Professional Documents
Culture Documents
Interruption of blood flow to the heart muscle that results in tissue necrosis Can be preceded by cardiac ischemia Can cause cardiac arrest. Medical Emergency! Admit to hospital.
Hypotension Pale Skin Palpitations Sweating Chest pain SOB Nausea and Vomiting Lightheadedness Can proceed to LOC and sudden death.
Mallinson, T (2010). "Myocardial Infarction". Focus on First Aid (15): 15.
ABCs: assess and correct hemodynamic status first bed rest, cardiac monitoring, oxygen nitroglycerin SL followed by IV morphine IV Time is Muscle
ECG MI can have ST elevation (STEMI) or no ST Elevation (NSTEMI). Monitor ST segment continuously if patient is in pain. Cardiac Biomarkers CK MB, Troponins
Get Baseline bloods, including lipid profile.
Chest pain lasts more than 20 minutes Opiates more effective than sublingual GTN
Atypical symptoms like syncope and dyspnoea seen in the elderly and diabetic patients.
ST elevation seen on ECG
REF: Kumar and Clarks Clinical Medicine
Thrombolysis In Myocardial Infarction (TIMI) score Global Registry of Acute Coronary Events (Grace)
Low Risk patients Drugs alone Medium risk patients early coronary angiography + Drugs High Risk Patients urgent coronary angiography, refer for CABG.
SL GTN 0.31 mg
oxygen nasal cannula 24 L/min (Fig. 15.21) H + E and risk calculation
Large bore IV access + blood for markers 12-lead ECG IV Opiate + antiemetic beta-blocker, if not contra-indicated.
Beta Blocker Clexane Morphine + Gravol Oxygen ASA Nitrates Statins ACEi
On call with Ward 9, SFGH.
Mallinson, T (2010). "Myocardial Infarction". Focus on First Aid (15): 15. Kumar and Clarks Clinical Medicine, 8th Edition. Saunders Ltd. Davidsons Principles and Practice of Internal Medicine. http://www.timi.org/ Wikipedia Commons (image)