Oxygen Therapy Of The Compromised Myocardium

Discuss The Published Evidence In
Regard To Oxygen Therapy Of The
Compromised Myocardium

Table of Contents
INTRODUCTION..............................................................................................................................1
MAIN BODY.................................................................................................................................... 1
Oxygen therapy of compromised myocardium in ACS.........................................................1
Improvements in oxygen administration therapy in given cases..........................................4
CONCLUSION................................................................................................................................. 6
REFERENCES...................................................................................................................................8

INTRODUCTION
The acute coronary syndrome refers to collection of several symptoms that ensures
about decrease in flow of blood coronary artery. Thus, It will results into unable heart muscle
which is not ca pable to conduct its functioning in proper manner. It has several signs
such as chest pain, vomiting, dyspnea, diaphoresis, dizziness, unexplained fatigue, feeling
restlessness and so on (Malecki-Ketchell, 2017). Oxygen therapy is utilised to provide required
amount of oxygen to maintain its concentrations in body as it has several side effects also. The
present report will focus on two respective cases of patients named as Mika who is an 11 years
old girl and 68 years old man Herz. It includes an oxygen therapy of compromised myocardium
in case of an acute coronary syndrome along with certain changes to maintain oxygen
administration.
MAIN BODY
Oxygen therapy of compromised myocardium in ACS
The acute coronary syndrome can be described as several conditions or signs which
associated with instant and reduced flow of blood to heart of human being. It includes the
situation of myocardial infarction which is another name of heart attack. Thus, it is known as
threatening situation of life which is raised due to blood flow cut off abruptly causing tissue
damage. There are various kinds of symptoms which are usually observed such as tightness &
pain in chest, sweating, nausea, anxiety, dizziness and fast heart rate. There are certain cause of
myocardial infarction like bad cholesterol, saturated fats and trans- fat (De Waha and et. al.,
2017).
Now, it is essential to conduct several pathological tests of patient to know actual
situation and understand certain factors. It will facilitates to select best diagnosis of acute
myocardial infarction in an accurate way to gain better outcomes of the same. It involves stress
test, angiogram with coronary catheterisation and echocardiogram to determine actual
situation of heart along with other relevant tissues or muscles. There are various kinds of things
which are risky and may cause an acute myocardial infarction such as high blood pressure,
increased cholesterol levels, improved triglyceride amount, diabetes, obesity, smoking, family
1

history, illegal use of drugs etc. Moreover several medications are provided to patients which
are favourable for them such as –
 Nitroglycerin
 Antiplatelet drugs
 Beta blockers
 Angiotensin-converting enzyme (ACE) inhibitors
 Angiotensin receptor blockers (ARBs)
 Statins
Oxygen therapy can be described as a process of medical science in which use of oxygen
is kind of treatment for a patient. It involves several health issues such as low concentration of
oxygen in blood, toxicity of carbon monoxide, cluster headaches and maintaining required
levels of oxygen.
Maintenance of oxygen administration therapy
This therapy is essential in several cases and medical specialists are required to provide
oxygen to patients for balancing concentration of the same in body. It is necessary to balance
risks and benefits of this therapy so that an individual can get relief from this therapy along
with reducing negative impacts as well. As per given scenario, oxygen should be rendered to
Mika and Hertz having an aim of maintain SpO2 levels throuhg provision of supplemental
oxygen in safe manner which can be tolerated by patinet as per their actual medical condition.
Thus, it is mandatory to carrying out certain tests which helps to gain information about real
health situation of a person. Several guidelines which should be followed are given below:
 It includes to relieve Hypoxaemia and maintain adequate oxygenation of tissues along
with vital organs, as assessed by SpO2 /SaO2 monitoring & clinical signs.
 Provide oxygen in such a way to reduce concentration of carbon dioxide which requires
selection of an accurate flow rate and delivery device.
 It involves the criteria to decrease work of breathing.
 Put efforts to make sure about an adequate clearance of secretions as well as limit the
adverse events of hypothermia and insensible water loss by use of optimal
humidification.
2

 At last, maintain an efficient and economical utilisation of oxygen carefully.
According to the views of Kane Guthrie; oxygen therapy is usually utilised to maintain
supply of desired amount of oxygen for patient having an acute myocardial infarction. But at
the same time, it is also observed that it has harmful impacts like paradoxical effects which
decrease coronary artery flow, increase coronary vascular resistance and then further decrease
the stroke volume as well as cardiac outputs (Westaby, Kharbanda and Banning, 2012). Health
care professionals are using morphine, oxygen, nitrates and aspirin from a long time to deal
with people having problem of an acute myocardial infarction. Thus, they suggest to provide
oxygen to an individual having an issue of heart attack so that they can breathe easily but
normal air is more beneficial for them. It has been identified that a selected group of heart
patients have given oxygen and normal air in which more number of people died in that
section who got oxygen to breathe.
It is believed that supply of oxygen to ischaemic myocardium is helpful in reducing
myocardial injury and medical professionals to patients. It is necessary to provide an accurate
supply of oxygen concentration in human body as per requirements. It is a rationale for
providing supplemental oxygen to an individual so that it can boost up oxygenation of
ischaemic myocardial tissue that helps to reduce ischaemic symptoms, infarct size and
consequent morbidity as well as mortality (Timóteo And et. al., 2016). It is necessary to utilise
this therapy in proper manner by supplying oxygen amount in an accurate amount to gain its
positive impacts in condition of patients. But at the same time, it is essential to use oxygen in
correct way in order to maintain its required concentration in body. There are many other side
effects of oxygen therapy which are observed in people and some of them are described below:
Skin Irritation and Nasal Dryness: This can be described as a dry effect of oxygen supply
on nasal passages, skin irritation and break down of the same is also observed. It is important
for medical professionals to take care of patient for that specific applied treatment which may
put harmful impacts on other body parts. Thus, oxygen therapy is required to be carried out
very carefully so that positive results can be received along with avoiding certain negative
effects (Kim And et. al., 2012).
3

Suppressing of Breathing: This includes facts about oxygen therapy which may suppress
the drive of breathe for an individual and create problem. Thus, it is required to maintain flow
rate of oxygen in blood and people should never adjust their oxygen dose without prescription
of medical specialists because it may results into critical health situation.
Oxygen Toxicity: This can be explained about critical situation which is called oxygen
toxicity that is caused due to continuously giving high concentration of the same to an
individual. It creates crucial medical condition of patient which is very difficult to control. Thus,
people who have more risk of this factor involves ventilator patients, premature infants and
people receiving hyperbaric oxygen treatment.
Fire Hazard: This involves fact that an oxygen is an inflammable gas which easily give
access to fire. Thus, it indicates not to use this gas near electric stove or wall furnace, never
smoke while having utilisation of oxygen and avoid using personal care products containing
petroleum.
Improvements in oxygen administration therapy in given cases
The given cases are based on two patients named as Mika and Hertz having an issue of
acute myocardial infarction in which their medical specialists carrying out an appropriate
diagnosis and render effective medication to make them relief from critical condition.
In case of Mika, she is 11 years old girl having history of bronchial asthma and feeling
sever chest pain due to which get admitted in emergency department. Several tests are
conducted and observed actual condition of patient in which no jugular venous distension is
found, lungs are normal along with cardiac examination to understand about no murmur, clicks
or gallops. The medical professionals provide regular needed fluids to her that can be tolerated
by body in proper manner. Moreover, they avoid to render oxygen as well as painkillers for
relief and even not provide other medication rather than certain fluids (Kipshidze And et. al.,
2014).
In case of Hertz, he is a 68 years old man having habit of smoking form past 4 years,
ischaemic heart disease, hypercholesteromia, PTCA and stenting his right coronary artery and
left circumflex before 12 months. He experience crushing chest pain and remain admitted to
4

emergency department for 6 days and angiography revealed about fact that left anterior
descending artery get 100% blocked proximally.
Changes in treatment in case of Mika and Hertz for improvement
5

Case of Mika Case of Hertz
 She has history of bronchial asthma
then it is necessary to provide oxygen
in limited amount to balance its
concentration in her body.
 Her medical specialist does not provide
any pain relief medications which is
required to be given that helps to
reduce her problem to feel
comfortable.
 They can provide aspirin which is
effective blood thinner and break
down blood clots.
 In case of Hertz, he is an old man so
more carefulness is required and
thoroughly investigate his previous
issues with present condition to
provide an accurate medication.
 His doctors can conduct coronary
artery bypass graft in which they
reroute arteries and veins that
felicitates flow of blood around the
blockages.
 The thrombolytics can be used to
dissolve clots.
The above mentioned changes can be applied by medical professionals associated with
both cases of Mika and Hertz to get better outcomes of treatment. It is not necessary that
similar medications are applicable for same disease in different individuals because their
response of body are not same. Moreover, other factors like previous habits, past medical
records or age also plays an important role while selecting treatment for particular patient to
solve their health problems.
CONCLUSION
The above report concludes that acute coronary syndrome can be explained as a set of
various signs which can make sure about reduce in flow of blood coronary artery. It will results
into bad functioning of blood tissues that creates problems in human body. It is also described
about several symptoms such as tightness & pain in chest, sweating, nausea, anxiety, dizziness
and fast heart rate. There are certain medications which are given such patients of having
myocardial infarction like Nitroglycerin, Antiplatelet drugs, Beta blockers, Angiotensin-
converting enzyme (ACE) inhibitors, Angiotensin receptor blockers (ARBs) and Statins are
6

mentioned. Oxygen therapy is useful to make patient breathe in easy manner which can reduce
myocardial injury but it should be done in correct way to get better results.
7

REFERENCES
Books and journals
Malecki-Ketchell, A., 2017. Pathophysiology, assessment and treatment of coronary heart
disease in women. Nursing Standard (2014+). 31(40). p.51.
De Waha, S. and et. al., 2017. Interventional therapies in acute myocardial infarction
complicated by cardiogenic shock. Herz. 42(1). pp.11-17.
Westaby, S., Kharbanda, R. and Banning, A. P., 2012. Cardiogenic shock in ACS. Part 1:
prediction, presentation and medical therapy. Nature Reviews Cardiology. 9(3). p.158.
Timóteo, A. T. And et. al., 2016. Role of intra-aortic balloon pump counterpulsation in the
treatment of acute myocardial infarction complicated by cardiogenic shock: evidence
from the Portuguese nationwide registry. European Heart Journal: Acute
Cardiovascular Care. 5(7). pp.23-31.
Kim, D. Y. And et. al., 2012. Synthesis of [18F]-labeled (6-fluorohexyl) triphenylphosphonium
cation as a potential agent for myocardial imaging using positron emission
tomography. Bioconjugate chemistry. 23(3). pp.431-437.
Kipshidze, N. N. And et. al., 2014. Urgent interventional therapies. John Wiley & Sons.
Online
Guthrie, K., 2018. Oxygen is it Friend or Foe in Acute MI. [Online]. Available through:
<https://lifeinthefastlane.com/oxygen-in-acute-myocardial-infarction/>
8