medications. Monitor vital signs, especially the blood pressure and pulse rate. Assess for presence of shortness of breath, dyspnea, tachypnea, and crackles. Assess for nausea and vomiting.
What drugs are used to treat mi?
Morphine administered in IV boluses is used for MI to reduce pain and anxiety. ACE Inhibitors. ACE inhibitors prevent the conversion of angiotensin I to angiotensin II to decrease blood pressure and for the kidneys to secrete sodium and fluid, decreasing the oxygen demand of the heart.
Why is it important to get treatment quickly for heart attack?
Heart attacks need to be urgently treated because the blockage of one of the coronary arteries that supplies blood to the heart causes an area of muscle to begin to die—and the longer blood flow is hindered, the more damage that occurs.
What should you do if a person is having a MI?
What to do if you or someone else may be having a heart attackCall 911 or your local emergency number. ... Chew and swallow an aspirin while waiting for emergency help. ... Take nitroglycerin, if prescribed. ... Begin CPR if the person is unconscious.More items...
What should you do if a patient has chest pain?
If you're having severe chest pain or new or unexplained chest pain or pressure that lasts more than a few moments, call 911 or emergency medical services. Don't waste any time for fear of embarrassment if it's not a heart attack. Even if there's another cause for your chest pain, you need to be seen right away.
What is the first aid for chest pain?
The American Heart Association recommends starting hands-only CPR. Push hard and fast on the person's chest for 100 to 120 compressions a minute. If an automated external defibrillator (AED) is immediately available and the person is unconscious, follow the device instructions for using it.
How to reduce the size of an infarct?
Aim of treatment#N#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: 1 dissolution of the thrombus to restore coronary blood flow 2 decreasing myocardial oxygen consumption
What is the main aim of a patient's treatment for an infarct?
Once the patient reaches hospital, the major aim of treatment is to decrease the size of the infarct. Fibrinolytic therapy with streptokinase or tissue plasminogen activator (tPA) restores coronary patency and significantly reduces mortality. Aspirin is mandatory unless there are absolute contraindications to its use.
How long does it take to give a streptokinase infusion?
An intravenous infusion of 1.5 million units is given over 30-60 minutes. Most patients will develop hypotension if streptokinase is given quickly, but this is usually easily overcome by slowing the infusion and giving fluid. Streptokinase is derived from Streptococci and will produce an antibody reaction.
How long does it take for Streptokinase to restore blood flow?
Despite reducing mortality by 25% 1,2, only about 30% of patients have their coronary flow restored to normal within 90 minutes of treatment. This increases to over 50% by 3 hours and up to 80% by 5-7 days. 4.
What is the best medicine for myocardial infarction?
Aspirin. All patients with a suspected myocardial infarction should be given aspirin. It is a powerful antiplatelet drug, with a rapid effect, which reduces mortality by 20%. 2 Aspirin, 150-300 mg, should be swallowed as early as possible.
Can ACE inhibitors be used for myocardial infarction?
ACE inhibitors and intravenous beta blockers are beneficial in acute myocardial infarction and intravenous glyceryl trinitrate probably has a role. Calcium channel blockers and magnesium should not be used routinely. Myocardial infarction is one of the most common causes of death in Australia.
What is MI in medical terms?
A heart attack, or myocardial infarction (MI), is permanent damage to the heart muscle. "Myo" means muscle, "cardial" refers to the heart, and "infarction" means death of tissue due to lack of blood supply. Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission.
How long does it take to get help for a heart attack?
The best time to treat a heart attack is within one hour of the onset of the first symptoms. Waiting just a couple hours for medical help may change your treatment options, increase the amount of damage to your heart muscle and reduce your chance of survival.
How to get rid of heart problems?
Keep all your medical appointments and be an active member of your health. Seeing your healthcare providers on a regular basis can uncover any heart-related issues quickly and treatment can begin immediately. You don't have to make lifestyle changes all on your own. Ask your healthcare team for help.
Can a paramedic monitor heart rate?
Frequently paramedics will do this test where you had the potential heart attack or on the way to the hospital. In addition, your heart rate and rhythm can be watched. You'll also be connected with leads (wires) to a monitor for continuous monitoring of your heart rate and rhythm.
Why does MI happen suddenly?
For most people this occurs suddenly and is due to the rupture of an atheromatous plaque and the formation of a thrombus within the coronary circulation. Less common causes of MI include vasospasm of a coronary artery, which causes temporary occlusion of the artery lumen, or a sudden increase in oxygen demand such as a sustained rapid cardiac ...
How long does it take to monitor a patient after MI?
This is usually due to a dysrhythmia and the patient will require continuous cardiac monitoring in coronary care for the first 24 to 48 hours.
Why does myocardial infarction occur?
Myocardial infarction (MI) occurs as a result of prolonged myocardial ischaemia that leads to irreversible injury and necrosis of myocardial tissue because of inadequate blood supply. For most people this occurs suddenly and is due to the rupture of an atheromatous plaque and the formation of a thrombus within the coronary circulation.
What is the most common presenting symptom of MI?
The most common presenting symptom of MI is chest pain, which is often described as severe retrosternal chest pain of a crushing or squeezing nature. Other clues to the differential diagnosis of chest pain are that the pain may radiate to the arms (commonly the left arm), shoulders, neck and/or jaw.
How soon after MI can you give thrombolytics?
Giving thrombolytics (clot-dissolving drugs) as soon as possible after an acute MI reduces the risk of death and disability.
How long does it take for a patient to be ready for discharge?
From then on mobilisation is rapid and the majority of patients should be ready for discharge in five to seven days. Psychological support is another vital component of the nurse’s role as patients often experience fear and anxiety for the first few days after admission.
Is MI atypical or silent?
Groups of people more likely to have atypical presentation include women, individuals with diabetes, older people and people from minority ethnic groups (Department of Health, 2000).
Additional risks
In addition to your diet, the following factors can also increase your risk of heart problems:
Follow-up
There are several ways to prevent another heart attack and promote healing, including working with your doctor to make changes to your diet and lifestyle.
How long does it take to take a syringe for MI?
1. For the first 24 to 48 hours in all patients with acute MI who do not have hypotension, bradycardia, or tachycardia. 2. Continued use (beyond 48 hours)* in patients with a large or complicated infarction.
What is MI in medical terms?
1. When MI is suspected to have occurred by a mechanism other than thrombotic occlusion at an atherosclerotic plaque. This would include coronary embolism, certain metabolic or hematological diseases, or coronary artery spasm.
What is the best treatment for monomorphic ventricular tachycardia?
If monomorphic ventricular tachycardia is not accompanied by chest pain, pulmonary congestion, or hypotension, it should be treated with intravenous lidocaine, procainamide, or amiodarone. The patient with acute MI and symptomatic sinus bradycardia or atrioventricular block should receive atropine.
How long should a patient be monitored for electrical shock?
The patient should be monitored closely for adverse electrical or mechanical events because reinfarction and death occur most frequently within the first 24 hours. The patient's physical activities should be limited for at least 12 hours, and pain and/or anxiety should be minimized with appropriate analgesics.
What is a spontaneous episode of myocardial ischemia?
1. Patients with spontaneous episodes of myocardial ischemia or episodes of myocardial ischemia provoked by minimal exertion during recovery from infarction. 2. Before definitive therapy of a mechanical complication of infarction such as acute mitral regurgitation, VSD, pseudoaneurysm, or LV aneurysm.
What is the best treatment for myocardial perfusion?
International guidelines recommend improving myocardial perfusion or decreasing the cardiac workload using a combination of therapies known as MONA: morphine, oxygen, nitrates, and aspirin. 1,2.
What is the AMI of CHD?
Acute myocardial infarction (AMI), which leads to myocardial injury and necrosis, is a common initial presentation of CHD and may recur over the course of the disease. 1. Cardiac ischemia may occur via many mechanisms, such as coronary thrombosis due to atherosclerotic plaque rupture, endothelial dysfunction, hypotension, and coronary embolism.
Can oxygen be given to patients with AMI?
Oxygen for AMI: Current Practice. Oxygen, via face mask or nasal cannula, is often administered to patients with suspected AMI in an attempt to increase myocardial oxygenation and decrease infarct size. 1.
Does oxygen help with AMI?
While treating AMI with oxygen makes sense from a physiologic standpoint, no studies have convincingly demonstrated that oxygen therapy improves outcomes in AMI. 1 In addition, recent data suggest that this practice may even be harmful.
Is oxygen therapy needed for myocardial infarction?
Evidence is lacking to support oxygen therapy for acute myocardial infarction. Coronary heart disease (CHD) remains a significant cause of death, accounting for 1 in 10 deaths worldwide and 1 in 7 deaths in the United States, even though medical advances have reduced mortality rates from CHD in developed nations.
What is the pathophysiology of MI?
Pathophysiology. In each case of MI, a profound imbalance exists between myocardial oxygen supply and demand. Uns table angina. There is reduced blood flow in a coronary artery, often due to rupture of an atherosclerotic plaque, but the artery is not completely occluded.
What is the cardinal symptom of MI?
Chest pain. This is the cardinal symptom of MI. Persistent and crushing substernal pain that may radiate to the left arm, jaw, neck, or shoulder blades. Pain is usually described as heavy, squeezing, or crushing and may persist for 12 hours or more.
What are the interventions in nursing?
Nursing Interventions. Nursing interventions should be anchored on the goals in the nursing care plan. Administer oxygen along with medication therapy to assist with relief of symptoms. Encourage bed rest with the back rest elevated to help decrease chest discomfort and dyspnea.
What is morphine used for?
Pharmacologic Therapy. Morphine administered in IV boluses is used for MI to reduce pain and anxiety. ACE Inhibitors. ACE inhibitors prevent the conversion of angiotensin I to angiotensin II to decrease blood pressure and for the kidneys to secrete sodium and fluid, decreasing the oxygen demand of the heart.
Risk Factors
Clinical Features
- The most common presenting symptom of MI is chest pain, which is often described as severe retrosternal chest pain of a crushing or squeezing nature. Other clues to the differential diagnosis of chest pain are that the pain may radiate to the arms (commonly the left arm), shoulders, neck and/or jaw. The pain usually continues for more than 20 minutes and is not relieved by sublingua…
Diagnosis
- A definitive diagnosis depends on electrocardiogram (ECG) changes and is supported by abnormal serum cardiac enzyme levels. ECG is the single most valuable immediate diagnostic tool for the nurse. ECGs record different views of the electrical activity of the heart and provide information by viewing the heart from different angles. Unequivocal ECG changes of an MI in 80 …
Management and Nursing Intervention
- The early diagnosis of an MI facilitates admission to coronary care units (CCUs) where registered nurses with clinical expertise in cardiac nursing can quickly identify and act on complications. Whether the patient is admitted directly to the CCU or an A&E department, the rapid management of patients with chest pain should ensure that there is no more than 30 minutes delay in decisio…
Conclusion
- Early identification of an MI facilitates prompt admission to coronary care where complications can be identified early and treated. The focus of what should be done for a patient with an acute MI has changed from bed rest to early intervention and attention is now given to treatment that can alter the course of the disease. The NSF provides eviden...