Complications of Myocardial Infarction

Complications of Myocardial Infarction

The complications of a myocardial infarction are as follows :
  • Arrhythmias – These usually occur within the first 48 hours following an infarct and may be life-threatening. They are due to myocardial irritability caused by lack of oxygen (ischaemia), release of potassium and calcium from dead cells and disturbances to the conductive mechanism of the heart. This is particularly true when the area around the sinoatrial or atrioventricular nodes is affected. Myocardial irritability is identified by the number of ventricular ectopics seen. There is a danger that an ectopic may fall on the T wave (r on T) and ventricular fibrillation ensues.
  • Heart failure – Backpressure from the ventricle affected onto the atrium on the same side exists due to the ventricle being unable to expel the blood in it effectively. This will cause backpressure on either the pulmonary circulation (causing pulmonary oedema) or the systemic circulation (peripheral in organ oedema). The cautious use of diuretics and vasodilators may minimise this.
  • Pericarditis – This is thought to be caused by an autoimmune response initiated by the necrotic tissue within the heart causing an inflammatory reaction in the pericardium. The symptoms of this are similar to the infarct though the pain is longer lasting and a pericardial rub may be heart on auscultation.
  • Mitral regurgitation – This is due to either papillary muscle infarct or rupture that causes the mitral (left side) valve to become incompetent. This will worsen any cardiac failure by allowing blood to enter the left atrium during systole.
  • Myocardial rupture – This is due to the weakened area of necrotic myocardium and is likely to occur within seven days post infarct. It is more often seen in patients with a transmural infarct (infarct extends through all the layers of the heart) and may cause a cardiac tamponade. An intraventricular septal rupture can occur within 2 weeks following the infarct and is a very serious complication. It allows the flow of blood from the left to right sides of the heart and will flood the lungs with pulmonary oedema. The blood entering the aorta will also be severely diminished causing cardiogenic shock. The combination of these is likely to kill the patient outright depending on the size of the rupture. Emergency surgery is the only treatment for this.
  • Myocardial aneurysm – This is the ballooning out of the infracted myocardial tissue into the chamber affected. This may seriously reduce the cardiac output and will cause the heart to contract in an abnormal fashion. The size of this can be identified my echocardiography. Surgery is the only treatment.
  • Emboli – These form when clots formed in the necrotic areas break free and enter the bloodstream. Pulmonary, cerebral or deep vein thrombosis may form. Also further myocardial infarction may occur if the emboli enter the coronary arteries. Emboli may or may not kill the patient outright, it will depend on the location and size of the vessel they are blocking. Anticoagulant drugs such as heparin and aspirin will be given and the patient closely monitored for further emboli or moving of the emboli to other areas.
  • When the patient is discharged from the coronary care / high dependency unit to a medical ward, their lifestyle is examined and teaching about how to change their lifestyle to one that will minimise the risk of a repeat infarct will begin. Involvement with a dietician is essential in order for the patient to start to look at their diet and alcohol intake.


Reference :
http://www.nursingtheory.nhs.uk

Popular posts from this blog

Administering a Metered Dose Inhaler (self administration)

Medical Equipments: Medication Administration Record (MAR) Medication with Dropper Emesis Basin (optional) Non-sterile Gloves Tissue Nursing Actions: Check the allergies that patient may have Determine the written order on MAR Wash hands Check patient’s identification armband Explain the procedures to the patient and provide privacy Ask patient to blow nose unless contraindicated Inform the patient that he/she may feel a burning sensation to the mucosa or a choking sensation, or both, as the drop trickles back into the throat Place patient in a supine position and hyperextend the neck and position the head to the site that facilitates the drop reaching the expected site Instruct the patient to breathe through mouth Squeeze medications into the dropper Insert the nasal drops about 3/8 inch into nostril and keep the tip of the dropper away from the sides of the nares. Instill the medication as prescribed and observe for signs and discomforts Ask the patient to maintain supine position fo
Read more

Nursing School Rankings

by: Milos Pesic The US News & World Report and the National Institutes of Health (NIH) Report on Research Funding conduct nursing school rankings to measure the status of quality of different nursing schools nationwide. Various factors affect how nursing school rankings are determined but it all serves the purpose of providing more information to anyone in search of a nursing school. As you evaluate different leaning institutions for your nursing education, nursing school rankings should supplement your own research. First, determine which specific nursing program you wish to enter and then based on that look at nursing schools in your chosen location that offer that specific program. You can use nursing school rankings to find out the areas of strength of a particular school and if it matches your interest and needs. In general, organizations determine nursing school rankings by gathering data through surveys that are prepared by professors and other scholars. Survey respondents c
Read more

10 Beneficial Foods for Maintaining Healthy Skin and Prevent Wrinkles

Image
Tight skin is the dream of all people, especially women. In addition to routine maintenance, you also need a balanced diet to have healthy skin. To prevent skin wrinkles, some foods are very beneficial when consumed. Most anti - wrinkle foods rich in antioxidants, which neutralize the effects of free radicals that attack collagen and elasticity of skin tissue. Some of these habits can be anti- wrinkling skin : Drink 4-6 glasses of water every day, wearing sunglasses, a hat, and sunscreen when in the sun, and of course do not smoke. Here are some foods that are beneficial for maintaining healthy skin, especially the skin to prevent wrinkles : 1. Blueberries Blueberries and other berries contain powerful antioxidants called polyphenols. Eat one serving or 1/2 cup every day, if possible choose organic berries. 2. Salmon Salmon and other cold water fish rich in omega - 3 fatty acids, which delays wrinkles by preventing inflammation and as a skin lubricant. Eat about 3 - ounce fish this typ
Read more