REVIEW OF TREATMENT PLANS USED FOR ACUTE MYOCARDIAL INFARCTION IN ISLAMABAD, PAKISTAN

2011 ◽  
Vol 1 ◽  
pp. 10-15
Author(s):  
Ashfaq Ahmad ◽  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Heart Rate ◽  
Chest Pain ◽  
Coronary Artery ◽  
Cardiac Muscle ◽  
Oxygen Supply ◽  
Oxygen Demand ◽  
Clinical Situation ◽  
Treatment Plans

Myocardial infarction is simply due to decreased supply of oxygen and blood to the particular tissue of heart which ultimately leads to the death of tissue. Naturally heart is quite stable in its involuntary action due to balance between oxygen supply and oxygen demand of the cardiac muscle. when this balance is disturbed by the clot formation(atherosclerosis) in coronary artery or increased demand of oxygen due to increased heart rate then clinical situation arises as tightening of chest,laboured breathing, sweating and radiating pain originating form chest and terminating to left arm and jaws as well. A male of 55 years was hospitalized in one of the most well reputed hospital of Federal area of Pakistan. The patients was nimble due to cold sweating, sever radiating left sided chest pain and was in the state of fear and apprehension.

scholarly journals Acute Myocardial Infarction due to External Compression of the Left Main Coronary Artery by a Large Pulmonary Artery Aneurysm

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
H. Sharma ◽  
S. N. Doshi ◽  
M. A. Nadir
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Coronary Artery ◽  
Pulmonary Arterial Hypertension ◽  
Pulmonary Artery ◽  
Left Main Coronary Artery ◽  
Left Main ◽  
External Compression ◽  
Pulmonary Arterial

Background. Although rare, external compression of the left main coronary artery (LMCA) by a pulmonary arterial aneurysm (PAA) as a consequence of pulmonary arterial hypertension causing stable angina pectoris is well described. However, acute myocardial infarction is extremely rare, particularly with a full array of electrocardiographic, biochemical, and echocardiographic features, as in this scenario. Case. In this case, a 62-year-old man with a past history of severe fibrotic lung disease was hospitalised with chest pain. The patient had dynamic anterolateral ischaemic changes on electrocardiography and serially elevated high-sensitivity troponin I. Transthoracic echocardiography revealed impaired left ventricular ejection fraction with anterolateral hypokinesis. Coronary angiography with intracoronary imaging revealed external compression of the LMCA. Computer tomography (CT) scans confirmed new PAA, compared to previous scans. The patient was successfully treated by percutaneous coronary stent implantation. Conclusion. Progressive dilatation of the pulmonary artery due to pulmonary arterial hypertension can result in acute MI secondary to external compression of the LMCA. Clinicians should be mindful of acute coronary syndromes in patients with long-standing pulmonary hypertension presenting with chest pain.

scholarly journals Role of Coronary Prognostic Index, and Thrombolysis, in ST Segment Elevation Myocardial Infarction

2021 ◽  
Vol 10 (29) ◽  
pp. 2212-2216
Author(s):  
Amol Andhale ◽  
Anuj Varma ◽  
Sourya Acharya ◽  
Samarth Shukla ◽  
Anuj Chaturvedi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Coronary Artery ◽  
Prognostic Index ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
St Elevation

Angioplasty is considered superior to fibrinolytic therapy in acute myocardial infarction (AMI) if the patient receives it within the therapeutic window. It is unclear if such advantages are available for patients who need to travel from a community hospital to a facility where invasive care is available, since primary thrombolysis often re-establishes coronary artery blood flow in patients with ST elevation acute myocardial infarction (STEMI). At the most severe end of the range of acute coronary syndromes is ST - segment elevation myocardial infarction (STEMI), which generally occurs when a fibrin-rich thrombus fully occludes an epicardial coronary artery. The diagnosis of STEMI is based on clinical features and persistent ST-segment elevation as evidenced by 12 - lead electrocardiography. Patients with STEMI should have a quick reperfusion treatment evaluation and a reperfusion strategy should be performed immediately following contact with the system. All patients with AMI who had chest pain within 12 hours were evaluated. The detailed history of chest pain, character, and radiation, had been taken in terms of duration from the beginning of chest pain in minutes. After 10 minutes, patients were given 10 mg of sublingual isosorbide dinitrate and repeated ECG. Patients were excluded if chest pain or ST elevation was resolved after 10 minutes of nitrate administration. In the analysis only those cases in which chest pain and ST shift were not resolved following sublingual nitrates. Serum CKMB estimates have been performed. All patients were treated with 1.5 million IU streptokinase in 100 ml of normal saline for more than 45 minutes. Clinical assessment for 2 hours every half hour was done to evaluate: 1. Chest pain reduction in a subjective scale percentage and to assess changes in the Killip class. 2. Continuous ECG monitoring of reperfusion rhythm occurrences. Patients are assessed at the end of 2 hours of follow-up for: a. Percentage reduction in subjective chest pain a. A 12 lead ECG to identify changes in the ST height c. Repeat CK-MB estimate. Patients with thrombolysis were classified into two classes on the basis of presence or absence of SCR at the end of two hours of initiation. Those with successful reperfusion were grouped into the SCR Group and into the SCR (negative) Group without successful reperfusion. Coronary prognostic index is a set of questionnaires which prognosticate the outcome in AMI. This review describes the role of Coronary Prognostic Index and thrombolysis in patients of STEMI. KEY WORDS ECG, AMI, STEMI, Angioplasty

MP14: UTILIZATION OF THE INVASIVE CARDIAC LABORATORY FOR IMMEDIATE CARDIAC CATHETERIZATION: A QUALITY IMPROVEMENT PROJECT

2016 ◽  
Vol 64 (3) ◽  
pp. 810.2-811
Author(s):  
D Friedman ◽  
A Bierzynski ◽  
N Coplan
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Coronary Artery ◽  
Cardiac Catheterization ◽  
Retrospective Chart Review ◽  
Coronary Artery Occlusion ◽  
Clinical Situation ◽  
Improvement Project ◽  
St Elevation ◽  
Invasive Evaluation

Purpose of StudyImmediate cardiac catheterization is indicated for patients presenting with ST elevation (STE) myocardial infarction, and door-to-balloon time should be <90 min. Patients with non-ST elevation myocardial infarction (NSTEMI) can often be stabilized with medication, and only require urgent invasive evaluation if there is persistent chest pain(despite medical therapy) or hemodynamic or electrical instability. Immediate cardiac catheterization for patients presenting to the ER with chest pain is available in many hospitals, but it involves a large investment of resources which need to be properly utilized. This study evaluated patients sent for urgent invasive evaluation to determine how the facility is utilized.Abstract MP14 Table 1STE+STE−≥90%2910≤90% 4 7Methods UsedIn a retrospective chart review, charts from all STEMI code patients presenting between the dates 1/1/15–9/1/15 were studied. The presenting EKG was evaluated to determine whether STE criteria (as per ACC guidelines) were met. The charts were reviewed for angiographic data to determine whether there was ≥90% stenosis of a coronary artery (≥90%) or not (≤90%). Clinical parameters were studied to determine if there were any differences between the groups.Summary of ResultsThe study group included 50 patients who went to the cardiology catheterization lab emergently secondary to an indication of STE; 33/50 (66%) patients met guideline criteria for ST elevation (STE+) while 17/50 (34%) did not (STE−). In the STE+ group, 29/33 (88%) had ≥90% occlusion of a coronary artery, while 10/17 (59%) in the STE-group had this degree of stenosis. The sensitivity and specificity of STE for ≥90% coronary artery occlusion on angiography was 74% and 64% respectively. The PPV of STE for >90% stenosis was 88%, while the NPV was 41%.ConclusionsSignificant STE in the proper clinical situation is a Class 1 indication for immediate coronary catheterization. However, 34% referred for immediate catheterization in this study did not meet ACC criteria for STEMI. Although a significant % in the NSTEMI group had ≥90% stenosis, urgent catheterization is only indicated in this group when there is a clinical parameter which dictates the necessity of immediate evaluation.

Effects of relaxing music on cardiac autonomic balance and anxiety after acute myocardial infarction

1999 ◽  
Vol 8 (4) ◽  
pp. 220-230 ◽  
Author(s):  
JM White
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Heart Rate ◽  
Respiratory Rate ◽  
Oxygen Demand ◽  
Control Group ◽  
Myocardial Oxygen Demand ◽  
Treatment As Usual ◽  
Physiological Indicators ◽  
Experimental Group

BACKGROUND: Acute myocardial infarction places additional demands on an already compromised myocardium. Relaxing music can induce a relaxation response, thereby reversing the deleterious effects of the stress response. OBJECTIVES: To compare the effects of relaxing music; quiet, uninterrupted rest; and "treatment as usual" on anxiety levels and physiological indicators of cardiac autonomic function. METHODS: A 3-group repeated measures experimental design was used. Forty-five patients, 15 per group, with acute myocardial infarction were assigned randomly to 20 minutes of (1) music in a quiet, restful environment (experimental group); (2) quiet, restful environment without music (attention); or (3) treatment as usual (control). Anxiety levels and physiological indicators were measured. RESULTS: Immediately after the intervention, reductions in heart rate, respiratory rate, and myocardial oxygen demand were significantly greater in the experimental group than in the control group. The reductions in heart rate and respiratory rate remained significantly greater 1 hour later. Changes in heart rate, respiratory rate, and myocardial oxygen demand in the attention group did not differ significantly from changes in the other 2 groups. The 3 groups did not differ with respect to systolic blood pressure. Increases in high-frequency heart rate variability were significantly greater in the experimental and attention groups than in the control group immediately after the intervention. State anxiety was reduced in the experimental group only; the reduction was significant immediately and 1 hour after the intervention. CONCLUSIONS: Patients recovering from acute myocardial infarction may benefit from music therapy in a quiet, restful environment.

Sign in / Sign up

Export Citation Format

Share Document