Tuesday, May 14, 2013

Acute Myocardial Infarction

Myocardial infarction is a heart condition of sudden onset caused by an abrupt reduction of blood flow to the myocardium.  The deprivation of oxygen and nutrients to the cardiac muscle, if not reversed, eventually leads to ischemia and myocardial cell death.  Ischemia occurs within 10 seconds of coronary occlusion.  After several minutes the heart cells lose the ability to contract, leading to a decrease in cardiac output.  Cardiac cells remain viable for approximately 20 minutes under ischemic conditions.  An MI occurs when coronary occlusion persists beyond 20 minutes.  If blood flow is restored beforehand, cellular repair begins and contractility is restored.  Time is of the essence to preventing permanent cardiac muscle damage-- Time is Muscle!!


 
Pathophysiology of an MI
 
Typical symptoms include:
  • Substernal or left-side chest pain or pressure
  • Radiation of pain to the neck, jaw, back, shoulder or arm
  • Shortness of breath
  • Nausea
  • Diaphoresis

According to the ACC/AHA guidelines, the treatment for MI include pharmalogical reperfusion of the myocardium using antiplatelet and antithrombolytic therapy.  Nitrates can be used to promote vasodilation and decrease cardiac workload.  Beta blockers also promote vasodilation and decrease oxygen demand on cardiac tissue.  Analgesics, like morphine, help relieve pain.

Drug of the Week:  aspirin


1 comment:

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