Management Of Myocardial Infarction Assignment Solution

Care and Management
of Myocardial Infarction

Table of Contents
INTRODUCTION...........................................................................................................................3
CONCLUSION................................................................................................................................9
REFERENCES..............................................................................................................................10

INTRODUCTION
Myocardial infarction is the most dangerous disease or it is also known as the
heart attack. Heart attack is mainly occurred due to the bad lifestyle and the changing
environment and the bad habits of the people like smoking, tobacco and drinking affect
the health of the people and also in today's lifestyle, the laziness and the sedentary life
style are the main cause of failure. In this assignment, I will discuss the Myocardial
infarction and what are the causes of heart failures and cardiac rehabilitation programs
are organized by the nurses to make the patients. Cardiac rehabilitation create the
awareness, help the patients to habituate healthy life style and improve the quality life of
the patient. I will also discuss the major cause and the factors that affect the heart like
tobacco, cigarette, drinking are the major factors and the precautions for avoiding these
etiological factors. I will also cover that how the surgical intervention are beneficial for
healing during the heart diseases such as pacemaker, Cardiac Re-synchronization
TherapyImplantable Cardioverter Defibrillators (ICDLeft Ventricular Assist Device
(LVADsAll these devices requires a care and patients also requires a high care and
needs a noise free environment and clean place. At last, it also includes the certain
measures and the care management of the Heart failure which includes several
measures such as Aspirin, Magnesium, Nitrates, Beta blockers etc. which is helpful in
healing the problem of heart failure.
The challenges of integrating heart failure.
Myocardial infarction and the problem associated at each level and this includes
the issues surrounding the patients and what are the factors responsible for the
Myocardial infarction. Myocardial Infarction which is also known as the heart attack,
occurs when the flow of blood suddenly stops or decreases and causing the damage to
the 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. The common symptoms of the heart attack is the chest pain,
shoulders, arm, back neck and jaw. Most of the time MI occurs due to the coronary
artery disease. The dis-balance in the lifestyle and the bad habits such as smoking,

diabetes, unorganized daily routine, laziness and the lack of exercise is the main cause
of Myocardial Infarction. The treatment of MI is to be done at a very short period
otherwise it may result into death. Aspirin is the most effective method that 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). The heart attack
is mainly occurs after 60 years but in the current research, children of about 15-20 years
are suffering from these diseases. The MI is now completely entered into the life of
everyone that can be kids, adults and the old ones and also ruins the life at a very less
age. The Myocardial infarction occurred in women in about 50% and the women who
generally experience the back pain, heartburn, breathing problems. According to the
latest research of World Health Organization of 2017, the death rate from the
Myocardial Infarction is of about 24.4% of the total death in Maldives. The acute disease
related with the MI is the Acute coronary syndrome and the symptoms of this syndrome
is the 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
the patients may lose their lives. Most of the people are not aware about the heat attack
problems and treated it as a “life threatening” problem, but this is not the case. This
disease can be treated easily with the few precautions (Vyas., Ahamed., Batar and
Gehlot., 2019).
In the recent research, one real case of 60 year old man who was aware about the
chest pin 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 the doctors and the especially for the nurses
because nurses are the first-aid of any disease and stabilize the patients when the
doctor is not available. In the treatment of Myocardial diseases, several parameters are
checked such as medical history of the patient, Elevtrocardiogram or ECG report if any
or for the new patient, it is required to get the and these are the necessary steps to get
rid of this problem (Schiele and Bassand., 2017).
There is a process which cure or stabilize the patients is the thrombolytic treatment or
the medication which is approved by the emergency treatment of heart failure. But the
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 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 gives the
personal home care to the patients because these kinds of patients required 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 extend. 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 are 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 encourage 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 the day to day exercise, training that helps in changing their lifestyle such as

the quitting smoking, drugs and liquor and adopting the proper diet (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).
Heart failure care and management
The technologies are also plays an important in changing the course of heart-failure
treatment. Pacemaker is the first device that was designed for the heart patients and it
was rarely used device in early 90s but nowadays, one out of ten patient is using this
device. Pacemaker acts like a “starter” and it works like a mini heart whose heart do not
function properly. It is placed in the chest near the collarbone and gives the sudden
spark to the heart (Carroll, Mount and Atkinson., 2016).
The primary aim of the doctors is to prevent the 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 the 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 medical history
of patient of several chest pain and also include irregularities of the pulse, bradycardia
or tachycardia, a third heart sound and basal rales. For these problems, the
electrocardiogram is obtained and at the early stage, the ECG is treated normally. In
case of ST-segment elevations 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. The blood sample is taken of the patients in the acute
phases and sometimes, the elevated marker of narcosis may be helpful in decided to
give the re-perfusion therapy. When ECG and serum markers are not diagnostic of
acute myocardial infarction the 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 prophylatics therapies in the acute

diseases such as Apirin, Anti-arrhythmic drugs, Beta-blockers, Nitrates, Magnesium and
the Glucose-insulin potassium. There are other diagnosis of the specific types of
management for the infarction is of the Right ventricular infarction and the Myocardial
infarction in diabetic patients. All these kinds of patients requires 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 the
nurses are more closed to the patients because the doctors are only diagnose the
problem and according to the medical science theory, the patient is only the subject for
doctors and only do experiments on their patients by the certain treatments (Lee,
Maggiore, and Chung., 2018). The nurses are more connected with the patients and
stay with their patients for the long time.
Myocardial infarction is the death of muscles of heart because of the blockage of the
coronary artery by the blood clot. Proper oxygen, aspirin, and the nitroglycerin is used
during the heart failure treatment. The morphine is used in case when nitroglycerin is
not effective. There are some nursing care plans for the Myocardial infarction such as
decrease the 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 the knowledge deficit (Schiele and Bassand., 2017). The
close monitoring of the patients and identification of response is only done by the
nurses. It is not possible for hospital to give personal care to the patients and some are
properly cared by the experienced staff. According to the researched data of UK, the
heart patients are not cared by the staff because the staffs are not experienced and due
to this, the patient older than 70 are died due to improper care of the patient by the
hospital management. The cardiovascular nurses are also cardiac nurses and the
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 the
training to the nurses to treat the patients and identify their problems. One of the famous
hospital of Maldives are ADK hospital in which all the nurses receive the advance

cardiac training and many of them achieve the certificates in critical care, progressive
care, cardiac medicine, cardiac surgery and cardiac vascular nursing and most of the
nurses are specialized in Electrophysiology, heart transplant, cardiac surgery, ICD and
pacemaker placement and the care of the outpatients and the cardiac rehabilitation
(Anand and Sharma., 2019).
Nurses represents the whole community and plays an important role in the treatment of
patient because the nurses are more closed to the patients. Nurses also meet the
needs of rehabilitative care of patients through education, support, supervision and the
reinforcement. The awareness of the nurses in the cardiac rehabilitation improves the
health outcome and also reduces the risk of heart failure. The healthcare and the
rehabilitation programs are organized by the nurses for the heart patients to improve
and make them aware about the heart failures and educate the patients about the
health of the heart because heart is the engine of the body and if the heart stops
working then the body will also stops working (Blumenthal and Hsiao., 2015).
There are several medical management of myocardial infraction to prevent the further
complications. Pain is the first stage of myocardial infraction 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 the 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 the heart failure such as the 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 the age 15-20
years. Smoking and is main cause of concern in the heart failure and the 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 the

heart healthy food, control the cholesterol, exercise regularly, stay at the healthy weight,
control high blood pressure, assess the mental health, medication on the regular basis,
control blood sugar, Limit alcohol and illegal drugs. These are all the measures which
helps in reducing the risk of heart failure and improve the 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 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 a lack of clear
communication between doctor and the patient so and the 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).
The supportive recommendation for myocardial infraction is that all the patients should
be given the aware about myocardial rehabilitation and also the patients should be
encouraged to attend the rehabilitation programs for the clinical needs and also if the
patients wants to quit the program then the medical professional 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.

CONCLUSION
This report concludes the critical analysis of the Myocardial infarction and the
various issues which are responsible for the heart failure. It also concludes that how the
nurses are responsible in keeping the patients healthy because the patients are more
connected and closed with the patients and take care of them. There are several factors
which are responsible heart failure which should be avoided like smoking, tobacco,
obesity, cholesterol, bad environment and the changing lifestyle of the people causes
such type of problems and the children are more attacked by these kinds of diseases
because the youngsters of age 15-25 do not take care of their health and consumes the
alcohol, cigarette, tobacco etc which creates the very bad impact on their body and can
lose their lives. All these researches about the health of heart will impact on my future
and all these theories will be beneficial for me and helps me in learning about the
prevention and the cure of heart health and also I am now aware about the heart, so I
can share the knowledge to other about the safety and the precaution for healing the
heart and also makes the heart safe and healthy.
REFERENCES
Books and journals
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.
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.

Vyas, A., Ahamed, J., Batar, K.K. and Gehlot, A., 2019. TO STUDY PRESCRIPTION
PATTERN OF DRUGS AND OTHER PROPHYLACTIC MEASUREMENTS FOR
SURVIVORS OF ACUTE MYOCARDIAL INFARCTION AT TERTIARY CARE
TEACHING HOSPITAL, WESTERN RAJASTHAN. International Journal of
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Schiele, F. and Bassand, J.P., 2017. Beyond Reperfusion Networks in ST-segment
Elevation Myocardial Infarction: Assessment of Quality of Care. Revista Española
de Cardiología (English Edition), 70(3), pp.140-141.
Handler, C., Coghlan, G. and Brown, N., 2018. Myocardial infarction and other acute
coronary syndromes. InManagement of Cardiac Problems in Primary Care (pp.
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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
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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.
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, p.207.
Yancy, C.W. and Harrington, R.A., 2018. The TREAT Trial—Moving ST-Elevation
Myocardial Infarction Care Forward, With More to Do. JAMA cardiology, 3(5),
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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
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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-
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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.
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.
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.