NURSING

1. Clinical Teaching On Myocardial
Infarction
Presented By
Monika Devi
M.S.c (N)
HCN , SRHU

2. Definition
It is defined as the death of a segment of
heart muscles, as a result of sustained
ischemia.

3. Etiology
• Acute coronary thrombosis
• Arteriosclerosis
• Other factors
Infectious disease
Hypoxia
Smoking
Excessive fat intake
Excessive exercise.

5. Clinical Manifestations
• Severe chest pain
• Diaphoresis
• Cold calm skin
• Hypertension or hypotension
• Dyspnoea
• Nausea & vomiting
• Palpitation
• Tachycardia

6. Characteristics of chest pain:
1. Severity:- more than angina pectoris
2. Duration:- > 15 minutes & not relieved by
nitroglycerine.
3. Radiation:- radiated to nose, jaw, shoulder,
fore arm, 4th , 5th fingers

7. Site Of Mi:
• Most common anterior wall of left ventricle –
due to thrombus in left arm.
• Posterior wall of heart – due to blockage in
right CA
• Inferior wall of heart – due to blockage in right
CA

8. Complications
• Heart failure
• Cardiogenic shock
• Dysrhythmias
• Acute pulmonary edema
• Pericardial effusion
• Myocardial rupture

9. Heart failure

10. Cardiogenic shock

11. Dysrhytmias

12. Acute pulmonary edema

13. Pericardial effusion

14. Myocardial rupture

15. Diagnostic studies
• History
• Physical examination
• ECG
• ECHO
• Lab findings:
– ↑ serum AST
– ↑ LDH
– ↑ ESR
• MRI

17. Medical Management
• Morphine sulphate 5-10mg for pain
• Vasodilators
– Nitrates
– β Blockers
– Calcium channel blockers
• Antioxlytics – benzodiazepines
• Anticoagulants - heparin
• Thrombolytic – streptokinase, urokinase
• Antiarrthymics - lignocaine, xylocaine

18. Dietary Management
• Low fat/ cholesterol
• Low sodium
• Avoid caffeine & alcohol intake

19. Surgical management
CABG

20. PTCA

21. Nursing Diagnosis
• Pain related to decrease blood supply to the
heart
• Anxiety related to fear of death
• Impaired cardiac output related to
dysrrhythmias
• Activity intolerance related to fatigue
• Impaired tissue perfusion related to
infarction

22. summary

23. References
• Lewis’s medical surgical nursing assessment and
measurement of clinical problems. Second
edition.
• Mypcardialinfarctionenm.wikipediaorg/wiki/my
ocardial
• Myocardial infarctionwww.webmed.com/heart-
disease
• Myocardial infarctionwww.medicine.com/script/