MI class Flashcards
What causes Mi?
Atherosclerosis
Coronary Spasm
MI
Myocardial infarction
Ischemic Death of the myocardial tissue
The area of infancy if caused by the coronary artery and its distribution of blood flow
3 areas of damage with MI
Injury
Ischemia
Black area of cellular death
Clinical manesfestations
Chest pain, SOB, Indigestion, Nausea, Anxiety, cool pale moist skin, heart rate and respiratory rate faster FACE OF DOOM AND GLOOM
Sudden Death?
1hr of when the symptoms actually started
Gerontological considerations
Increased: Vascular myocardial stiffness, systolic and pulse pressure, bradycardia Arrythmias,
IMPAIRED: sinus node and epithelial function.
hypertension CAD, Amyloidal function
Confuction problems
The Heart
Muscle relaxes less between beats
More stuff
May not pump blood efficiently
Less responsive to stimulation by the nervous system
Less able to unscrew strength of contractions
Walls may thicken
Treatment - Echocardiogram
Look at the conduction of the heart
Troponin
Protein - We USE IT MORE now than anything else. PEAK SOONER LAST LONGER SHOWS UP QUICKER SNG DAMAGE WITHIN 3 weeks
CPK MB
- Peaks within 24 hours but after that it drops
Myoglobin
HEME PROTEIN- 1-3 peaks at 12 hours non specific cardiac and skeletal an INCREASE IS NOt SPECIFIC
Goals for MI
Minimize myocardial Damage
Preserve Myocardial function
Prevent Complications
MONA
MORPHINE
OXYGEN
NITROCLYCERINE -check headache
Aspirin DO NOT GIVE ENTERIC COATED
Phase 1 on admit
Mobilization of patient, teach essentials of self care low level activity and education improved outcomes
Phase 11
On discharge
that ohh sessions
3-5x/week supervised exercise
Training - Short term long ten goals everyone involved
Phase 3
Long term program to maintain cardiovascular stability and long term conditioning usually self directed
ANGINA
Insufficient coronary blood flow, from the narrowing of the coronary artery.
Types of Angina
Stable
Unstable
Stable Angina
Constant pain relieved by rest or nitroglycerin
Unstable
Symptoms get worse and my boy be relieved by nitroglycerin
Variant
At rest
Silent shows up on the stress test.
Clinical manifestations of Angina
Feeling indigestion Choking sensation Agonizing chest pain Radiating to jaw and arms Fear of impending death May feel like thru are going to die
Gerontological Considerations
Intense Dyspnea Pain radiated to both arms Weakness is present Diagnostic test may be masked as other diseases
