Anoop Singh Dr. B R Amedkar University

1. Presented By-
Anoop Singh
Department of Pharmacy,
Dr. B. R. Ambedkar University,
Agra

2.  Myocardial infarction (MI)
refers to the process by which
areas of myocardial cells in the
heart are permanently destroyed.
 It occurs when myocardial
tissues are abruptly and
severely deprived of oxygen.

3.  Myocardial infarction is a
diseased condition which is
caused by reduced blood flow
in a coronary artery due to
atherosclerosis and occlusion
of an artery by an embolus or
thrombus.

6. FACTOR
AGE
SEX
FAMILY
HISTORY

7. AGE: More than 40
years.
FAMILY HISTORY:
Myocardial infarction can
be inherited from parents
to children.
GENDER: Myocardial
infarction is 3 times more
in men than women.

8. FACTOR
HIGH
BLOOD
LIPIDS
LEVEL
HYPER-
TENSION
SMOKING
PHYSICAL
INACTIVITY
OBESITY
DIABETES
MELLITUS
STRESS

9. HIGH BLOOD CHOLESTROL LEVEL
LOW DENSITY
LIPOPROTEIN
(LDL)
DANGEROUS
HIGH DENSITY
LIPOPROTEIN
(HDL)
LIPIDS
(LIPOPROTIENS)

10. HDL is not dangerous because it contains more
proteins & very less lipids.
Secondly it carry lipids away from arteries to the
liver for metabolism. So it prevents lipids
accumulation within arteries.
LDL is dangerous because it contains more lipids
& has capacity to deposit fat within arteries.
So, LDL level more than 160mg/dl will place a
person at a risk of myocardial infarction.

11. If a person’s blood pressure is more than 140/90
mmHg continuously for 4-5 years
Sustained stress on arterial walls injury to
endothelial lining atherosclerosis
narrowed & thickened arterial walls risk of
M.I.
Also salt consumption 5gms/ day cause M.I.

12. Smoking nicotine catecholamine (epinephrine &
nor epinephrine) release increases heart rate &
blood pressure increases cardiac workload.
+
CO decreases O2 available to myocardium
Injury to myocardium

13. Improper lipid metabolism
LDL level increases
Starts accumulating
in blood vessels
Risk of M.I.

14. More lipids are produced
LDL level increases
Atherosclerosis
Risk of M.I.

15. Glucose molecules may stick to lumen of
artery
Blockage of artery
Risk of having M.I.

16. SNS stimulation
Release of catecholamine
Increases heart rate & intensify the force of
myocardial contraction
Increases O2 demand
Cell death
Risk of M.I.

18. Causative factor: Obesity
Atherosclerosis
Narrowing of lumen
ed heart insufficient blood flow to myocardium
Contractility ed O2 demand of myocardial cells
Inadequate creates an O2 deficit
Blood supply
myocardial cell death
inflammation
Oliguria
CK-MB & Troponine released Fever

19. Anaerobic glycolysis
Accumulation of lactic acid
Irritation of myocardial nerve fibers
Transmission of pain massage to myocardium
Chest pain & radiation towards shoulder & arm

20. Stimulation of vomiting SNS Stimulation
center
increased
Nausea & Vomiting catecholamine
Diaphoresis Increased
(perfuse sweating) Heart Rate
Cold & Clammy skin
“Cold Sweat”

21.  Cardiovascular-
 Chest pain/Discomfort
 Palpitations
 Elevated BP
 ECG may show tachycardia, bradycardia and
dysarrythmia

22.  Respiratory-
 Shortness of breath
 Dyspnea/Tachypnea
 Crackles
 Pulmonary edema-may be present
 Gastrointestinal-
 Nausea
 Vomiting

23.  Genitourinary-
 Decreased urinary output
 Skin-
 Cool, clammy skin
 Diaphoresis
 Pallor, Cyanosis
 Coolness of extremities

24.  Neurogenic-
 Anxiety, restleness
 Light- headedness
 Headache
 Visual Disturbances
 Altered speech
 Altered motor functions
 Altered level of consciousness

25.  Psychosocial-
 Fear feeling
 Pt. may deny that anything is wrong

26. Characteristics: Severe,
immobilizing chest pain.
Usually prescribed as heaviness,
pressure, tightness, burning.
Radiation: It may radiate to neck,
jaw, arm or back.
Duration: Lasts for 20 minutes or
more.

27. Stimulation of vomiting center by severe pain
causes nausea & vomiting.
FEVER
100.4 to 102.2°F
It is due to inflammatory process caused by
Myocardial cell death.

29.  It is generally based on presenting symptoms, ECG
and laboratory test results.
 Patient history-it includes
• Description of presenting
symptoms
• History of previous illness,
family health history

30.  Electrocardiogram-
ECG provides information that
assists in diagnosing acute MI.
 The classic ECG changes are-
 T wave inversion
 ST segment elevation
 Abnormal Q wave

31. PURPOSE: it is useful to assess the ability of
heart muscles to contract & relax.
It is done to evaluate ventricular function by
checking ejection rate.
MEGNATIC RESONANCE IMAGING (MRI)
PURPOSE: To detect site & extent of myocardial
cells.

32. To detect percentage of blockage & type of MI.
CHEST X-RAY
To detect cardiomegaly.

33. DRUG
THERAPY
FIBRINOLYTIC
THERAPY
MEDICAL
MANAGEMENT

34. How Can Myocardial Infarction Be Prevented?
 One way to lower your risk is to eat a heart-healthy diet.
This diet should largely consist of:
 whole grains
 vegetables
 fruits
 lean protein
 You should also reduce the amount of the following in your
diet:
 sugar
 saturated fat
 trans fat
 cholesterol

35. THANK
STHANK
YOU