Cardiac depressant effects of certain drugs (beta-blockers, antiarrhythmics)įollowing a thorough assessment, it is essential to formulate a nursing diagnosis that specifically addresses the problems associated with myocardial infarction (heart attack).Presence of ischemic/necrotic myocardial tissues.An imbalance between myocardial oxygen supply and demand.Tissue ischemia (coronary artery occlusion).Alterations in heart rate and BP with activityĪssess for factors related to the cause of myocardial infarction:.Restlessness, changes in the level of consciousness.Reports of chest pain with/without radiation.Distinguishing between MI and unstable angina based on symptoms alone can be challenging, leading to the broader term acute coronary syndrome.Īssess for the following subjective and objective data: These signs and symptoms, caused by sympathetic nervous system activation, can be brief or persistent. They may exhibit cool, pale, and moist skin, along with an increased heart and respiratory rate. Patients with MI commonly present with acute and continuous chest pain, often accompanied by symptoms like shortness of breath, indigestion, nausea, and anxiety.

Monitoring for potential complications.The following are the nursing priorities for patients with myocardial infarction: Confirmation of blood flow through an open vessel in the catheterization laboratory provides evidence of successful reperfusion. Relief of pain and improvement in ECG findings indicate a balanced oxygen demand and supply, as well as potential reperfusion. To minimize damage, strategies focus on reducing oxygen demand and increasing oxygen supply through medications, oxygen therapy, and rest. This is achieved by interventions that restore blood flow in the coronary arteries. The primary goals of managing acute myocardial infarction (MI) are to limit myocardial damage, preserve cardiac function, and prevent complications. (Thygesen et al., 2018) Nursing Care Plans and Management This includes clients who manifest a typical presentation of MI and die before it is possible to obtain blood for cardiac biomarker determination. Type 3 MI is suspected when an acute myocardial ischemic event is high, even when cardiac biomarker evidence of MI is lacking. The pathophysiological mechanism leading to ischemic myocardial injury in the context of a mismatch between oxygen supply and demand has been classified as type 2 MI. MI caused by atherothrombotic coronary artery disease and usually precipitated by atherosclerotic plaque disruption is designated as a type 1 MI. MI may be classified into various types based on pathological, clinical, and prognostic differences, along with different treatment strategies. The prognosis improves if vigorous treatment begins immediately. Mortality is high when treatment is delayed and almost one-half of sudden deaths due to an MI occur before hospitalization, within one hour of the onset of symptoms. The ACS continuum representing ongoing myocardial ischemia or injury consists of unstable angina, non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI).Ĭardiovascular diseases, the leading cause of death in the United States and Western Europe usually result from cardiac damage or complications of MI. Myocardial infarction is a part of a broader category of a disease known as acute coronary syndrome (ACS), resulting from prolonged myocardial ischemia due to reduced blood flow through one of the coronary arteries. This usually results from an imbalance in oxygen supply and demand, which is most often caused by plaque rupture with thrombus formation in a coronary vessel, resulting in an acute reduction of blood supply to a portion of the myocardium (Zafari, 2015). Myocardial infarction (MI) or acute myocardial infarction (AMI) commonly known as heart attack, is the irreversible necrosis of heart muscle secondary to prolonged ischemia. Improving Tissue Perfusion & Initiating Cardiac Rehabilitation Improving Cardiac Output & Monitoring Potential Complications Administering Medication and Pharmacologic Support Initiating Pain Relief and Ischemia & Improving Respiratory Function

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