Early Recognition and Treatment of the Patient Suffering from Acute Myocardial Infarction: A Description of the Myocardial Infarction Triage and Intervention Project

1990 ◽  
Vol 2 (4) ◽  
pp. 681-688 ◽  
Author(s):  
Jenny S. Martin ◽  
Paul E. Litwin ◽  
W. Douglas Weaver
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Early Recognition

scholarly journals Percepção do enfermeiro frente ao paciente com suspeita de infarto agudo do miocárdio

2020 ◽  
Vol 10 (30) ◽  
pp. 38-44
Author(s):  
Anderson Leonel Ribeiro Mathias ◽  
Elaine Freitas da Cruz Rocha ◽  
Luiz Augusto Silva ◽  
Camila Zilli Palmeiro Fedalto ◽  
Alexis Pereira da Silva
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Exploratory Study ◽  
Early Recognition ◽  
Signs And Symptoms ◽  
Professional Autonomy ◽  
The Face ◽  
Qualitative Descriptive ◽  
The City ◽  
Suspected Acute Myocardial Infarction

O estudo teve como objetivo identificar a percepção da enfermeira frente ao atendimento ao paciente com suspeita de Infarto Agudo do Miocárdio (IAM). Trata-se de um estudo qualitativo, descritivo e exploratório, realizado na Unidade de Pronto Atendimento do município de Pedro Leopoldo (MG).  Fizeram parte do estudo onze enfermeiros. Emergiram categorias empíricas “A percepção do enfermeiro sobre o reconhecimento do paciente com suspeita de IAM” e “Fatores que interferem na atuação do enfermeiro durante o atendimento ao paciente com suspeita de IAM”. Concluímos que os enfermeiros possuem percepção quanto à importância do reconhecimento precoce dos sinais e sintomas dos pacientes com suspeita de IAM. No entanto, encontram barreiras para realizar esse atendimento. É necessário que se mantenham na busca por capacitação e atualização para continuarem com essa autonomia profissional frente ao paciente com suspeita de IAM, mas espera-se que investimentos sejam feitos pela instituição, visando à melhoria no funcionamento do serviço.Descritores: Infarto Agudo do Miocárdio, Enfermeiro, Assistência. Perception of nurse in front of patient with suspected acute myocardial infarctionAbstract: The study aimed to identify the nurse's perception of the care provided to patients with suspected acute myocardial infarction (AMI). This is a qualitative, descriptive and exploratory study, carried out at the Emergency Care Unit in the city of Pedro Leopoldo (MG). Eleven nurses took part in the study. Empirical categories emerged: “The nurse's perception about the recognition of the patient with suspected AMI” and “Factors that interfere with the nurse's performance during the care of the patient with suspected AMI”. We conclude that nurses are aware of the importance of early recognition of signs and symptoms of patients with suspected AMI. However, they encounter barriers to perform this service. It is necessary to remain in the search for training and updating to continue with this professional autonomy in the face of patients with suspected AMI, but investments are expected to be made by the institution, aiming at improving the service's functioning.Descriptors: Acute Myocardial Infarction, Nurse, Care. Percepción de enfermero delante de pacientes miocardios agudos sospechosoResumen: El estudio tuvo como objetivo identificar la percepción de la enfermera de la atención brindada a los pacientes con sospecha de infarto agudo de miocardio (IAM). Este es un estudio cualitativo, descriptivo y exploratorio, realizado en la Unidad de Atención de Emergencia en la ciudad de Pedro Leopoldo (MG). Once enfermeras participaron en el estudio. Surgieron categorías empíricas: "La percepción de lo enfermero sobre el reconocimiento del paciente con sospecha de IAM" y "Factores que interfieren con el desempeño de la enfermera durante la atención del paciente con sospecha de IAM". Concluimos que los enfermeros son conscientes de la importancia del reconocimiento temprano de los signos y síntomas de pacientes con sospecha de IAM. Sin embargo, encuentran barreras para realizar este servicio. Es necesario permanecer en la búsqueda de capacitación y actualización para continuar con esta autonomía profesional frente a pacientes con sospecha de IAM, pero se espera que la institución realice inversiones, con el objetivo de mejorar el funcionamiento del servicio.Descriptores: Infarto Agudo del Miocardio, Enfermero, Asistencia.

Abstract WP315: Acute Myocardial Infarction Associated With Worse Outcomes in Acute Cerebrovascular Disease

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Sea mi Park ◽  
Shouri Lahiri ◽  
Asma Moheet ◽  
Jaspreet Mann ◽  
Axel Rosengart
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cerebrovascular Disease ◽  
Hospital Stay ◽  
Early Recognition ◽  
Hospital Costs ◽  
Care Facility ◽  
Length Of Hospital Stay ◽  
Female Gender ◽  
Nationwide Inpatient Sample Database

Introduction/Hypothesis: We examined the prevalence and outcomes of patients admitted with acute cerebrovascular disease (ACVD) and concomitant acute myocardial infarction (AMI). Methods: We utilized the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database (1998-2009) and identified 1,760,415 adult ACVD patients among 92,848,710 patients enrolled. Using SAS 6.4 and applying SPSS 22 the outcome variables mortality, length of hospital stay (LOS), hospital costs >$20,000, and disposition (home or any care facility) were selected and logistic regression analyses was performed adjusting for the covariates hypertension, diabetes mellitus, age, race, sex, number of comorbidities, and care complexity (numbers of inpatient procedures) among all ACVD with and without AMI. Results: Mean age was 71 years (SD 15) with 76% >65 years old; 54% female gender; 55% Whites, 11% Blacks, and 6% Hispanics. Among all ACVD, 66% had HTN, 28% DM, AMI 4.1%, LOS was 7.6 days (SD 9.8), in-patient mortality 12%; disposition home 42% and facility 44%, and mean hospital costs $36,010 (SD $63,331). After covariate adjustment, ACVD patients with AMI compared to those without AMI had a mortality of 30% vs 12% (P<0.000); LOS ≥7 days 53% vs 30% (P<0.000), facility discharge 68% vs 51% (P<0.000), and adjusted hospital costs 71% vs 44% (P<0.000). Conclusions: Acute myocardial infarction occurred in 4.1% of patients with acute cerebrovascular disease. It was associated with significantly increased risks of in-patient mortality, length of hospital stay, facility disposition and hospital costs. Considering the poor outcomes of ACVD patients with AMI may indicate more aggressive strategies for early recognition and reduction of myocardial injury.

scholarly journals Symptom presentation of acute myocardial infarction – can we correctly identify patients with atypical symptoms of myocardial infarctions over the phone?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.L Moeller ◽  
E.H.A Mills ◽  
F Gnesin ◽  
N Zylyftari ◽  
F Folke ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Early Recognition ◽  
High Risk Patient ◽  
Funding Source ◽  
Symptom Presentation ◽  
Atypical Symptoms ◽  
Risk Of Death ◽  
Emergency Ambulance

Abstract Introduction Acute myocardial infarction (AMI) can manifest itself with a variety of symptoms which can hinder early recognition of the disease, particularly when diagnosis is performed over the phone. It is currently unknown to what extent AMI patients are correctly recognized and quickly referred to treatment when calling for help at the emergency medical services (EMS) and out-of-hours service (OOHS). Therefore, we investigated how the symptom presentation of AMI patients affected their chances of being recognized. Purpose This study aimed to describe the symptoms reported by AMI patients when calling the EMS and OOHS and investigate to what extent these patients were correctly recognized and lastly, how the symptom presentation affected the survival. Methods All calls to the EMS and OOHS in the Capital Region of Denmark from 1st January 2014 to 31st December 2017 are included in this study resulting in 4,905,318 calls made by 1,313,980 people. A total of 5,526 people were identified with either a hospital admission with an AMI or an AMI as cause of death maximum 72 hours after a call to the EMS or OOHS. The main symptoms were registered by the EMS and OOHS personnel and we grouped the symptoms into symptom categories. Finally, a patient was defined as recognized if an emergency ambulance were dispatched. The unrecognized patients were separated into one group which were not referred to any treatment and another group that received none-urgent treatment. Results 72% of all AMI patients reported chest pain as their main symptom followed by breathing problems (7%) and unknown problems (5%). A total of 76% of all AMI patients were correctly recognized and received an emergency ambulance. The proportion of recognized AMIs was 88% at the EMS, but only 55% at the OOHS. The symptom presentation was highly associated with the help provided to the patient and less than 14% of patients reporting musculoskeletal pain, infection/fever or pain in stomach/back/intestine received an emergency ambulance. In comparison, 87% of patients with chest pain and 96% of unconscious patients received an emergency ambulance (Figure 1). Results from a multiple logistic regression showed that chest pain patients had the lowest risk of death at 30-days follow-up compared to all other symptom presentation. Conclusion 24% of AMI patients were not correctly recognized with an acute life-threatening disease when calling for help. Patients presenting without chest pain and unconsciousness had a much lower chance of being recognized. Similarly, patients calling the OOHS were less likely to be recognized compared to patients calling the EMS. Symptom presentations without chest pain had a dramatically increased 30-day mortality indicating that AMI patients with atypical symptoms truly are a high-risk patient group. Figure 1 Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): The Danish Heart Association

scholarly journals Case Report of the Patient with Acute Myocardial Infarction: “From Flatline to Stent Implantation”

2017 ◽  
Vol 34 (4) ◽  
pp. 329-337
Author(s):  
Dejan Petrović ◽  
Marina Deljanin Ilić ◽  
Bojan Ilić ◽  
Sanja Stojanović ◽  
Milovan Stojanović ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Arrest ◽  
Lung Tumor ◽  
Early Recognition ◽  
Coronary Intervention ◽  
Anterior Wall ◽  
Severe Form ◽  
St Segment Elevation ◽  
Catheterization Laboratory

Summary Asystole is a rare primary manifestation in the development of sudden cardiac death (SCD), and survival during cardiac arrest as the consequence of asystole is extremely low. The aim of our paper is to illustrate successful cardiopulmonary resuscitation (CPR) in patients with acute myocardial infarction (AMI) and rare and severe form of cardiac arrest - asystole. A very short time between cardiac arrest in acute myocardial infarction, which was manifested by asystole, and the adequate CPR measures that have been taken are of great importance for the survival of our patient. After successful reanimation, the diagnosis of anterior wall AMI with ST segment elevation was established. The right therapeutic strategy is certainly the early primary percutaneous coronary intervention (PPCI). In less than two hours, after recording the “flatline” and successful reanimation, the patient was in the catheterization laboratory, where a successful PPCI of LAD was performed, after emergency coronary angiography. In the further treatment course of the patient, the majority of risk factors were corrected, except for smoking, which may be the reason for newly discovered lung tumor disease. Early recognition and properly applied treatment of CPR can produce higher rates of survival.

scholarly journals Sinais, sintomas e complicações do infarto agudo do miocárdio

2018 ◽  
Vol 12 (1) ◽  
pp. 247 ◽  
Author(s):  
Renata Soares Passinho ◽  
Cândida Caniçali Primo ◽  
Walckiria Garcia Romero Sipolatti ◽  
Mirian Fioresi
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Nursing Care ◽  
Early Recognition ◽  
Signs And Symptoms ◽  
Nursing Diagnosis ◽  
Affected Person ◽  
Insuficiencia Cardiaca ◽  
Care Nursing

RESUMOObjetivo: analisar as produções científicas a respeito da frequência dos sinais, sintomas e complicações do infarto agudo do miocárdio. Método: revisão integrativa, com busca publicações entre 2010 a 2014 nas bases de dados LILACS, MEDLINE e CINAHL. O processo de análise dos 122 artigos selecionados deu-se por meio da leitura exploratória e crítica dos títulos, resumos e dos resultados das pesquisas, onde se buscaram os fenômenos relacionados ao IAM (sinais, sintomas e complicações). Resultados: A dor no peito (N = 75), a insuficiência cardíaca (N = 52), a dispneia (N= 24) e a arritmia (N= 20) foram os sinais e sintomas mais encontrados. Conclusão: a dor no peito é o sintoma mais frequente da doença. O reconhecimento precoce desses fenômenos irá contribuir para a melhoria do prognóstico da pessoa acometida. Descritores: Cuidados de Enfermagem; Diagnóstico de Enfermagem; Infarto Agudo do Miocárdio; Classificação; Enfermeiras e Enfermeiros; Cardiologia.ABSTRACTObjective: to analyze the scientific productions regarding the frequency of signs, symptoms and complications of acute myocardial infarction. Method: integrative review, with search publications between 2010 to 2014, in the databases LILACS, MEDLINE and CINAHL. The process of analysis of the 122 articles selected was based on the exploratory and critical reading of the titles, abstracts and results of the research, in which the AMI-related phenomena (signs, symptoms and complications) were searched. Results: chest pain (N = 75), heart failure (N = 52), dyspnea (N = 24) and arrhythmia (N = 20) were the most common signs and symptoms. Conclusion: chest pain is the most frequent symptom of the disease. The early recognition of these phenomena will contribute to the improvement of the prognosis of the affected person. Descriptors: Nursing Care; Nursing diagnosis; Acute Myocardial Infarction; Classification; Nurses and Nurses; Cardiology.RESUMENObjetivo: analizar las producciones científicas acerca de la frecuencia de los signos, síntomas y complicaciones del infarto agudo de miocardio. Método: revisión integrativa, con búsqueda publicaciones entre 2010 a 2014, en las bases de datos LILACS, MEDLINE y CINAHL. El proceso de análisis de los 122 artículos seleccionados se dio por medio de la lectura exploratoria y crítica de los títulos, resúmenes y de los resultados de las investigaciones, donde se buscaron los fenómenos relacionados al IAM (signos, síntomas y complicaciones). Resultados: el dolor en el pecho (N = 75), la insuficiencia cardiaca (N = 52), la disnea (N = 24) y la arritmia (N = 20) fueron los signos y síntomas más encontrados. Conclusión: el dolor en el pecho es el síntoma más frecuente de la enfermedad. El reconocimiento precoz de estos fenómenos contribuirá a la mejora del pronóstico de la persona acometida. Descriptores: Cuidados de Enfermería; Diagnóstico de Enfermería; Infarto Agudo de Miocardio; Clasificación; Enfermeras y Enfermeras; Cardiología.

scholarly journals Pregnancy-related acute myocardial infarction: a review of the recent literature

2021 ◽  
Author(s):  
Andrea Carlo Merlo ◽  
Gian Marco Rosa ◽  
Italo Porto
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Recent Literature ◽  
Early Recognition ◽  
Artery Dissection ◽  
Coronary Artery Dissection ◽  
Clinical Scenarios ◽  
Key Points ◽  
Life Threatening ◽  
Medical Advances

AbstractPregnancy-related acute myocardial infarction is a rare and potentially life-threatening cardiovascular event, the incidence of which is growing due to the heightened prevalence of several risk factors, including increased maternal age. Its main aetiology is spontaneous coronary artery dissection, which particularly occurs in pregnancy and may engender severe clinical scenarios. Therefore, despite frequently atypical and deceptive presentations, early recognition of such a dangerous complication of gestation is paramount. Notwithstanding diagnostic and therapeutic improvements, pregnancy-related acute myocardial infarction often carries unfavourable outcomes, as emergent management is difficult owing to significant limitations in the use of ionising radiation—e.g. during coronary angiography, potentially harmful to the foetus even at low doses. Notably, however, maternal mortality has steadily decreased in recent decades, indicating enhanced awareness and major medical advances in this field. In our paper, we review the recent literature on pregnancy-related acute myocardial infarction and highlight the key points in its management.

Abstract 19159: Assessment of Myocardial Viability After Acute Myocardial Infarction: A Head-to-head Comparison of the Perfusable Tissue Index by PET and Delayed Contrast-enhanced CMR

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Stefan A Timmer ◽  
Paul F Teunissen ◽  
Ibrahim Danad ◽  
Laurens F Robbers ◽  
Pieter Raijmakers ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Myocardial Viability ◽  
Contractile Function ◽  
Early Recognition ◽  
Clinical Importance ◽  
Lv Function ◽  
Wall Thickening ◽  
Contrast Enhanced

Introduction: Early recognition of viable myocardium is of great clinical importance after acute myocardial infarction (AMI). Delayed contrast-enhanced magnetic resonance imaging (DCE-CMR) has been validated extensively for the detection of viability. An alternative method for detecting viability is the perfusable tissue index (PTI), a positron emission tomography (PET) derived parameter, which is inversely related to the extent of myocardial scar (nonperfusable tissue). Aims: To investigate the predictive value of PTI on recovery of LV function after percutaneous coronary intervention (PCI) for AMI. Methods: Twenty-six patients with AMI successfully treated by PCI were included. Subjects were examined one week and three months after AMI with [15O]H2O PET and DCE-CMR to assess PTI, regional function and scar. Viability was defined as recovery of systolic wall thickening (SWT) ≥ 3.0 mm at follow-up. Results: A total of 396 segments were available for serial analysis. At baseline, 166 segments were dysfunctional, of which 125 (75%) exhibited significant DCE and were located in the myocardial territory supplied by the culprit-artery. Fourty-nine of these dysfunctional segments showed full recovery during follow-up (viable), whereas 76 segments remained dysfunctional (nonviable). Baseline PTI of viable segments was 0.94 ± 0.07 and was significantly higher compared to nonviable segments (0.80 ± 0.11, p = 0.01). The optimal cut-off value for the PTI was 0.85 with a sensitivity of 92% and specificity of 71%, and an area under the curve (AUC) of 0.88. In comparison, a cut-off value of 40% for the extent of DCE resulted in a sensitivity of 75% and a specificity of 65%, and an AUC of 0.75 (p = 0.02 vs PTI). Conclusions: This study shows that assessment of myocardial viability shortly after reperfused AMI is feasible with PET, and that the PTI is a good prognostic indicator for recovery of contractile function when compared to DCE-CMR.

An electron microscopic study of the intra-myocardial lesions in cases of acute myocardial infarction

1978 ◽  
Vol 36 (2) ◽  
pp. 484-485
Author(s):  
Masahiro Ono ◽  
Kaoru Aihara ◽  
Gompachi Yajima
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Vessels ◽  
Vascular Wall ◽  
Vascular Changes ◽  
Electron Microscopic ◽  
Main Trunk ◽  
Mechanical Destruction ◽  
Transmission Electron ◽  
Myocardial Lesions

The pathogenesis of the arteriosclerosis in the acute myocardial infarction is the matter of the extensive survey with the transmission electron microscopy in experimental and clinical materials. In the previous communication,the authors have clarified that the two types of the coronary vascular changes could exist. The first category is the case in which we had failed to observe no occlusive changes of the coronary vessels which eventually form the myocardial infarction. The next category is the case in which occlusive -thrombotic changes are observed in which the myocardial infarction will be taken placed as the final event. The authors incline to designate the former category as the non-occlusive-non thrombotic lesions. The most important findings in both cases are the “mechanical destruction of the vascular wall and imbibition of the serous component” which are most frequently observed at the proximal portion of the coronary main trunk.

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