Scribd
Upload
157 views6 pages

Acute Myocardial Infarction

A 66-year-old male presented to the emergency room with chest pain. He has a history of hypertension and smoking. His symptoms, vital signs, and physical exam are consistent with an acute myocardial infarction (AMI) or heart attack. An AMI occurs when blood flow to the heart is blocked, usually due to a buildup of plaque in the coronary arteries. Risk factors include diabetes, high blood pressure, smoking, and family history. Treatment involves opening the blocked artery through angioplasty or medication, along with medications to reduce blood pressure and risk of additional clots. Lifestyle changes can help prevent future heart attacks.

Uploaded by

Aliyah Kaye Lacdaying Romero
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
157 views6 pages

Acute Myocardial Infarction

A 66-year-old male presented to the emergency room with chest pain. He has a history of hypertension and smoking. His symptoms, vital signs, and physical exam are consistent with an acute myocardial infarction (AMI) or heart attack. An AMI occurs when blood flow to the heart is blocked, usually due to a buildup of plaque in the coronary arteries. Risk factors include diabetes, high blood pressure, smoking, and family history. Treatment involves opening the blocked artery through angioplasty or medication, along with medications to reduce blood pressure and risk of additional clots. Lifestyle changes can help prevent future heart attacks.

Uploaded by

Aliyah Kaye Lacdaying Romero
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 6

CASE SCENARIO:

A 66-year-old male complaining of chest pain is brought to the emergency room by


ambulance. The pain began six hours ago and has become more severe over the past hour
prompting him to call emergency services. He describes the pain as retro-sternal, pressure-like,
and non- radiating. He endorses some mild dyspnea and nausea accompanying the pain. He
has also noted intermittent palpitations since last evening.
He has a past medical history of hypertension (not currently under treatment) and
tobacco use of one pack per day of cigarettes for the past 47 years. Vital signs on arrival to the
emergency room show a blood pressure of 160/100 mmHg, a heart rate of 92 beats per minute,
and a respiratory rate of 18 per minute. His physical exam is unremarkable. He reports no
allergies and no medication use.

DIAGNOSIS:

ACUTE MYOCARDIAL INFARCTION


Acute Myocardial Infarction is an Acute Coronary Syndrome and is the medical name for
a heart attack. It is a life-threatening condition that occurs when blood flow to the heart muscle
is abruptly cut off, causing tissues or cells to be damaged.

CAUSES
A heart attack occurs when one or more of the coronary arteries become blocked. Over
time, a buildup of fatty deposits, including cholesterol, form substances called plaques, which
can narrow the arteries (atherosclerosis). During a heart attack, a plaque can rupture and spill
cholesterol and other substances into the bloodstream. A blood clot forms at the site of the
rupture. If the clot is large, it can block blood flow through the coronary artery, starving the heart
of oxygen and nutrients (ischemia). A complete or partial blockage of the coronary artery may
be possible. A complete blockage means that there is an ST elevation myocardial infarction
(STEMI). A partial blockage means the case is a non-ST elevation myocardial infarction
(NSTEMI). Diagnosis and treatment might be different depending on which type you've had.
Another cause of a heart attack is a spasm of a coronary artery that shuts down blood flow to
part of the heart muscle. Using tobacco and illicit drugs, such as cocaine, can cause a life-
threatening spasm. Infection with COVID-19 also may damage your heart in ways that result in
a heart attack.
SIGNS AND SYMPTOMS:
While the classic symptoms of a heart attack are chest pain and shortness of breath, the
symptoms can be quite varied. The most common heart attack signs and symptoms include:
 Pressure or tightness in the chest
 Pain in the chest, back jaw, and other areas of the upper body that lasts more than a few
minutes or that goes away and comes back
 Shortness of breath (Dyspnea)
 Sweating
 Nausea
 Vomiting
 Anxiety
 A cough
 Dizziness
 A fast heart rate
 Collapse or syncope

It is important to note that not all people who have heart attacks experience the same
symptoms or the same severity of symptoms. Chest pain is the most commonly reported
symptom among both women and men. However, women are more likely than men to have:
 Shortness of breath
 Jaw pain
 Upper back pain
 Lightheadedness
 Nausea

In fact, some women who have had a heart attack report that their symptoms felt like the
symptoms of the flu.

RISKS

 Diabetes & High blood sugar levels

 High blood pressure


 High cholesterol levels

 High triglyceride levels

 Smoking
 Obesity
 Family History
 Age

INVESTIGATION

 Electrocardiography (ECG) - most important initial diagnostic procedure when doctors


suspect an acute coronary syndrome. This procedure provides a graphic representation of
the electrical current producing each heartbeat. In many instances, it immediately shows
that a person is having a heart attack.
 Chest X-ray - checks the size of your heart and its blood vessels and to look for fluid in
your lungs.
 Echocardiography (ECHO) or Radionuclide imaging -   how heart's chambers and valves
are pumping blood through the heart. An echocardiogram can help identify whether an
area of your heart has been damaged.
 Lactate Dehydrogenase Test (LDH) - looks for signs of damage to the body’s tissues.
 Electrolytes (Na, K, Cl) Test- it is accompanied with other heart tests to know if treatment
is working.
 Other blood tests;
o Complete Blood Count (CBC)
o Erythrocyte Sedimentation Rate (ESR) – indirectly measures the degree
of inflammation present in the body. The test actually measures the rate of fall
(sedimentation) of erythrocytes (red blood cells) in a sample of blood that has
been placed into a tall, thin, vertical tube.
o Cardiac Marker: Creatinine Kinase-MB Test (CK-MB) - measures the blood level
of CK-MB, the bound combination of two variants of the enzyme phosphocreatine
kinase.
o Lipid Profile- initial screening tool for abnormalities in lipids, such as cholesterol
and triglycerides.
o Myoglobin Test - help diagnose conditions associated with muscle damage.
o Cardiac Marker: Troponin Test - measures the levels of troponin T or troponin I
proteins in the blood. These proteins are released when the heart muscle has
been damaged, such as occurs with a heart attack. The more damage there is
to the heart, the greater the amount of troponin T and I there will be in the
blood.
o Glucose Test- measures the glucose levels in the blood.

TREATMENT
Heart attacks require immediate treatment, so most treatments begin in the emergency
room. A minimally invasive procedure called angioplasty may be used to unblock the arteries
that supply blood to the heart. During an angioplasty, a surgeon will insert a long, thin tube
called a catheter through your artery to reach the blockage. He or she will then inflate a small
balloon attached to the catheter in order to reopen the artery, allowing blood flow to resume.
The surgeon may also place a small, mesh tube called a stent at the site of the blockage. The
stent can prevent the artery.
A number of different medications can also be used to treat a heart attack:
 Blood thinners, such as aspirin, are often used to break up blood clots and improve
blood flow through narrowed arteries.
 Thrombolytic are often used to dissolve clots.
 Antiplatelet drugs, such as clopidogrel, can be used to prevent new clots from forming
and existing clots from growing.
 Nitroglycerin can be used to widen the blood vessels.
 Beta-blockers lower blood pressure and relax heart muscles. This can help limit the
severity of damage to the heart.
 Angiotensin-converting enzyme (ACE) inhibitors can also be used to lower blood
pressure and decrease stress on the heart.
 Pain relievers may be used to reduce any discomfort.

PREVENTION
It's never too late to take steps to prevent a heart attack — even for having the same
case in history. Here are ways to prevent a heart attack:
 Medications. Taking medications can reduce risk of a subsequent heart attack
and help damaged heart function better. Continuation of following Doctor’s
prescription, and frequency of intake for monitoring.
 Lifestyle factors. Maintaining a healthy weight with a heart-healthy diet,
prevention of smoking, exercising regularly, managing stress and controlling
conditions that can lead to a heart attack, such as high blood pressure, high
cholesterol and diabetes.
References na Site :
https://prezi.com/p/wmxjgnnsdkai/acs/
https://www.heart.org/en/health-topics/heart-attack/about-heart-attacks/acute-coronary-
syndrome
https://watchlearnlive.heart.org/index.php?moduleSelect=corart
https://www.heart.org/en/health-topics/heart-attack/treatment-of-a-heart-attack/cardiac-
medications
https://www.mayoclinic.org/diseases-conditions/sudden-cardiac-arrest/symptoms-causes/syc-
20350634
https://www.heart.org/en/health-topics/heart-attack/about-heart-attacks/heart-attack-or-sudden-
cardiac-arrest-how-are-they-different
https://www.healthline.com/health/acute-myocardial-infarction#risk-factors
https://www.healthline.com/health/abnormal-heart-rhythms#diagnosis
https://www.msdmanuals.com/home/heart-and-blood-vessel-disorders/coronary-artery-
disease/acute-coronary-syndromes-heart-attack-myocardial-infarction-unstable-
angina#:~:text=Acute%20coronary%20syndromes%20result%20from,to%20lack%20of
%20blood%20supply.
https://www.mayoclinic.org/diseases-conditions/heart-attack/diagnosis-treatment/drc-
20373112#:~:text=If%20you've%20had%20or,for%20fluid%20in%20your%20lungs.

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy