Care and Medical Management of Myocardial Infarction

This assignment discusses the care and medical management of myocardial infarction, including symptoms, causes, treatment, and cardiac rehabilitation programs. It explores the impact of lifestyle factors and provides recommendations for better heart health. The document type is an assignment.

Contents
Introduction
CARE AND MEDICAL MANAGEMENT OF MYOCARDIAL INFARCTION ..................7
RECOMMENDATION
CONCLUSION.........................................................................................................................9
REFERENCE.........................................................................................................................10
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CARE AND MEDICAL MANAGEMENT OF MYOCARDIAL
INFARCTION
INTRODUCTION
Myocardial infarction is the most dangerous disease or it is also known as the heart
attack. Myocardial Infarction is mainly occurred due to bad lifestyle and changing
environment (Lee, Maggiore, and Chung, 2018). Also smoking, tobacco and alcohol
consumption effect the health of people. Moreover, the symptoms include vomiting,
shortness of breath, weakness, etc. in recent times, many people are suffering from
this disease. This is due to increase in consumption of tobacco, smoking habits, etc.
so, it is resulting in rise in number of deaths. However, there are some treatment
available for cure of this disease. There are many types of myocardial infraction that
occurs. It depends on person health and age. Furthermore, its impact on physical
health differs as well. In addition to it, ECG is used to find out Myocardial infarction.
The key tool for diagnosing an acute MI remains measurement of the serum level of
troponin, although when this is not available it's possible to instead use the serum
level of creatine kinase-MB mass.
For MI types 1 and 2, the troponin or creatine kinase-MB level should be
above the 99%, compared with an appropriate control using an assay with a cutoff
independent of assay imprecision of 10% or less.
In this assignment, it will be discussed about Myocardial infarction, , medical
management and cardiac rehabilitation programs. Cardiac rehabilitation creates
awareness, Also, it will be described about major causes and factors that affect the
heart. Moreover, certain measures and care management of Heart failure which
includes several medical managements such as Aspirin, Magnesium, Nitrates, Beta
blockers etc. are discussed.
Myocardial infarction occurs when flow of blood suddenly stops or decreases and
damage cardiac muscles which contains three types of vertebrate muscles which is
the main wall of the heart (Romero, Greenwood and Glaser., 2018). Heart attack
suddenly stops the flow of oxygen. Common symptoms of heart attack are pain of
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chest, shoulders, arm, back neck and jaw. Most of the time MI occurs due to
coronary artery disease (Schiele and Bassand, 2017). Dis-balance in lifestyle such
as smoking, diabetes, unorganized daily routine, laziness and lack of exercise are
the main causes of Myocardial Infarction. Treatment of MI is to be done at a very
short period otherwise it may result into death. Aspirin is the most effective drug,
which is given just after the heart attack. According to the survey, there are about
500,000-700,000 people suffer from this disease every year (Lee, Maggiore, and
Chung., 2018). Heart attack is mainly occurring after 60 years but in current
researches, children of about 15-20 years are suffering from these diseases. MI is
now completely entered into life of everyone that can be children, adults and old
ones and also ruins the life at a very less age. Myocardial infarction occurs in women
about 50% and generally experience back pain, heartburn, breathing problems
(Anand and Sharma, 2019). According to the latest research of World Health
Organization of 2017, death rate from Myocardial Infarction is about 24.4% of the
total death in Maldives. Acute disease related with MI is acute coronary syndrome
and symptoms are chest pain or discomfort, indigestion, sudden heavy sweating,
dizziness and fatigue. This is a medical emergency and this should be treated at a
priority otherwise patients may lose their lives. Most of the people are not aware
about the heart attack and treated it as a “life threatening” problem, but this is not the
case. This disease can be treated easily with few precautions (Vyas., Ahamed.,
Batar and Gehlot., 2019).
In recent research, one real case of 60-year-old man who was aware about chest
pain from last one-year problem. He admitted that he is a chain-smoker and
consumes heavy dose of alcohol. Chest pain is also a part of Myocardial infarction
and this is the most challenging task for doctors and especially for nurses because
nurses are the first-aiders of any disease and stabilize patients when doctor is not
available. In treatment of Myocardial diseases, several parameters are checked such
as medical history, Electrocardiogram or ECG (Schiele and Bassand., 2017).
There is a process which cure or stabilize patients, the thrombolytic treatment or the
medication which is approved by the emergency treatment of heart failure. But
recent study states that the patients older than 60 years are kept out from this
thrombolytic treatment but this proves a better treatment for the patients in between
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25-55 and it is found that approximately 20,000 patients are sustained or stabilized
by this treatment in one year. All these diseases are occurred because of the bad life
style and food product that are currently in the market (Handler, Coghlan and
Brown., 2018). There are several issues which are responsible for heart failures are
bad cholesterol, saturated and the trans-fat which are responsible for the blockage
and the heart failure.
Nurse plays a major role in the patient management and also gives the primary
treatment to the patients. There are several Cardiac Rehabilitation Programs which
includes the nursing training and the role of nurses in this training includes the
technical training in which the nurses deal with the technical diagnostic test, provides
the relevant information to the patients about the problems and the solutions
regarding the problem. Heart diseases requires the proper nursing care and
sometimes nurses give the personal home care to the patients because these kinds
of patients require the relaxed and noise free environment (Anand and Sharma.,
2019). Nurses can give the significant treatment and reduces the chance of risk due
to the heart problems. For example, nurses of ADK hospital of Maldives, are working
very efficiently to the advance cardiovascular healthcare which includes the study of
health literacy and the impact of depression because the depression is the main
reason of heart problems and provides the solutions according to the problem. Heart
failure is the major issue in the countries like US, UK and China because of the fast
and the changing lifestyle of the people. As per the researched data, about
thousands of people are died because of heart problems and most of the patients
are from these countries. The pollution in these countries are on the great extent.
The nurses of Maldives have been asked to improvise the nursing role in treating the
heart diseases and it results in a positive way. There is still the requirement of
motivation in the nurses to play an important role in educating the patients and
improvising their lifestyle to overcome this problem (Blumenthal and Hsiao., 2015).
If the patient is suffering from the heart disease, then the doctor encourages the
patient to participate in the cardiac rehabilitation program which gives the right
direction to the people and also helps in them mentally to improvise their thoughts.
This program includes day to day exercise, training that helps in changing their
lifestyle such as the quitting smoking, drugs and liquor and adopting the proper diet
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(Deepti and Roy., 2018). The dietitians help in changing their diets that can make
their heart healthy. The cardiac rehabilitation includes several kinds of exercises
such as cycling, swimming, and low-impact aerobics. Cardiac rehab is beneficial for
the patients in improving the cardiovascular disease or the people who had a recent
cardiac attack, heart failures. The good rehabilitation program is beneficial for the
patients and understand each person's need and requirement and these programs
are multidisciplinary (Saklani and Mittal., 2017).
There are several medical managements of myocardial infarction to prevent further
complications. Pain is the first stage of myocardial infarction which is treated by
nitroglycerin and morphine and it improves the blood supply and decreases the
excessive work of heart to relax the muscles. Anti-coagulation is given as a loading
dose to reduce the clot size and also reduces further clotting in the artery and also
decreases the mortality by at least 50%. Cardiac rehabilitation is beneficial to
reduce the heart damage and also the rehabilitation program includes the programs
like exercises, social support, driving, flying, sport participation, stress management
etc.
There are several factors that are responsible for heart failure such as smoking,
tobacco, physical inactivity, improper nutrition, overweight and obesity, high blood
cholesterol etc. According to the latest research, Tobacco is the main cause of heart
failure because of the elements in the tobacco directly attack the walls of blood
vessels and these may cause the sudden failure and there are about 7 million deaths
are from tobacco only and these problems are generally occurred in the children of
age 15-20 years. Smoking is main cause of concern in heart failure and regular
increase in the e-cigarette among children is the main cause of concern in the
demographic areas. The measures of preventing heart failures are quit smoking, eat
heart healthy food, control the cholesterol, exercise regularly, stay at healthy weight,
control high blood pressure, assess the mental health, medication on regular basis,
control blood sugar, Limit alcohol and illegal drugs. These are all measures which
helps in reducing the risk of heart failure and improve life style. The risk of heart
attack is mainly in the age of 45 for men and 55 in case of women (Blumenthal and
Hsiao., 2015). As per the research, women are more affected by the heart attack.
There are certain groups and communities which are mostly attacked by the heart
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attack are African Americans are more likely than whites to have heart disease, while
Hispanic Americans are less tacked by the heart failure. Some Asian groups, such
as East Asians, have lower rates, but South Asians have higher rates. The heart
attack is also generally happened due to the heredity in the family. Heart failure is a
very complex illness, with a difficult disease trajectory, often complicated by patients
suffering from other diseases. There are a number of key issues; the first appears to
be lack of clear communication between doctor and the patient and people generally
do not consult with the doctor about this problem and due to this reason, it may
cause the serious problem and also results into death (Schiele and Bassand., 2017).
Having a supportive clinical team of multi-disciplinary specialists-including the better
team of doctor and the skilled and trained nurses is therefore important in giving
patients the information and understanding to self-manage their condition and
symptom exacerbation where possible (Schiele and Bassand., 2017).
Supportive recommendation for myocardial infarction is that all patients should be
given aware about myocardial rehabilitation and also patients should be encouraged
to attend rehabilitation programs for the clinical needs and also if patient wants to
quit the program then the medical professionals like nurses and doctors should
encourage the patients about attending the program and tell them about the benefits
of the rehabilitation program. If a patient has cardiac or other clinical conditions that
may worsen during exercise, these should be treated if possible before the patient is
offered the exercise component of cardiac rehabilitation. Also, people who are not
able to attend the program should be encouraged by giving them the motivational
letters, prearranged meetings, telephone calls and the other measures that is
possible.
CARE AND MEDICAL MANAGEMENT
The primary aim of the doctor is to prevent health of patient and also aims to
minimize the patient discomfort and distress and limit the case of myocardial
infarction and there are some management criteria of myocardial infarction is rapid
diagnosis of early risk stratification to relieve the pain and to prevent or treat cardiac
arrest. Firstly, the working diagnosis of myocardial infarction which is based upon the
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medical history of patient of several chest pain and also include irregularities of
pulse, bradycardia or tachycardia and a third heart sound. For these problems, the
electrocardiogram is obtained and at the early stage, the ECG is treated normally. In
case of ST-segment elevation or new or presumed new left bundle-branch block, re-
perfusion therapy is given to the patients and measures to initiate this treatment is to
be taken as soon as possible. Blood sample is taken in acute phases and
sometimes, the elevated marker of necrosis may be helpful in deciding to give re-
perfusion therapy. When ECG and serum markers are not diagnostic of acute
myocardial infarction, patient can proceed safely to stress testing for investigation of
underlying coronary artery disease (Alghanem and Clements., 2019). There are
several other measures of routine prophylactics therapies in acute diseases such as
Aspirin, Anti-arrhythmic drugs, Beta-blockers, Nitrates, Magnesium and Glucose-
insulin potassium. Other diagnosis of specific types of management for infarction is
of the Right ventricular infarction and the Myocardial infarction in diabetic patients.
All these kinds of patients require a sensitive care and needs a noise free
environment and clean place because environment is responsible for these kinds of
patients and also it needs a medical touch i.e., nurses, doctors. But nurses are
closer to patients because doctors are only diagnosing and according to medical
science theory, patient is only the subject for doctors and only do experiments on
their patients by certain treatments (Lee, Maggiore, and Chung., 2018). Nurses are
more connected with patients and stay for long time.
Myocardial infarction is death of muscles of heart because of the blockage of
coronary artery by blood clot. There are some nursing care plans for the Myocardial
infarction such as decrease cardiac output by changing the heart rate frequency,
impaired tissue perfusion, ineffective airway clearance, changing breathing pattern,
impaired gas exchange, acute pain, fluid volume excess, imbalanced nutrition,
activity intolerance, self-care deficit, anxiety and knowledge deficit (Schiele and
Bassand., 2017). Close monitoring of patients and identification of response is only
done by nurses. It is not possible for hospital to give personal care to patients and
some are properly cared by experienced staff. According to the researched data of
UK, heart patients are not cared by the staff because staff are not experienced and
due to this, patients older than 70 are died due to improper care of patients by the
hospital management. The cardiovascular nurses are also cardiac nurses and the
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registered nurses. There are some core values of nurses which are caring practices,
clinical excellence and there are some elements of professional practice model such
as research, professional development, quality outcomes, shared leadership skills,
evidence based practice and the exemplary practice. Most of the hospitals give
training to nurses to treat patients and identify their problems. One of the famous
hospital of Maldives are ADK hospital in which all nurses give advanced cardiac
training to patients and also rehabilitation program gives proper relaxation to heart
patients. Medical professionals also start camps for the awareness of patients and
this helps in spreading the message about the healthy heart to others who are not
aware about the heart. (Anand and Sharma., 2019).
Nurses represents the whole community and plays an important role in treatment of
patients because nurses are more closed to patients. Nurses also meet the needs of
rehabilitative care of patients through education, support, supervision and
reinforcement. Awareness of nurses in cardiac rehabilitation improves the health
outcome and also reduces the risk of heart failure. Healthcare and rehabilitation
programs are organized by nurses for heart patients to improve and make them
aware about heart failures and educate patients about health of heart because heart
is the engine of the body and if it stops working then the body will also stops working
(Blumenthal and Hsiao., 2015).
Recommendation
There are several recommendations that can be followed :-
 A policy can be developed to provide high care quality services to patients. Also, it
will enable in following a systematic process in it.
 Past medical records of patients can be checked to determine whether patient is
suffering from any disease or not.
CONCLUSION
This report concluded that Myocardial infarction and various issues which are
responsible for heart failure. It also concludes that how nurses are responsible in
keeping patients healthy because patients are more connected and closed with the
nurses. There are several factors which are responsible in heart failure which should
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be avoided like smoking, tobacco, obesity, cholesterol, bad environment and the
changing lifestyle of people causes such type of problems and children are more
attacked by these kinds of diseases because youngsters of age 15-25 do not take
care of their health and consumes alcohol, cigarette, tobacco etc which creates
very bad impact on their body and can lose their lives. All these researches about
health of heart will impact on my future and all these theories will be beneficial for me
and helps me in learning about prevention and cure of heart health and also I am
now aware about the heart, so I can share knowledge to others about safety and
precaution for healing the heart and also makes the heart safe and healthy.
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REFERENCE
Books and journals
Alghanem, F. and Clements, J.M., 2019. Narrowing performance gap between rural
and urban hospitals for acute myocardial infarction care. The American
journal of emergency medicine.
Anand, R. and Sharma, H., 2019. A STUDY ON THE GENDER RISK PROFILE IN
ACUTE MYOCARDIAL INFARCTION IN A TERTIARY CARE CENTRE IN
EASTERN BIHAR. Indian Journal of Applied Research, 9(3).
Blumenthal, D. and Hsiao, W., 2015. Lessons from the East—China's rapidly
evolving health care system. New England Journal of Medicine, 372(14),
pp.1281-1285.
Carroll, I., Mount, T. and Atkinson, D., 2016. Myocardial infarction in intensive care
units: a systematic review of diagnosis and treatment. Journal of the Intensive
Care Society, 17(4), pp.314-325.
Carroll, I., Mount, T. and Atkinson, D., 2016. Myocardial infarction in intensive care
units: a systematic review of diagnosis and treatment. Journal of the Intensive
Care Society, 17(4), pp.314-325.
Deepti, S. and Roy, A., 2018. A system of care for patients with ST-segment
elevation myocardial infarction in India. The National medical journal of India,
31(4), p.222.
Handler, C., Coghlan, G. and Brown, N., 2018. Myocardial infarction and other acute
coronary syndromes. InManagement of Cardiac Problems in Primary Care
(pp. 122-136). CRC Press.
Isted, A., Williams, R. and Oakeshott, P., 2018. Secondary prevention following
myocardial infarction: a clinical update.The British Journal of General Practice,
68(668), p.151.
Kalavrouziotis, D., Rodés-Cabau, J. and Mohammadi, S., 2017. Moving beyond
SHOCK: New paradigms in the management of acute myocardial infarction
complicated by cardiogenic shock. Canadian Journal of Cardiology, 33(1),
pp.36-43.
Lee, F., Maggiore, P. and Chung, K., 2018. Self-management of an inferior ST-
segment elevation myocardial infarction. New England Journal of Medicine,
378(10), pp.960-962.
Romero, T., Greenwood, K.L. and Glaser, D., 2018. Sex Differences in Acute
Myocardial Infarction Hospital Management and Outcomes: Update From
Facilities With Comparable Standards of Quality Care. The Journal of
cardiovascular nursing, 33(6), p.568.
Saklani, N.R. and Mittal, R.B., 2017. Thrombolysis with Reteplase in the
Management of ST-Elevation in Myocardial Infarction and Evaluation of
Patients in a Primary Care Setup (TRIME Study). Indian Medical Gazette,
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Española de Cardiología (English Edition), 70(3), pp.140-141.
Vyas, A., Ahamed, J., Batar, K.K. and Gehlot, A., 2019. TO STUDY PRESCRIPTION
PATTERN OF DRUGS AND OTHER PROPHYLACTIC MEASUREMENTS
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FOR SURVIVORS OF ACUTE MYOCARDIAL INFARCTION AT TERTIARY
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Yancy, C.W. and Harrington, R.A., 2018. The TREAT Trial—Moving ST-Elevation
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