MI - Myocardial Infarction
Pathophysiology Course
Pathophysiology Diagnostics
Myocardial Infarction (MI) the heart muscles DIE “necrosis” 1st–EKG
from lack of oxygen. This occurs when there is a (Any chest pain or MI symptoms)
blockage of the coronary arteries, the “O2 tubes”
feeding the heart oxygen.
Signs & Symptoms
O2
PAIN–Jaw, back, mid back/shoulder pain, heartburn (epigastric),
Substernal Normal ST elevation ST Depression
Key words = priority: “Sudden” “Crushing” “radiating” NCLEX TIP
SOB “dyspnea” “labored breathing”
NAUSEA Vomiting “Abdominal pain”
SWEATING “Diaphoresis”
PALE COOL SKIN “dusky”
ANXIETY
Causes
SODDA 2nd–LABS
T–Troponin (Over 0.5 ng/mL) T–
S–Stress, Smoking, Stimulants (caffeine, amphetamines) Trauma (ONLY indicator of MI)
O–Obesity–(BMI over 25) D– Other labs: Crp, Ckmb,
Diabetes & HTN (over 140/90) D– Myoglobin, CRP (inflammation)
Diet (high cholesterol) animal fats
A–African American males & Age (over 50) Treatment: Pharmacology
*Men more than women
Progression O–Oxygen A–
Asa
CAM N–Nitro–under tongue x 3 Max
M–Morphine - Any pain after = MI (injury)
C–CAD “coronary artery disease”
A–ACS “acute coronary syndrome” AFTER–MI
Angina - Stable “Safer”- relieved w/rest
Stabilization:
Angina - Unstable “Unsafe” - Unrelieved Heparin: prevents CLOT growth (NOT dissolve only t-PA)
M–MI (heart die) PTT: 46 - 70 “3 x MAX” Antidote: Protamine Sulfate
Memory Trick: “HaPTT” frog
Rest:
B–Beta Blockers (-lol) Atenolol
Blocks both BP & HR (Lol = Low BP & HR)
CAUTION:
B–Bad for Heart Failure patients (CHF)
B–Bradycardia (60 or Less) & BP low (HR LESS than 60)
Nursing Interventions B–Breathing Problems “wheezing” (Asthma, COPD) B–
Blood sugar masking “hides s/s” (Diabetics)
DRESS C–Calcium Channel Blockers
D–Diet low (sodium & fluids (2g/2L per day) Calms BP & HR-(AVOID Low Hr & BP)
Prevent HF Heart Failure=Heavy Fluid (Nifedipine, Diltiazem, Verapamil)
-dipine “declined BP & HR”
Report "New, Rapid" Weight Gain-Water Gain! -zem “zen yoga for heart”
R–Reduce Stress, Alcohol, Caffeine, Cholesterol (animal fats) -amil “chill heart”
E–Exercise (30 min x 5 days/wk)
S–Smoking Cessation
S–Sex (2 flights of stairs with NO SOB) NO viagra “-afil” Sildenafil = DEATH!
*AVOID NSAIDS (naproxen, ibuprofens) = increases CLOT risk!
Treatment: Pharmacology DISCHARGE–GOING HOME
AC–Anti Clogging of Arteries Heart Rest:
1st choice A–Ace (-pril) Lisonopril “chill pril”
A–Antiplatelet HOLD if: Platelets 50K or LESS CHOLESTEROL
2nd choice A–ARBs (-sartan) Losartan “relax man”
“below 50 gets risky” (not INR, not aPTT) PANEL
Antihypertensive (BP ONLY) *HOLD: Low BP (not HR)
A–ASA C-CLOGGED ARTERIES (risk) Precautions:
A–Avoid Pregnancy
C–Clopidogrel 200 or Less-Total Cholesterol A–Angioedema “thick tongue”
C–Cholesterol Lowering “-Statin” 150 or Less-Triglycerides
(Airway Risk) *only Ace NCLEX TIP
100 or Less-LDL
Lovastatin “stay clean” C–Cough *only Ace
Creatinine (Kidney) (normal: 0.9 -1.2) *only Ace
CAUTION: 40 or More = HDL
E–Elevated K+ (normal 3.5-5.0) NCLEX TIP
NO grapefruit AVOID Salt Substitues + Green Leafy veggies
Liver Toxic–report “clay colored stools” • 1st–Cardiac Monitor
• High Potassium = High Pump
Muscle pain (Rhabdomyolysis risk)
• Monitor: muscle cramps, spasms,
Late night–take at dinner peaked T waves, ST changes
Pathophysiology Course
Pathophysiology Diagnostics
Myocardial Infarction (MI) the heart muscles DIE “necrosis” 1st–EKG
from lack of oxygen. This occurs when there is a (Any chest pain or MI symptoms)
blockage of the coronary arteries, the “O2 tubes”
feeding the heart oxygen.
Signs & Symptoms
O2
PAIN–Jaw, back, mid back/shoulder pain, heartburn (epigastric),
Substernal Normal ST elevation ST Depression
Key words = priority: “Sudden” “Crushing” “radiating” NCLEX TIP
SOB “dyspnea” “labored breathing”
NAUSEA Vomiting “Abdominal pain”
SWEATING “Diaphoresis”
PALE COOL SKIN “dusky”
ANXIETY
Causes
SODDA 2nd–LABS
T–Troponin (Over 0.5 ng/mL) T–
S–Stress, Smoking, Stimulants (caffeine, amphetamines) Trauma (ONLY indicator of MI)
O–Obesity–(BMI over 25) D– Other labs: Crp, Ckmb,
Diabetes & HTN (over 140/90) D– Myoglobin, CRP (inflammation)
Diet (high cholesterol) animal fats
A–African American males & Age (over 50) Treatment: Pharmacology
*Men more than women
Progression O–Oxygen A–
Asa
CAM N–Nitro–under tongue x 3 Max
M–Morphine - Any pain after = MI (injury)
C–CAD “coronary artery disease”
A–ACS “acute coronary syndrome” AFTER–MI
Angina - Stable “Safer”- relieved w/rest
Stabilization:
Angina - Unstable “Unsafe” - Unrelieved Heparin: prevents CLOT growth (NOT dissolve only t-PA)
M–MI (heart die) PTT: 46 - 70 “3 x MAX” Antidote: Protamine Sulfate
Memory Trick: “HaPTT” frog
Rest:
B–Beta Blockers (-lol) Atenolol
Blocks both BP & HR (Lol = Low BP & HR)
CAUTION:
B–Bad for Heart Failure patients (CHF)
B–Bradycardia (60 or Less) & BP low (HR LESS than 60)
Nursing Interventions B–Breathing Problems “wheezing” (Asthma, COPD) B–
Blood sugar masking “hides s/s” (Diabetics)
DRESS C–Calcium Channel Blockers
D–Diet low (sodium & fluids (2g/2L per day) Calms BP & HR-(AVOID Low Hr & BP)
Prevent HF Heart Failure=Heavy Fluid (Nifedipine, Diltiazem, Verapamil)
-dipine “declined BP & HR”
Report "New, Rapid" Weight Gain-Water Gain! -zem “zen yoga for heart”
R–Reduce Stress, Alcohol, Caffeine, Cholesterol (animal fats) -amil “chill heart”
E–Exercise (30 min x 5 days/wk)
S–Smoking Cessation
S–Sex (2 flights of stairs with NO SOB) NO viagra “-afil” Sildenafil = DEATH!
*AVOID NSAIDS (naproxen, ibuprofens) = increases CLOT risk!
Treatment: Pharmacology DISCHARGE–GOING HOME
AC–Anti Clogging of Arteries Heart Rest:
1st choice A–Ace (-pril) Lisonopril “chill pril”
A–Antiplatelet HOLD if: Platelets 50K or LESS CHOLESTEROL
2nd choice A–ARBs (-sartan) Losartan “relax man”
“below 50 gets risky” (not INR, not aPTT) PANEL
Antihypertensive (BP ONLY) *HOLD: Low BP (not HR)
A–ASA C-CLOGGED ARTERIES (risk) Precautions:
A–Avoid Pregnancy
C–Clopidogrel 200 or Less-Total Cholesterol A–Angioedema “thick tongue”
C–Cholesterol Lowering “-Statin” 150 or Less-Triglycerides
(Airway Risk) *only Ace NCLEX TIP
100 or Less-LDL
Lovastatin “stay clean” C–Cough *only Ace
Creatinine (Kidney) (normal: 0.9 -1.2) *only Ace
CAUTION: 40 or More = HDL
E–Elevated K+ (normal 3.5-5.0) NCLEX TIP
NO grapefruit AVOID Salt Substitues + Green Leafy veggies
Liver Toxic–report “clay colored stools” • 1st–Cardiac Monitor
• High Potassium = High Pump
Muscle pain (Rhabdomyolysis risk)
• Monitor: muscle cramps, spasms,
Late night–take at dinner peaked T waves, ST changes
