Concept Map For Anterior Myocardial Infarction: I. Introduction and Objectives
Concept Map For Anterior Myocardial Infarction: I. Introduction and Objectives
ETIOLOGY - Myocardial infarctions (MIs) result from an acute thrombus that obstructs an atherosclerotic coronary
artery. Plaque rupture and erosion are the major triggers for coronary thrombosis. Following plaque erosion or
rupture, platelet activation and aggregation, coagulation pathway activation, and endothelial vasoconstriction occur,
leading to coronary thrombosis and occlusion. Risks include age, sex, family history, male-pattern baldness, smoking,
hypertension, diabetes, obesity, and psychosocial stress.
Nonmodifiable risk factors for atherosclerosis include the following: age, sex,
family history of premature coronary heart disease, male-pattern baldness. Modifiable
risk factors for atherosclerosis include the following: smoking or other tobacco use,
hypercholesterolemia, and hypertriglyceridemia, including inherited lipoprotein disorders
dyslipidemia, diabetes mellitus, hypertension, obesity (abdominal obesity), psychosocial
stress, sedentary lifestyle and/or lack of exercise, reduced consumption of fruits and
vegetables, poor oral hygiene, type a personality elevated homocysteine level,
presence of peripheral vascular disease. MI can also occur for causes other than
atherosclerosis. In addition, MI can result from hypoxia due to carbon monoxide
poisoning or acute pulmonary disorders. Although rare, pediatric coronary artery
disease may be seen with Marfan syndrome, Kawasaki disease, Takayasu arteritis,
progeria, and cystic medial necrosis. Acute MI is rare in childhood and adolescence.
Although adults acquire coronary artery disease from lifelong deposition of atheroma
and plaque, which causes coronary artery spasm and thrombosis, children with acute
MI usually have either an acute inflammatory condition of the coronary arteries or an
anomalous origin of the left coronary artery. Intrauterine MI also does occur, often in
association with coronary artery stenosis.
The signs and symptoms of MI are fatigue, chest discomfort (often radiates up to
the neck, shoulder, jaw, and down to the left arm, described as a substernal pressure
sensation), malaise, tachycardic, irregular pulse, hypotension for right ventricular mi,
hypertension for ventricular dysfunction, elevated respiratory rate, coughing with frothy
sputum, wheezing, anxiety, lightheadedness, nausea, and shortness of breath. the
diagnostic test that will confirm MI are Cardiac Biomarkers/Enzymes, Troponin Levels,
CBC, Comprehensive Metabolic Panel, Lipid Profile, ECG, Cardiac Imaging. The
managements that can alleviate these signs and symptoms are administration of SL
nitroglycerin, aspirin, nitrates, analgesia, PCI, O2 therapy.
During a heart attack, blood flow to the heart stops due to a blockage in a
coronary artery. These are the arteries that carry blood to the heart. 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, Cardiogenic shock, and
Heart failure. The longer a heart attack is left untreated, the more damage that occurs
and the worse the outcome becomes.
These are the pharmacologic, medical, and nursing interventions. Monitor and
document characteristic of pain, noting verbal reports, nonverbal cues (moaning, crying,
grimacing, restlessness, diaphoresis, clutching of chest) and BP or heart rate changes.
Obtain full description of pain from patient including location, intensity (using scale of 0–
10), duration, characteristics (dull, crushing, described as “like an elephant in my
chest”), and radiation. Assist patient to quantify pain by comparing it to other
experiences. Review history of previous angina, anginal equivalent, or MI pain. Discuss
family history if pertinent. Instruct patient to report pain immediately. Provide quiet
environment, calm activities, and comfort measures. Approach patient calmly and
confidently. Instruct patient to do relaxation techniques: deep and slow breathing,
distraction behaviours, visualization, guided imagery. Assist as needed. Check vital
signs before and after narcotic medication. Administer supplemental oxygen by
means of nasal cannula or face mask, as indicated. Administer anticoagulant
medication, Enoxaparin Na as per doctor’s order. Administer vasodilator, ISMN as per
doctor’s order. Administer NSAID, ASA as per doctor’s order. Administer anti-anginal
medication, ISDN as per doctor’s order. Administer analgesic, Paracetamol as per
doctor’s order. Administer laxative, Lactulose as per doctor’s order. Perform
percutaneous coronary intervention if patient’s condition worsens.
VI. REFERENCES
Oren J. Mechanic; Michael Gavin; Shamai A. Grossman, O. J. M. M. G. S. A. G.
(2021). Acute Myocardial Infarction. Acute Myocardial Infarction. Published.
https://www.ncbi.nlm.nih.gov/books/NBK459269/
Joshua Chadwick Jayaraj, Karapet Davatyan, S.S. Subramanian And Jemmi Priya,
J. C. J. K. D. S. S. S. J. P. (2018). B.Epidemiology of Myocardial Infarction.
B.Epidemiology of Myocardial Infarction. Published.
https://www.intechopen.com/chapters/59778
C.The Process Of Care-seeking For Myocardial Infarction Among Patients With
Diabetes, C. T. P. C.-M. I. A. P. D. (2018). C.The Process of Care-seeking for
Myocardial Infarction Among Patients with Diabetes. C.The Process of Care-
Seeking for Myocardial Infarction Among Patients with Diabetes. Published.
https://doi.org/10.1097/JCN.0000000000000195
Moien Ab Khan, Muhammad Jawad Hashim, Halla Mustafa, May Yousif
Baniyas, Shaikha Khalid Buti Mohamad Al Suwaidi, Rana AlKatheeri, Fatmah
Mohamed Khalfan Alblooshi, Meera Eisa Ali Hassan Almatrooshi, Mariam Eisa
Hazeem Alzaabi, Reem Saif Al Darmaki, Shamsa Nasser Ali Hussain Lootah, M.
A. K. M. J. H. H. M. M. Y. B. S. K. B. M. A. S. R. A. K. F. M. K. A. M. E. A. H.
A. M. E. H. A. R. S. A. D. S. N. A. H. L. (2020). D.Global Epidemiology of
Ischemic Heart Disease: Results from the Global Burden of Disease Study.
D.Global Epidemiology of Ischemic Heart Disease: Results from the Global
Burden of Disease Study. Published. https://pubmed.ncbi.nlm.nih.gov/32742886/