Clinical Vignette Concept – Assignment

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Added on 2020-10-04

Clinical Vignette Concept – Assignment

Added on 2020-10-04

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CLINICAL VIGNETTE CONCEPT

TABLE OF CONTENTSINTRODUCTION...........................................................................................................................1Discussion on published evidence..............................................................................................1Mika's case..................................................................................................................................2Mr. Hers case..............................................................................................................................3REFERENCES................................................................................................................................5

Clinical Vignette Concept – Assignment_2

INTRODUCTIONAcute “myocardial infarction” is the medical term of heart attack. It generally occursduring the blockage in flow of blood to the heart and causes severe damage to all the tissue andin critical cases may lead to death. Many factors are responsible for increasing the chances ofheart attack like increasing blood pressure, diabetes and high cholesterol level in body.In most of the cases patient suffering with acute myocardial infarction is given oxygentherapy in form of emergency treatment. Supply of oxygen to the patient in this case isconsidered to be the best therapy. Supplementation of oxygen is the standard treatment methodfor patients having heart related disease but in some cases, it may be considered dangerous forthe health of patients. According to the survey among physicians around 50% believe thatoxygen supply decreases the chances of mortality, 25% believe that it aids in lowering the levelof pain and left 25% thought that it has no effect on the body. Discussion on published evidenceAccording to Oxygen Guidelines for Acute Oxygen Use in Adults (2015), it is logical toand biologically accepted to provide patient with oxygen therapy in case of AMI, this is done toenhance the oxygenation of ischemic myocardial tissues and help in decreasing the pain relatedto ischemia. But on the other side it can also proved to be harmful in decreasing the blood flowof coronary artery and increases resistance of coronary vascular which was measured by usingintra coronary Doppler ultrasonography. Decrease in level of cardiac output and stroke volume,hyperoxia leads to increase in the vascular resistance and injury due to re perfusion because ofthe increasing number of free oxygen radicals. But in situation of lack in myocardial perfusiontheir is decrease in level of oxygen in myocardium and in this case oxygen therapy is used toincrease the concentration of oxygen in blood vessels.Non-random study performed by Nicholson proves that oxygen can increase themyocardial ischemia. According to Australian Clinical Guidelines for the Management of AcuteCoronary Syndromes(2016), Air verses Oxygen In myocardial infraction study (AVOID)mentioned that the regular supply of oxygen in case of acute myocardial infraction can prove tobe harmful for heart. According to this study there was increase in the creatine kinase thatincreased the myocardial injury and cardiovascular magnetic resonance technology was used forimaging that shows increase in the size of infraction after oxygen therapy. 1

Clinical Vignette Concept – Assignment_3

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