02 - Myocardial Infarction
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Questions and Answers

Which muscular layer of the heart covers the entire heart?

  • Endocardium
  • Pericardium
  • Epicardium (correct)
  • Myocardium

Which chamber of the heart propels deoxygenated blood into the pulmonary circulation?

  • Left ventricle
  • Right atrium
  • Right ventricle (correct)
  • Left atrium

Which valve is located between the left atrium and left ventricle?

  • Pulmonic valve
  • Tricuspid valve
  • Mitral valve (correct)
  • Aortic valve

Which part of the heart's conduction system is known for delayed conduction?

<p>Atrioventricular node (C)</p> Signup and view all the answers

What returns blood from the myocardium back to the right atrium?

<p>Coronary sinus (D)</p> Signup and view all the answers

Where does the exchange of O2 and CO2 occur between blood and tissues?

<p>Capillaries (C)</p> Signup and view all the answers

Which of the following is a symptom of myocardial infarction?

<p>Severe, persistent chest pain (B)</p> Signup and view all the answers

Which laboratory finding is indicative of myocardial cell death?

<p>Elevated myocardial enzymes (B)</p> Signup and view all the answers

Which medication is commonly administered for myocardial infarction?

<p>Thrombolytics (D)</p> Signup and view all the answers

What position is recommended for a patient experiencing myocardial infarction?

<p>Semi-fowler's position (B)</p> Signup and view all the answers

What is the primary goal of initial medical management for patients with acute coronary syndrome?

<p>Minimize myocardial damage (D)</p> Signup and view all the answers

Which cardiac biomarkers are primarily elevated in the diagnosis of NSTEMI?

<p>Troponin (B)</p> Signup and view all the answers

Which intervention is preferred as the initial treatment method for STEMI?

<p>Emergent Percutaneous Coronary Intervention (D)</p> Signup and view all the answers

What is the recommended door-to-needle time for administering thrombolytics?

<p>Within 30 minutes (C)</p> Signup and view all the answers

Which of the following is NOT a clinical manifestation of unstable angina?

<p>Elephantiasis (C)</p> Signup and view all the answers

In the management of acute coronary syndrome, which medication should be introduced within 24 hours for optimal effect?

<p>Beta-blocker (D)</p> Signup and view all the answers

During inpatient management of myocardial infarction, which parameter is NOT typically monitored continuously?

<p>Body temperature (A)</p> Signup and view all the answers

What characterizes unstable angina in terms of coronary artery obstruction?

<p>Reduced blood flow without complete blockage (D)</p> Signup and view all the answers

Which symptom is typically associated with myocardial infarction?

<p>Severe crushing chest pain (A)</p> Signup and view all the answers

What is the main event leading to myocardial infarction?

<p>Complete blockage of a coronary artery (D)</p> Signup and view all the answers

In which time frame can myocardial cell necrosis occur after artery occlusion?

<p>Minutes to hours (B)</p> Signup and view all the answers

Which lab test is crucial in diagnosing myocardial infarction?

<p>Troponin levels (A)</p> Signup and view all the answers

What is a common physiological response in patients experiencing myocardial infarction?

<p>Diaphoresis and cold clammy skin (A)</p> Signup and view all the answers

What should be included in the patient history assessment for diagnosing cardiac issues?

<p>Description of presenting symptoms (B)</p> Signup and view all the answers

Which of the following is NOT a typical assessment finding for myocardial infarction?

<p>Fainting spells (C)</p> Signup and view all the answers

Flashcards

Myocardium layer

The muscular layer of the heart that covers the entire heart.

Right Ventricle function

Pumps deoxygenated blood to the lungs (pulmonary circulation).

Mitral Valve location

Located between the left atrium and left ventricle.

Atrioventricular node function

Delays electrical signal to allow time for atrial contraction before ventricular contraction.

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Coronary Sinus function

Returns blood from the heart muscle (myocardium) to the right atrium.

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Capillaries function

Sites of gas and nutrient exchange between blood and tissues.

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Myocardial Infarction cause

Death of heart muscle cells due to lack of oxygen, often from a blocked coronary artery.

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Myocardial Infarction symptom - chest pain

Severe pain, often crushing, in the chest and radiating to the neck, arm, jaw, or back.

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Myocardial Infarction lab findings

Elevated myocardial enzymes (CK-MB, LDH, Troponin) and ECG changes (ST segment elevation, T wave inversion).

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Myocardial Infarction treatment - Medications

O2, morphine, thrombolytics, aspirin, anticoagulants, and stool softeners are common treatment for myocardial infraction.

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Acute Coronary Syndrome (ACS)

An emergent condition involving sudden myocardial ischemia, potentially leading to myocardial death (e.g., MI).

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Myocardial Infarction (MI)

Death of heart muscle cells due to insufficient oxygen, often from a complete coronary artery blockage.

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Unstable Angina

A form of ACS where blood flow to the heart is reduced, but not completely blocked.

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NSTEMI

A form of ACS where heart muscle damage is present but not extensive enough to show significant changes on initial ECG.

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STEMI

A form of ACS where there is complete blockage of a coronary artery, leading to significant heart muscle damage and changes in ECG.

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ACS Pathophysiology (Unstable Angina)

Reduced blood flow in a coronary artery, often with clot formation, but the artery is not fully blocked.

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ACS Pathophysiology (MI)

Artery blockage causes significant damage, including plaque rupture and thrombus formation. Complete blockage leads to ischemia and necrosis in the heart muscle.

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ACS Assessment: Chest Pain

Severe, persistent, crushing pain centered in the chest, often radiating to the neck, arm, jaw, or back. This pain is often unrelieved by rest, nitroglycerin, and lasting 30 minutes or more.

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ACS Assessment: Dyspnea

Shortness of breath

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ACS Assessment Findings: Cold, Clammy Skin

A sign of reduced blood flow in the body due to decreased perfusion.

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ACS Assessment Findings: Labs

Elevated myocardial enzymes (CK-MB, LDH, Troponin) are detected, indicating heart muscle damage.

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ECG Changes in STEMI

Characteristic changes in 2 contiguous ECG leads indicate a ST-elevation Myocardial Infarction (STEMI).

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Unstable Angina Characteristics

Unstable angina presents with symptoms of coronary ischemia but lacks evidence of acute changes on ECG or cardiac biomarkers.

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NSTEMI Biomarkers

NSTEMI (non-ST-elevation MI) is diagnosed by elevated cardiac biomarkers (like troponin) but lacks definite ECG evidence.

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STEMI ECG

STEMI is diagnosed with characteristic ECG changes in 2 contiguous leads.

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PCI & Door-to-Balloon Time

Percutaneous coronary intervention (PCI) is the preferred initial treatment for acute coronary syndromes (ACS) such as STEMI, aiming for door-to-balloon time (<60 minutes).

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Thrombolytics Use

Thrombolytics are used for opening blocked coronary arteries when PCI is not immediately available or transport time is too long.

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Thrombolytics Mechanism

Thrombolytics dissolve the thrombus (blood clot) causing the blockage.

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Door-to-Needle Time

The time between recognizing the need for thrombolytic therapy and the actual administration of the medication (within 30 minutes).

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Initial ACS Management

Initial management for ACS (acute coronary syndromes) includes oxygen, aspirin, nitroglycerin, morphine, and sometimes a beta-blocker.

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Inpatient Monitoring (ACS)

Inpatient management of ACS includes continuous ECG monitoring, ongoing medication management (aspirin, beta-blockers, ACE inhibitors), and close monitoring of vital signs.

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Cardiac Biomarkers

Cardiac biomarkers (troponin, CK-MB, myoglobin) are used to detect and assess the severity of cardiac damage in patients.

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Echocardiogram Role

Echocardiogram assesses ventricular function and wall motion abnormalities in patients.

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Goal of ACS Treatment

The primary treatment goals for acute coronary syndrome (ACS) include minimizing myocardial damage, maintaining heart function, and preventing any complications.

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Study Notes

Cardiovascular System

  • The cardiovascular system is responsible for transporting blood throughout the body.
  • The heart is a vital organ in this system, responsible for pumping blood.
  • Different parts of the heart include the right and left ventricles, right and left atria.

Heart Wall

  • The epicardium covers the entire heart.
  • Other important layers are the myocardium and endocardium.

Heart Chambers

  • The right ventricle pumps deoxygenated blood into the pulmonary artery.

Heart Valves

  • The mitral valve is located between the left atrium and left ventricle.

Conduction System

  • The atrioventricular node is part of the heart's conduction system. It is also called the delayed conduction system.

Coronary Circulation

  • The coronary sinus returns blood from the myocardium back to the right atrium.

Vascular System

  • Capillaries are responsible for the exchange of oxygen, carbon dioxide, and other substances between blood and tissues.

Cardiac Disorders

  • Myocardial infarction (MI) is the death of myocardial cells due to inadequate oxygenation, often caused by a blockage of a coronary artery.
  • Symptoms of MI may include severe, persistent, crushing substernal discomfort radiating to the neck, arm, jaw, and back, occurring without cause, mainly in the early morning; unrelieved by rest and nitroglycerine; and lasting 30 minutes or more. Other symptoms include dyspnea, diaphoresis (sweating), cold clammy skin, nausea, vomiting, restlessness, and hypotension.
  • Diagnosing MI could involve elevated myocardial enzymes (CK-MB, LDH, and Troponin); ECG changes, including ST segment elevation and T wave inversion.

Nursing Management

  • Nursing management for myocardial infarction (MI) includes administering oxygen as prescribed, administering medications (morphine, thrombolytics, aspirin, anticoagulants, stool softeners), providing bed rest in a semi-Fowler's position, minimizing anxiety, monitoring ECG, instructing the patient to avoid constipation and use of suppositories, assisting with treatment modalities like PTCA and CABG, and minimizing metabolic demands through a soft diet, low-sodium, low-cholesterol, and low-fat diet.

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Related Documents

Cardiovascular System PPT PDF
Acute Coronary Syndrome PDF

Description

Explore the key components of the cardiovascular system, including the heart's structure, chambers, and valves. This quiz covers the vital roles of the heart and the vascular system in blood circulation. Test your knowledge on the functions of heart layers and the conduction system.

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