Myocardial Infarction

In: Science

Submitted By mslankford
Words 906
Pages 4
Myocardial Infarction
Mr. X., aged 55 years, arrives at the emergency department with severe chest pain. He appears very anxious, and his facial skin is cool and clammy. His blood pressure is 90/60, and his pulse around 90, weak, and irregular. He is given oxygen, and intravenous line is opened, and leads for ECG are attached. Blood is taken for determination of serum enzymes and electrolytes. Tentative diagnosis is myocardial infarction involving the left ventricle. His wife arrives and, in response to questions, indicates that her husband is a heavy cigarette smoker, prefers a diet of fried foods and meat (he is obese), and had complained periodically of indigestion, with brief episodes of epigastric pain. He also seemed to be more fatigued at night recently but was very busy at work. He was fearful of heart disease because his father had died of a heart attack. He had also noticed more fatigue and intermittent leg pain when playing golf recently. Generalized atherosclerosis is suspected.
1. List the high-risk factors for atherosclerosis in this patient’s history. The high-risk factors for the atherosclerosis in the patient’s history include smoking, obesity, and a diet high in cholesterol and animal fat. Other factors include past history of heart disease and heart attack

2. Describe how atherosclerosis caused myocardial infarction. Atherosclerosis caused myocardial infarction by causing a build up of plaque occurring in five different phases over time. Development of a fatty streak is first, low density lipoproteins adhere, MAC’s ingulf the LDL’s, smooth muscle infiltrates, fibroblasts produce a collagen cap, and finally, the cap tears and forms a lesion, forming a clot and finishing closure of the lumen.

3. It is suspected that the indigestion reported in the history was really angina. Explain how this pain may have occurred.…...

Similar Documents

Micardic

...Myocardial Infarction Mortality 1.0 Introduction In the UK, about 838,000 men and 394,000 women have had a myocardial infarction (MI) at some point in their lives, (NICE clinical guideline 48, 2007). The latest statistics from the British Heart Foundation state that approximately 227,000 people suffer from an acute MI (heart attack) each year (British Heart Foundation Statistics Website). To put this figure in to perspective this equates to one person every 2 minutes. Mortality is at approximately 30% which is 68,100 deaths in the UK per year. The National Service Framework (NSF) for Coronary Heart disease (CHD) is a 10-year programme published by the Department of Health in 2000 and has set key standards for the prevention and treatment of CHD. Access to the right treatment for those who suffer from an AMI, is essential to reduce morbidity and mortality and improve clinical outcomes. People with diabetes mellitus constitute a group of patients who have a higher risk of having an MI and also a poorer prognosis post infarction. The higher death and complication rates appear to be multifactorial but a significant finding in the Diabetes Mellitus Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) Trial showed to reduce one year mortality by 30% (Malberg et al., 1995). It’s recommended 1.1 Primary Objective To determine the relationship between HbA1c and prognosis of patients in East Lancashire having a myocardial infarction. 1.2 Secondary Objectives To......

Words: 3063 - Pages: 13

Case Analysis

...Respodent: LUCITA R. VILLAREAL Nature of the case: Civil case PART III Facts of the case: Respondent is the widow of Zacarias F. Villareal, a technical education and skills development supervisor in the Technical Education and Skills Development Authority at the time of his death on October 20, 2002 due to myocardial infarction. Respondent filed with petitioner a claim for death benefits under PD 626, as amended. Petitioner denied the claim on the ground that the cause of death was not work-connected. The ECC upheld petitioner. On appeal, however, the CA reversed petitioner and the ECC and held that myocardial infarction, a cardiovascular disease, was a compensable occupational disease. Thus, this petition. Is respondent entitled to compensation for her husband’s death? Yes, she is. Under PD 626, the beneficiaries of an employee are entitled to death benefits under the system if the cause of death of the employee is a sickness listed as an occupational disease by the ECC or any other illness caused by employment, subject to proof that the risk of contracting the same is increased by the working conditions. The CA correctly ruled that myocardial infarction was considered as an occupational disease because it was included under the classification “cardiovascular disease,” a compensable occupational disease under ECC Resolution No. 432 (dated July 20, 1977) subject to substantial evidence proving any of the following conditions: (a) ......

Words: 1226 - Pages: 5

Acute Myocardial Infarction

...Cardiac – Coronary Artery Disease/Acute Myocardial Infarction Topic: Cardiac – Coronary Artery Disease/Acute Myocardial Infarction 1 Cardiac – Coronary Artery Disease/Acute Myocardial Infarction Table of Contents Introduction...................................................................................................................3 Patient’s profile..............................................................................................................4 Pathophysiology...............................................................................................................................5 Clinical manifestations...................................................................................................................6 Short of breath and ‘light headed’...................................................................................................6 Nauseous and uncomfortable feeling...............................................................................................6 Crushing substernal chest pain .......................................................................................................6 Modifiable and Non-modifiable risk factors.................................................................7 Laboratory tests results and ECG findings................................................................................7 ECG (Electrocardiogram)....................................................................

Words: 1624 - Pages: 7

Effect of Potentially Modifiable Risk Factors

...Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study Summary Background Although more than 80% of the global burden of cardiovascular disease occurs in low-income and middle-income countries, knowledge of the importance of risk factors is largely derived from developed countries. Therefore, the effect of such factors on risk of coronary heart disease in most regions of the world is unknown. Methods We established a standardised case-control study of acute myocardial infarction in 52 countries, representing every inhabited continent. 15152 cases and 14820 controls were enrolled. The relation of smoking, history of hypertension or diabetes, waist/hip ratio, dietary patterns, physical activity, consumption of alcohol, blood apolipoproteins (Apo), and psychosocial factors to myocardial infarction are reported here. Odds ratios and their 99% CIs for the association of risk factors to myocardial infarction and their population attributable risks (PAR) were calculated. Findings Smoking (odds ratio 2·87 for current vs never, PAR 35·7% for current and former vs never), raised ApoB/ApoA1 ratio (3·25 for top vs lowest quintile, PAR 49·2% for top four quintiles vs lowest quintile), history of hypertension (1·91, PAR 17·9%), diabetes (2·37, PAR 9·9%), abdominal obesity (1·12 for top vs lowest tertile and 1·62 for middle vs lowest tertile, PAR 20·1% for top two tertiles vs lowest tertile),......

Words: 283 - Pages: 2

Myocardial Infarction

...ACMS 6001 Introduction to Applied Critical Evaluation Module Plan Semester One, January 2012 (On-line delivery) Week | Topic (Discussion Thread) | Closing Date for Posting Response | Date of Feedback by Tutor | Assignment Dates | Wk 1. Mon 16th January | Skills Audit self assessment | Not posted. Used for first part of assignment | | Assignment A 10th FebruaryAssignment B 27th February | Wk 2. Mon 23rd January | Reflection | By 29th January | By 3rd February | | Wk 3. Monday 30th January | Critical Reading / Critical Thinking. Referencing Technique | By 5th February | By 7th February | | Wk 4. Monday 6th February | Information and How to Search for it | By 12th February | By 15th February | | Wk 5. Monday 13th February | Evaluating the Quality of Information | By 19th February | By 21st February | | Wk 6. Monday 20th February | | | | | N.B. Feedback to threads will be given as group feedback and will be posted within the announcements page of the module Blackboard site. Where necessary students will be emailed individually if specific issues need to be addressed. Week 1. Attend classroom workshop, 10 – 4pm: 16 January in Carlisle, 17 January Lancaster Activity – Skills audit self assessment. To be discussed with Personal Tutor by 30th January Week 2. Activity – Read resources on reflection within learning resources for the module. Thread - In a maximum of 300 words, prepare a reflective account of experience of undertaking the......

Words: 423 - Pages: 2

Beta Blockers After Myocardial Infarction

...Beta Blockers After Myocardial Infarction Clinical Scenario The acute care nurse practitioner on the cardiology service treats a 67 year-old-male admitted after recovering from an acute ST-Elevation Myocardial Infarction (STEMI). His risk factors include obesity, Type II diabetes mellitus, and family history. Upon exam the patient asks why he has not been started on a beta blocker yet. He explains further that when his brother had a “heart attack” in 2005, he was immediately placed on a beta blocker because the cardiologist reported how beta blockers reduce mortality after myocardial infarction (MI). The patient wants to know if a beta blocker would reduce his chance of mortality? Using the Patient-Intervention-Comparator-Outcome (PICO) format we formulated the following question. In a 67-year-old male with multiple co-morbidities with MI (P), does treatment with a beta blocker (I), compared with no beta blocker or placebo (O), reduce mortality rate (O)? Risk Factors, Incidence and Prevalence of Disease * US incidence rates of cardiovascular disease, including MI, are seen in men more than women (Alexander et al., 2007). This trend is also true in Utah ("Impact of heart," 2007). * The incidence rates of cardiovascular disease increase with age (Alexander et al., 2007). * Risk factors for cardiovascular disease include not eating enough fruits and vegetables, lack of physical exercise, smoking cigarettes and the co-morbidities of diabetes, hypertension,......

Words: 3414 - Pages: 14

Myocardial Infarction

...com/content/12/2/R36 Research Vol 12 No 2 Open Access Detecting myocardial infarction in critical illness using screening troponin measurements and ECG recordings Wendy Lim1, Paula Holinski1, PJ Devereaux1,2, Andrea Tkaczyk2, Ellen McDonald2, France Clarke2, Ismael Qushmaq3, Irene Terrenato4, Holger Schunemann2,4, Mark Crowther1 and Deborah Cook1,2 1Department 2Department of Medicine, McMaster University, Canada of Clinical Epidemiology and Biostatistics, McMaster University, Canada 3Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia 4Department of Epidemiology, Italian National Cancer Institute Regina Elena, Rome, Italy Corresponding author: Deborah Cook, debcook@mcmaster.ca Received: 6 Dec 2007 Revisions received: 22 Jan 2008 Accepted: 4 Mar 2008 Published: 4 Mar 2008 Critical Care 2008, 12:R36 (doi:10.1186/cc6815) This article is online at: http://ccforum.com/content/12/2/R36 © 2008 Lim et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction To use screening cardiac troponin (cTn) measurements and electrocardiograms (ECGs) to determine the incidence of elevated cTn and of myocardial infarction (MI) in patients admitted to the intensive......

Words: 2698 - Pages: 11

Pathophysiology of a Myocardial Infarction

...For the purpose of this assignment the author will discuss the pathophysiology of a myocardial infarction and will give an in-depth discussion of one central aspect of care and in this assignment the author has chosen the management of anxiety. Due to word restrictions a brief mention will be given to the other aspects of care. Ischaemia is a term which is used to describe the deficiency in blood supply to any part of the body. In ischaemic heart disease there is a deficiency in the blood supply to the heart muscle which can be caused by an obstruction to, or even a narrowing of the coronary arteries. This in turn reduces the supply of nutrients and oxygen to the heart muscle. Without an optimum oxygen supply the heart muscle is unable to function efficiently.(Boersma et al 2003) There are three ways in which an infarction may develop. 1) The narrowing and hardening of arteries is caused by degenerative changes and also the build up of cholesterol and other fatty deposits which occur in the vessel wall. Plaques which then develop and subsequently become ‘calcified or fibrotic’ is through a process known as atherosclerosis. The atherosclerotic plaque slowly builds up in the inner lining of a coronary artery. The presence of the plaques causes the linings of the artery walls to become roughened and this in turn reduces the size of the lumen and eventually occludes it. As circulation slows down there is a strong possibility of thrombus formation. Should a coronary artery......

Words: 2492 - Pages: 10

Myocardial Infaraction

...after acute myocardial infarction. Three-drug-resistant hypertension has also been found to respond to spironolactone in modest dosages. The combination of an angiotensin converting enzyme inhibitor (ACEI) with spironolactone to treat such resistant hypertension may be more effective than adding an angiotensin receptor blocker to an ACEI. The role of spironolactone has also been shown to decrease albuminuria in chronic kidney disease including diabetic nephropathy in the presence of maximal dosages of ACEI. The effect of aldosterone in metabolic syndrome is also discussed in this review. PMID: 20448074 [PubMed - as supplied by publisher] 2010 May 10;170(9):759-64. Rethinking the epidemiology of acute myocardial infarction: challenges and opportunities. Yeh RW, Go AS. Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Abstract BACKGROUND: During the previous decade, many strategies for preventing acute myocardial infarction found to be efficacious in randomized controlled trials have been adopted by physicians in the community. Although evaluations of quality improvement typically focus on process measures at the hospital, practice, or clinician level, assessment of improvements in health outcomes remains the true test for the successful translation of evidence into practice. METHODS: We performed a review of the current literature examining trends in the incidence of myocardial infarction in......

Words: 6201 - Pages: 25

Myocardial Infarction

...Myocardial Infarction Cardiovascular disease is the leading cause of death in the United States; approximately 500,000-700,000 deaths related to the coronary artery occur each year. Approximately 1.5 million cases of myocardial infarction occur annually in the United States. Myocardial infarction, commonly known as a heart attack, is the irreversible necrosis of heart muscle secondary to prolonged ischemia. This usually results from an imbalance in oxygen supply and demand, which is most often caused by plaque rupture with thrombus formation in a coronary vessel, resulting in an acute reduction of blood supply to a portion of the myocardium. Patients with typical myocardial infarction may have the following prodromal symptoms: Intense sharp chest pain, radiation of chest pain up to neck, shoulder, jaw and down left arm, ventricular tachycardia, atrial fibrillation or flutter, Coughing, wheezing, Fever, Fatigue, chest discomfort, and Malaise. Atherosclerosis is the disease primarily responsible almost 90% of myocardial infarctions that result from an acute thrombus that obstructs an atherosclerotic coronary artery. Plaque rupture and erosion are considered to be 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. The damage in the myocardium is essentially the result of a tissue response......

Words: 913 - Pages: 4

Women and Heart Disease

...Women and Heart Disease Coppin State University Abstract Heart disease is a leading cause of death for women and men worldwide. Women are more vulnerable to myocardial infarction because of the size of their coronary arteries. They have unique risk factors such as a high level of cholesterol, hypertension, and smoking that cause heart disease, which leads to the high mortality rate. To reduce the high mortality rate among women, nurses must play their roles as educators because they interact frequently with patient, moreso than any other health care workers. Nurses must educate their patients on how to prevent the risk factors of heart disease. In order to reduce the high mortality rate due to MI in women, the Obama administration implemented the Patient Protection and Affordable Care Act (PPACA), popularly called t "Obama Care". This policy has mandated that insurance companies cover important preventive care at no cost, which will help eliminate the expensive bills that would have been incurred. As a future nurse, I would address the issue of heart disease by providing qualitative education and creating awareness of the causes and preventive measures of heart diseases. Keywords: Affordable Care Act, Heart Disease, Myocardial Infarction, "Obama Care", and Women's Health. Introduction Although both men and women have increased mortality rates due to heart disease in the United States, women have the higher rate and carry a heavier cardiovascular......

Words: 1846 - Pages: 8

Stem Cells & Cardia Disease

... one fact that cannot be denied is that stem cell research has led to many life saving discoveries in various sectors of scientific research. In regards to the ethical dilemma of stem cells, recent developments in induced pluripotent stem cells (iPSCs) have made it possible to explore the applications of stem cells while avoiding the ethical problems associated with embryonic stem cell research (Seki & Fekuda, 2015). One intriguing area in stem cell research is the potential applications for them in the treatment of cardiac diseases. Studies have explored the potential uses for stem cells for the treatment of heart disease (Yamakawa & Ieda, 2015). Additionally, stem cells have been explored for the treatment of heart failure and myocardial infarction (Rasmussen, et al., 2013). Stem cells and how they may be used for the treatment of various cardiac diseases is an exciting topic and has the potential to change future approaches to the treatment. This paper will examine the applications and significance of stem cells in relation to these common cardiac pathologies. Heart disease is one of the leading causes of death in developed countries and currently there are few effective treatment options available (Yamakawa & Ieda, 2015). This it is important to research and make state of the art treatments available to address this issue. The use of stem cells may become an option for treatment of coronary artery disease (CAD). One approach has involved the use of endothelial......

Words: 1567 - Pages: 7

Nursing Intervention

...com/nursing-care-plans-for-diabetes-mellitus/ Nursing care plans for Myocardial infarction (MI). Myocardial infarction (MI) or acute Myocardial infarction is an acute coronary syndrome, results from reduced blood flow through one or more coronary arteries, which causes myocardial ischemia and necrosis. Myocardial infarction (MI) results when myocardial tissue becomes necrotic because of absent or diminished blood supply. When myocardial tissue is deprived of oxygenated blood supply for a period of time, an area of myocardial necrosis develops, this necrosis is surrounded by injured and ischemic tissue. The infarction site depends on the vessels involved. For instance: * Occlusion of the circumflex coronary artery causes a lateral Myocardial infarction (MI). * Occlusion of the left anterior coronary artery causes an anterior Myocardial infarction (MI). * Occlusion of the right coronary artery or one of its branches causes True posterior and inferior Myocardial infarction (MI) * Right ventricular infarctions can also result from right coronary artery occlusion, can accompany inferior MI, and may cause right-sided heart failure. * If a thrombus partially occludes a coronary vessel, distal microthrombi may cause necrosis in some myocytes, leading to a non-ST-segment elevation MI (NSTEMI). * If a thrombus fully occludes the vessel for a prolonged time, an ST-segment elevation MI (STEMI) usually develops. Men are more susceptible to Myocardial infarction......

Words: 5609 - Pages: 23

Acute Myocardial Infarction

...procedure, including stent placement. Fever and chest pain within the first few weeks after surgery warrant immediate workup for infection, because infection carries a 40 percent mortality or death rate. 3. Describe administration, pharmacokinetics and the desired effect of nitroglycerin. Nitroglycerin (NTG) may be given to reduce the ischemic pain of AMI. NTG increases coronary perfusion because of its vasodilator effects. It is usually started at doses of 5 to 10 mcg/ min IV and titrated to a total dose of 50 to 200 mcg/min until chest pain is absent, pulmonary artery occlusion pressure decreases, and/ or systolic blood pressure decreases. Caution should be used in administering NTG to patients with inferior or right ventricular infarctions because it can lead to profound hypotension. Pharmacokinetics: Nitroglycerin is widely distributed in the body with an apparent volume of distribution of approximately 200 L in adult male subjects (only 1% present in the plasma). Half-life is estimated at 1 to 4 minutes. Nitroglycerin is rapidly metabolized in the liver by hepatic enzymes to dinitrates and mononitrates. The 2 active major metabolites are the hydrolysis products, 1,3- and 1,2-dinitroglycerols. There are also 2 inactive minor metabolites. Nitroglycerin is approximately 60% protein bound while the metabolites 1,2 dinitroglycerol and 1,3 dinitroglycerol are 60 and 30% protein bound, respectively. Extensive first-pass deactivation follows gastrointestinal absorption.......

Words: 2162 - Pages: 9

Myocardial

...Immunisation or vaccination is a very effective and safe form of medicine used to prevent severe diseases occurring from viruses and other infectious organisms and increase the amount of protective antibodies. It is given by drops in the mouth or injecting a person with a dead or modified disease-causing agent, in order for the person to become immune to that disease. If enough people in a community are immunised, the infection can no longer be spread from person to person and the disease will eventual die out altogether. This is how smallpox was eradicated from the world, and polio, which has been removed from many countries. But for this to happen in Australia at least 95 percent of the population would have to be immunised, which is far more then what it is now being at only 78 percent. So by making it compulsory for all children to be immunised this percentage would rise well above 95 and the diseases that are in our country now will soon disappear all together. Immunisation is the only effective way of protection for children against these diseases because children’s immune systems are defenceless ageist them because they are not fully developed yet, and once infected in most cases there is no cure or at least a very low chance of one. Minor side effects of immunisation, like redness at the injection site, or occasionally a mild fever, which can easily be reduced with a paracetamol. But why would any one rather let your child be able to catch and spread these......

Words: 274 - Pages: 2

4 K linuxmint-18 3-cinnamon-64bit iso | Ginger Patch 2 | Full Version