lOMoARcPSD|26582732
Lomoarcpsd|26582732
NUR 213 Myocardial Infarction
2025-2026
Complex Health Concepts (Forsyth Technical
Community College)
Care Of Patients With Acute Coronary Syndromes – Chapter 38
- Coronary Artery Disease (CAD) Broad Term That Includes Chronic
Stable Angina And Acute Coronary Syndromes Affects The Arteries That
Provide Blood, Oxygen, And Nutrients To The Myocardium
- Ischemia Occurs When Insufficient Oxygen Is Supplied To Meet The
Requirements Of The Myocardium
- Infarction (Necrosis, Cell Death) Occurs When Severe Ischemia Is
Prolonged And Decreased Perfusion Causes Irreversible Damage To Cells
Chronic Stable Angina (CSA)
Angina
Chest Pain Caused By A Temporary Imbalance Between The
Coronary Arteries’ Ability To Supply Oxygen And The Cardiac
Muscle’s Demand For Oxygen
Ischemia That Occurs With Angina Is Limited In Duration And Does Not
Cause Permanent Damage Of Myocardial Tissue
Chronic Stable Angina (CSA)
Chest Discomfort That Occurs With Moderate To Prolonged
Exertion In A Pattern That Is Familiar To The Patient
Frequency, Duration, And Intensity Of Symptoms Remain The
Same Over Several Months
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, lOMoARcPSD|26582732
Results In Only Slight Limitation Of Activity And Is Usually
Associated With A Fixed Atherosclerotic Plaque
Relieved By Nitroglycerin Or Rest And Is Often Managed With Drug
Therapy
Does Not Require Aggressive Treatment
Acute Coronary Syndrome
Used To Describe Patients Who Have Unstable Angina Or An Acute MI
Atherosclerotic Plaque Ruptures, Resulting In Platelet Aggregation,
Thrombus Formation, And Vasoconstriction
Artery Has To Have At Least 40% Plaque Accumulation Before It Starts
To Block Blood Flow
Unstable Angina
Chest Pain Or Discomfort That Occurs At Rest Or With Exertion And
Causes Severe Activity Limitation
Increase In The Number Of Attacks And In The Intensity Of The Pressure
Indicates Unstable Angina
Pain Usually Intermittent Or Short Term
Can Produce EKG Changes, Not ST Segment Elevation
No Long Term Damage To The Myocardium
Can Be A Precursor Or A Warning Of A Future MI
Differs From Stable Because It Comes Frequently And Is Poorly Relieved
By Rest Or Nitroglycerin
Myocardial Infarction
Acute MI Or AMI
Occurs When Myocardial Tissue Is Abruptly And Severely Deprived Of
Oxygen
When Blood Flow Is Quickly Reduced By 80-90%, Ischemia Develops
Ischemia Can Lead To Injury And Necrosis Of Myocardial Tissue If Blood
Flow Is Not Restored
Plaque In Coronary Artery Becomes Unstable/Inflamed Plaque Ruptures
Rough Area Of Collagen In Artery Is Exposed And Platelets Adhere
Platelets Release Chemical That Attracts More Platelets Thrombus
Forms In Artery Artery Is Occluded
Infarction Is A Dynamic Process That Does Not Occur Instantly, Rather It
Evolves Over A Period Of Several Hours
Process And Evolution Of Infarcted Area
Obvious Changes Do Not Occur In The Heart Until 6 Hours After
The Infarction (Infarcted Region Appears Blue And Swollen)
These Changes Explain The Need For Intervention Within
The First 4-6 Hours Of Symptom Onset!!
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, lOMoARcPSD|26582732
After 48 Hours, The Infarcted Area Turns Gray With Yellow Streak
As Neutrophils Invade The Tissue And Begin To Remove The
Necrotic Cells
By 8-10 Days, Granulation Tissue Forms At The Edges Of The
Necrotic Tissue
Over A 2-To-3 Month Period, The Necrotic Area Eventually
Develops Into A Shrunken, Thin, Firm Scar
Scar Tissue Permanently Changes The Size And Shape Of The
Entire Left Ventricle, Called Ventricular Remodeling
May Cause Heart Failure Or Chronic Ventricular
Dysrhythmias
NSTEMI
Pain, Usually Lasting Longer Than 20 Minutes
May Produce EKG Changes, But NOT Elevation Of The ST
Segment
Elevates Cardiac Enzymes Indicates Partial Blockage
Risk For Potential Long Term Damage To Myocardium
Requires Treatment, Usually Non Invasive
STEMI
Pain, Usually Lasting Longer Than 20 Minutes
Produced Elevation Of The ST Segment On EKG
Elevates Cardiac Enzymes
Indicates Complete Blockage
Require Immediate And Invasive Treatment
Most Serious Of ACS
If Not Treated, Then The Patient May Go Into Dysrhythmias And
That Will Be The Cause Of Death
Etiology And Risk Factors
Atherosclerosis Is The Primary Factor In The Development Of CAD
Non-Modifiable Risk Factors
Family History
Age
Gender
Ethnicity
African American
Hispanic Women
Modifiable Risk Factors
Hyperlipidemia
Smoking/Tobacco Use
Limited Physical Activity
Hypertension
Diabetes Mellitus
Obesity
Downloaded by NELSON KIIRU ()
Lomoarcpsd|26582732
NUR 213 Myocardial Infarction
2025-2026
Complex Health Concepts (Forsyth Technical
Community College)
Care Of Patients With Acute Coronary Syndromes – Chapter 38
- Coronary Artery Disease (CAD) Broad Term That Includes Chronic
Stable Angina And Acute Coronary Syndromes Affects The Arteries That
Provide Blood, Oxygen, And Nutrients To The Myocardium
- Ischemia Occurs When Insufficient Oxygen Is Supplied To Meet The
Requirements Of The Myocardium
- Infarction (Necrosis, Cell Death) Occurs When Severe Ischemia Is
Prolonged And Decreased Perfusion Causes Irreversible Damage To Cells
Chronic Stable Angina (CSA)
Angina
Chest Pain Caused By A Temporary Imbalance Between The
Coronary Arteries’ Ability To Supply Oxygen And The Cardiac
Muscle’s Demand For Oxygen
Ischemia That Occurs With Angina Is Limited In Duration And Does Not
Cause Permanent Damage Of Myocardial Tissue
Chronic Stable Angina (CSA)
Chest Discomfort That Occurs With Moderate To Prolonged
Exertion In A Pattern That Is Familiar To The Patient
Frequency, Duration, And Intensity Of Symptoms Remain The
Same Over Several Months
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
Results In Only Slight Limitation Of Activity And Is Usually
Associated With A Fixed Atherosclerotic Plaque
Relieved By Nitroglycerin Or Rest And Is Often Managed With Drug
Therapy
Does Not Require Aggressive Treatment
Acute Coronary Syndrome
Used To Describe Patients Who Have Unstable Angina Or An Acute MI
Atherosclerotic Plaque Ruptures, Resulting In Platelet Aggregation,
Thrombus Formation, And Vasoconstriction
Artery Has To Have At Least 40% Plaque Accumulation Before It Starts
To Block Blood Flow
Unstable Angina
Chest Pain Or Discomfort That Occurs At Rest Or With Exertion And
Causes Severe Activity Limitation
Increase In The Number Of Attacks And In The Intensity Of The Pressure
Indicates Unstable Angina
Pain Usually Intermittent Or Short Term
Can Produce EKG Changes, Not ST Segment Elevation
No Long Term Damage To The Myocardium
Can Be A Precursor Or A Warning Of A Future MI
Differs From Stable Because It Comes Frequently And Is Poorly Relieved
By Rest Or Nitroglycerin
Myocardial Infarction
Acute MI Or AMI
Occurs When Myocardial Tissue Is Abruptly And Severely Deprived Of
Oxygen
When Blood Flow Is Quickly Reduced By 80-90%, Ischemia Develops
Ischemia Can Lead To Injury And Necrosis Of Myocardial Tissue If Blood
Flow Is Not Restored
Plaque In Coronary Artery Becomes Unstable/Inflamed Plaque Ruptures
Rough Area Of Collagen In Artery Is Exposed And Platelets Adhere
Platelets Release Chemical That Attracts More Platelets Thrombus
Forms In Artery Artery Is Occluded
Infarction Is A Dynamic Process That Does Not Occur Instantly, Rather It
Evolves Over A Period Of Several Hours
Process And Evolution Of Infarcted Area
Obvious Changes Do Not Occur In The Heart Until 6 Hours After
The Infarction (Infarcted Region Appears Blue And Swollen)
These Changes Explain The Need For Intervention Within
The First 4-6 Hours Of Symptom Onset!!
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
After 48 Hours, The Infarcted Area Turns Gray With Yellow Streak
As Neutrophils Invade The Tissue And Begin To Remove The
Necrotic Cells
By 8-10 Days, Granulation Tissue Forms At The Edges Of The
Necrotic Tissue
Over A 2-To-3 Month Period, The Necrotic Area Eventually
Develops Into A Shrunken, Thin, Firm Scar
Scar Tissue Permanently Changes The Size And Shape Of The
Entire Left Ventricle, Called Ventricular Remodeling
May Cause Heart Failure Or Chronic Ventricular
Dysrhythmias
NSTEMI
Pain, Usually Lasting Longer Than 20 Minutes
May Produce EKG Changes, But NOT Elevation Of The ST
Segment
Elevates Cardiac Enzymes Indicates Partial Blockage
Risk For Potential Long Term Damage To Myocardium
Requires Treatment, Usually Non Invasive
STEMI
Pain, Usually Lasting Longer Than 20 Minutes
Produced Elevation Of The ST Segment On EKG
Elevates Cardiac Enzymes
Indicates Complete Blockage
Require Immediate And Invasive Treatment
Most Serious Of ACS
If Not Treated, Then The Patient May Go Into Dysrhythmias And
That Will Be The Cause Of Death
Etiology And Risk Factors
Atherosclerosis Is The Primary Factor In The Development Of CAD
Non-Modifiable Risk Factors
Family History
Age
Gender
Ethnicity
African American
Hispanic Women
Modifiable Risk Factors
Hyperlipidemia
Smoking/Tobacco Use
Limited Physical Activity
Hypertension
Diabetes Mellitus
Obesity
Downloaded by NELSON KIIRU ()
