Cardiac Alterations
Acute MI
o Signs and symptoms
S/S in women- extreme fatigue, diaphoresis, abdominal discomfort, arm and
shoulder pain, nausea/vomiting, indigestion, SOB, bradycardia, dizziness,
hypotension
...
Cardiac Alterations
Acute MI
o Signs and symptoms
S/S in women- extreme fatigue, diaphoresis, abdominal discomfort, arm and
shoulder pain, nausea/vomiting, indigestion, SOB, bradycardia, dizziness,
hypotension
Normal s/s- midsternal chest pain, Severe, crushing, and squeezing pressure may
radiate, unrelieved with nitrates, pale and diaphoretic, dyspnea and tachypneic,
syncope, nausea and vomiting, dysrhythmias
o Diagnostic tests: based on s/s, analysis of 12 lead ECG, and cardiac enzymes
12-lead: ST elevation followed by Q wave formation (Q-wave myocardial
infarction or STEMI) – This is the more severe type of AMI, requires immediate
intervention send to Cath Lab. A STEMI occurs b/c of plaque rupture leading to
complete occlusion of artery. 1
st thing you do
ST depression (non–Q-wave myocardial infarction or NSTEMI). NSTEMI
results from a partially occluded coronary vessel> heparin, nitro> then
will go to cath lab
Elevated cardiac enzymes- serial enzymes every 6 hours
CPK & CPK-MB
Serum troponin I: (0.05) most specific for cardiac muscle, will rise w/in
after injury
Myoglobin
PTT ( ), INR 2-3, CBC, electrolytes
Stress test: exercise the heart while monitoring VS and ECG
Chest x-ray: can show fluid and a mass
Echocardiography: tells you fx of left ventricle, shows structures
o Transthoracic echocardiography
o Transesophageal echocardiography: better pictures
Cardiac catheterization may be performed
o Ask about allergies to shellfish and contrast
o If they have allergies block H1 w/ Benadryl and H2 with Pepcid
o If they have a reaction during test stop give medication and support
respiratory system
Diagnosis is confirmed w/ ST elevation
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