This document provides an overview of myocardial infarction (MI), also known as a heart attack. It defines MI as the death of heart muscle due to sustained lack of blood supply. Common causes of MI include coronary thrombosis, arteriosclerosis, infections, hypoxia, smoking, excessive fat or exercise. Symptoms include severe chest pain, sweating, nausea, shortness of breath, and abnormal heart rhythms. Treatment involves pain medications, vasodilators, anticoagulants, thrombolytic drugs, antiarrhythmics, lifestyle changes like a low-fat diet, and potentially coronary artery bypass grafting or angioplasty procedures. Nursing diagnoses for patients include pain, anxiety, impaired cardiac output, limited activity,

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/