Myocardial Infarction Quiz: Heart Attack Overview

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Questions and Answers

What duration of chest pain typically indicates an instance of angina?

Up to 10 minutes

15 to 30 minutes

More than 15 minutes

Less than 15 minutes (correct)

Which diagnostic tool is primarily used to detect ischemia or acute coronary injury?

Stress test

Coronary angiogram

Electrocardiogram (correct)

Echocardiogram

What is a common symptom of angina?

Pressure radiating to the left shoulder (correct)

Pain in the right arm

Nausea without chest discomfort

Severe abdominal pain

After a myocardial infarction, when can elevated levels of cardiac troponin I first be detected in serum?

3 to 4 hours Signup and view all the answers

What is the main purpose of a coronary angiogram?

To visualize narrowing or obstructions in heart vessels Signup and view all the answers

Symptoms of angina are typically relieved by which method?

Rest or nitroglycerin Signup and view all the answers

Which of the following enzymes is specifically analyzed in acute myocardial infarction?

CK-MB Signup and view all the answers

What is the primary cause of irreversible death of heart muscle during a myocardial infarction?

Prolonged lack of oxygen supply Signup and view all the answers

Which symptom would most likely indicate a developing myocardial infarction rather than angina?

Chest pain lasting more than 15 minutes Signup and view all the answers

At what age do men independently acquire a higher risk factor for myocardial infarction?

45 Signup and view all the answers

Which symptom is least characteristic of a myocardial infarction?

Hyperventilation Signup and view all the answers

Which risk factor is not mentioned as contributing to myocardial infarction?

High cholesterol levels Signup and view all the answers

What occurs at the cellular level during a myocardial infarction due to prolonged ischemia?

Cellular death and tissue necrosis Signup and view all the answers

What is the most likely immediate effect of a rupture in an atherosclerotic plaque?

Complete occlusion of the artery Signup and view all the answers

What term describes the condition when smaller arteries dilate to maintain blood flow to the cardiac muscle?

Collateral circulation Signup and view all the answers

Which statement differentiates myocardial infarction from angina?

Myocardial infarction is associated with heart damage. Signup and view all the answers

What is the primary purpose of myoglobin in the context of myocardial infarction?

To act as a marker for early detection of myocardial damage Signup and view all the answers

What critical period is indicated for the effectiveness of thrombolytic therapy following the onset of myocardial ischemia?

Within 12 hours of symptom onset Signup and view all the answers

Which finding may be observed during the physical examination of a patient experiencing acute myocardial infarction?

Cool and pale skin Signup and view all the answers

What complication can arise within 3 to 5 days after a myocardial infarction due to increased pressure against the heart walls?

Myocardial rupture Signup and view all the answers

Which medication is commonly used to decrease myocardial oxygen demand?

Beta adrenergic blocking agents Signup and view all the answers

What effect does morphine sulfate have on a patient with myocardial infarction?

It decreases pain and anxiety Signup and view all the answers

Which of the following is an elevated laboratory finding in a complete blood count during myocardial injury?

Elevated white blood cell count Signup and view all the answers

What condition can result from inflammation affecting the heart muscle after a myocardial infarction?

Pericarditis Signup and view all the answers

What is one key objective of cardiac rehabilitation?

Return patients to work and pre-illness life Signup and view all the answers

Which phase of cardiac rehabilitation occurs immediately after the patient is discharged?

Phase II Signup and view all the answers

Which of the following is NOT a priority for patient education in cardiac rehabilitation?

The history of their illness Signup and view all the answers

Why are intravenous sites examined frequently in patients with myocardium infarction?

To guarantee access for emergent medication administration Signup and view all the answers

What is a potential complication for patients on anticoagulation therapy during prolonged bed rest?

Deep venous thrombosis Signup and view all the answers

What change does calcium channel blocking agents primarily induce?

Decrease heart rate and workload Signup and view all the answers

What is one psychological goal of cardiac rehabilitation?

Enhance the psychological status of the patient Signup and view all the answers

Which assessment is critical for a nurse caring for a patient with myocardium infarction?

Evaluating cognitive and emotional status Signup and view all the answers

What is the primary goal related to ineffective cardiopulmonary tissue perfusion?

Relieve chest pain and discomfort Signup and view all the answers

Which intervention is NOT appropriate for managing ineffective cardiopulmonary tissue perfusion?

Encourage physical activity Signup and view all the answers

What should be closely monitored to assess potential altered peripheral tissue perfusion?

Urine output hourly Signup and view all the answers

What intervention can help reduce a patient's anxiety related to fear of death and chest pain?

Provide information about treatment Signup and view all the answers

Which of the following is a sign that may indicate decreased cardiac output?

Decreased urine output Signup and view all the answers

Which method is recommended for helping to relieve chest pain and discomfort in patients with ineffective cardiopulmonary tissue perfusion?

Elevating the head to decrease venous return Signup and view all the answers

When monitoring vital signs in patients with potential altered peripheral tissue perfusion, how often should blood pressure be assessed?

Every 2 hours Signup and view all the answers

What physical intervention can help decrease myocardial oxygen consumption in patients with confined activity?

Limit them to bed or chair rest Signup and view all the answers

Study Notes

Myocardial Infarction (Heart Attack)

Irreversible death of heart muscle caused by prolonged lack of oxygen (ischemia)
Atherosclerosis, a buildup of plaque in coronary arteries, is a primary cause
Plaque ruptures, blocking blood flow and causing damage

Risk Factors

Tobacco smoking
High blood pressure
Family history of ischemic heart disease
Obesity
Age: Men over 45, Women over 55 have increased risk
Excessive alcohol consumption

Pathophysiology

Plaque rupture in coronary arteries leads to a blood clot blocking blood flow
Ischemia lasting over 20-45 minutes causes irreversible cell death (necrosis)
Good collateral circulation can limit the size of the infarction

Signs and Symptoms

Chest pain: can be mild discomfort or severe crushing pain, radiating to arms, neck, jaw, back, or waist
Shortness of breath
Nausea or stomach discomfort
Fatigue
Trouble sleeping
Heart palpitations
Anxiety
Sweating

Myocardial Infarction vs. Angina

Myocardial Infarction:
- Chest pain with heart muscle damage
- Pain is sudden, severe, and lasts over 15 minutes
- Symptoms not relieved by rest or nitroglycerin
Angina:
- Chest pain without heart muscle damage
- Pain is a pressure or tightness in the chest, lasting less than 15 minutes
- Symptoms relieved by rest or nitroglycerin

Diagnosis

Electrocardiogram (ECG): detects ischemia or acute coronary injury
Coronary Angiography: visualizes narrowing or blockages in heart vessels, allowing immediate intervention
Echocardiogram: assesses heart function
Stress Test: measures heart response to physical activity
Laboratory Tests:
- Serum Cardiac Markers (Enzymes):
  - Troponins I: elevated within 3-4 hours after MI, peaking at 4-24 hours
  - Creatine Kinase (CK): rises rapidly after MI, peaking at 4-6 hours
  - CK-MB: most specific enzyme for heart muscle, detectable within 3-5 hours after MI
  - Myoglobin: early indicator, rises within 1-3 hours after MI
- Complete Blood Count: elevated white blood cells due to inflammation
- Erythrocyte Sedimentation Rate: elevated due to inflammation
Physical Examination:
- Assess general appearance, vital signs, skin color, and fever
- Monitor blood pressure, pulse, and respiratory rate

Complications

Congestive Heart Failure: compromised heart function
Myocardial Rupture: weakening of heart walls, occurring 3-5 days after MI
Pericarditis: inflammation of the heart sac

Management

Pharmacological Management:
- Thrombolytic Therapy: used within 12 hours of symptom onset (most effective within 2 hours)
  - Streptokinase, urokinase, alteplase
- Analgesics:
  - Morphine Sulfate: intravenous for pain and anxiety
- Nitroglycerin: dilates veins and arteries, reducing myocardial workload
- Beta-Blockers: reduce heart rate, blood pressure, and myocardial contractility
- Anticoagulation Therapy: prevents deep vein thrombosis during bed rest
- Calcium Channel Blockers: slow heart rate and relax blood vessels
- Antidysrhythmics: manage irregular heartbeats (e.g., lidocaine)
Cardiac Rehabilitation:
- Phases:
  - Phase I: initial education and stabilization
  - Phase II: outpatient program for 4-6 weeks, including exercise training
  - Phase III: long-term maintenance of cardiovascular stability
- Education: signs and symptoms, medication regimen, rest and activity balance

Nursing Process

Assessment: gather information about chest pain, vital signs, and patient appearance
Nursing Diagnoses, Planning & Intervention:
- Ineffective Cardiopulmonary Tissue Perfusion:
  - Goal: relieve chest pain and discomfort
  - Intervention:
    - Oxygen administration
    - Physical rest
    - Elevate head of bed
    - Monitor vital signs
    - Administer nitroglycerin and morphine
- Potential Altered Peripheral Tissue Perfusion:
  - Goal: promote adequate tissue perfusion
  - Intervention:
    - Monitor urine output
    - Monitor mental status
    - Limiting patient to bed or chair rest
    - Oxygen therapy
    - Monitor body temperature
    - Monitor blood pressure
    - Monitor respiration and lung sounds
- Anxiety:
  - Goal: reduce anxiety
  - Intervention:
    - Provide education and reassurance
    - Explore stress reduction methods
    - Ensure quiet environment

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Description

Test your knowledge on myocardial infarction, commonly known as a heart attack. This quiz covers causes, risk factors, pathophysiology, and signs and symptoms associated with this critical medical condition. Enhance your understanding of heart health and prevention strategies.