MI, Angina, CAD
MI, Angina, CAD
MI, Angina, CAD
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.
Causes
SODDA 2nd–LABS
T–Troponin (Over 0.5 ng/mL)
S–Stress, Smoking, Stimulants (caffeine, amphetamines) T–Trauma (ONLY indicator of MI)
O–Obesity–(BMI over 25) Other labs: Crp, Ckmb,
D–Diabetes & HTN (over 140/90) Myoglobin, CRP (inflammation)
D–Diet (high cholesterol) animal fats
A–African American males & Age (over 50) Treatment: Pharmacology
*Men more than women
DURING–Any Chest Pain
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
Clot 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
Heart Rest:
B–Beta Blockers (-lol) Atenolol
Blocks both BP & HR (Lol = Low BP & HR)
CAUTION:
B–Bad for Heart Failure patients (CHF)
Patient Education B–Bradycardia (60 or Less) & BP low (HR LESS than 60)
B–Breathing Problems “wheezing” (Asthma, COPD)
DRESS B–Blood sugar masking “hides s/s” (Diabetics)
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) D–Dilators (vasOdilators = O2 to heart)
Nitroprusside (only for HTN crisis) & Isosorbide
S–Smoking Cessation Nitro “Pillow for heart”
S–Sex (2 flights of stairs with NO SOB) NCLEX TIP NO viagra “-afil” Sildenafil = DEATH!
*AVOID NSAIDS (naproxen, ibuprofens) = increases CLOT risk! Nitro drip: STOP if Systolic BP below 90 or 30 mmHg Drop
SE: HA is Common + SLOW Positions changes “syncope” t