Cardiovascular conditions - Acute coronary syndrome- MI

Question 1

Myocardial infarction happens when a?

Answer 1

a portion of cardiac muscle is deprived of coronary blood flow long enough that portions of the muscle die.

Question 2

Myocardial infarction can be caused by?

Answer 2

• occlusion due to a blood clot
• spasm of coronary artery
  reduction of blood flow due to any cause

Question 3

Pathophysiology of a MI

Answer 3

-Presence of plaque or Thrombus with a coronary vessel.
- vessel occlusion
- reduced or ceased blood flow
-tissue ischemia or tissue death (infarction)

Question 4

Signs and symptoms of a MI

Answer 4

• Ashen (Grey) pallor
• Diaphoresis (sweating)
• clamminess
• acute dyspnoea
• Nausea and vomiting
• Dizziness and lightheadedness or profound weakness
• Apprehensive look, looking scared, sense of pending doom.
• women can present with different symptoms but can also ignore their symptoms.
  -pts can present without pain with associated symptoms.

Question 5

Treatment of an MI

Answer 5

• identify complaint
• gain sufficient evidence
• obs
• 12-lead
  -act on findings

-Aim to be en route within 10 minutes

Question 6

MI treatment - MONA

Answer 6

Morphine - max dose of 20ml
Oxygen - SP02 <94%
Nitrates -(GTN) = 400-800MCG
Asprin - 300mg

Question 7

Goals of treatment in an MI

Answer 7

-limit the size of the infarct
- decrease pt fear and pain
- prevent development of serious cardiac arrhythmias and cardiac arrest
- transport PPCI ASAP

Question 8

what else can we consider when treating an MI?

Answer 8

• minimize effort exerted by pt.
• use a stretcher or chair to move the pt
• place pt in a semi-recumbent position on the stretcher
  -reduce anxiety and stress as much as possible through reassurance.
• monitor continuously

Question 9

Drug action - relation to MI/ACS
Asprin

Answer 9

• when necessary take 200mg orally

Question 10

What is aspirin used for?

Answer 10

• the antiplatelet function which helps to reduce clot formation.
• analgesic and antipyretic properties

Question 11

What does aspirin work to inhibit

Answer 11

• Formation of an enzyme which helps construct a thrombus (clot)

Question 12

Asprin should be administered ASAP

Question 13

Drug action- in relation to MI/ACS
GTN

Answer 13

400-800mch should be taken sublingual

Question 14

What does GTN do?

Answer 14

Dilates the coronary arteries and relieves coronary spasms enabling a greater passage of blood to the myocardium.