Causes, Incidence and Risk Factors of the Myocardial Infarction - Assignment Example

Myocardial Infarction Name Institution Affiliation Date Topic 1: Outline the causes, incidence and risk factors of the identified condition and how it can impact on the patient and family. Myocardial Infarction (MI), also known as a heart attack occurs when the heart muscles fail therefore making it incapable of carrying out its functions of pumping blood to the body parts. The inability of the heart to pump the blood negatively impacts the tissues by failing to provide sufficient supply of oxygen. Causes The death of the heart muscles is caused by a condition known as cardiac ischemia brought about by a reduction in the amount of oxygen in the blood (Harman, 2012 ). The heart is the main organ of the cardiovascular system, therefore, requiring high levels of oxygen. It is therefore made up of different types of veins with the most important being the coronary arteries. Among the three coronary arteries, only two of them deliver the oxygenated blood to the heart. Oxygen in the blood is transported in two methods. In one of the method, oxygen molecules are dissolved in the hemoglobin molecules whereas in the other blood molecules are just suspended in the blood (Harman, 2012 ). Any blockage to either of the two coronary arteries deprives the heart of sufficient supply of oxygen causing a condition known as cardiac ischemia. If cardiac ischemia is prolonged, it causes the death of heart muscles, therefore, resulting into Myocardial Infarction (MI) (Cui, 2007). One of the main contributing factors to Myocardial Infarction is the consumption of bad cholesterol. Although the body requires some low level of cholesterol, the uptake of high level is harmful to the body by causing the blockage of the arteries (Martens, 2007). Low-density lipoprotein is one of the highest contributors of the condition by leading to blockage of the artery. It leads to the condition by enhancing the production of a hard substance known as plaque in the body thus increasing the production of platelets thus clotting of the blood. Saturated fats also enhance the buildup of plaque in the arteries. Such fats are found in meat and dairy products. Incidence The incidence of Myocardial Infarction is known to increase with age but the perception has been heavily criticized with an estimated 50 percent of the cases of myocardial infarction within the United States occurring in individuals younger than 65 years old (Martens, 2007). Other factors are however linked with the increase in the prevalence of the Myocardial Infarction such as the predisposing risk factors for atherosclerosis. Risk factors Some of the factors known to double the relative risk of developing Myocardial Infarction include hypertension, diabetes mellitus and also the use of tobacco (Blicher, 2015). Systolic and diastolic hypertension is known to increase the risk of Myocardial Infarction. The risk can be reduced by taking the appropriate medication of hypertension. Abuse of tobacco increases the risk by damaging the walls of the arterial blood vessels. By affecting the lipid profile and increasing the spread of atherosclerosis, diabetes mellitus increases the risk of Myocardial Infarction (Blicher, 2015). Topic 2: List five (5) common signs and symptoms of the identified condition: for each provide a link to the underlying pathophysiology. Signs and symptoms and their pathophysiology There are several signs and symptoms that patients can use as an evaluation on whether they may be infected with Myocardial Infarction. The main one is where the patient endures severe chest pain that feels like the chest has been put under heavy pressure. This may travel to other body organs such as the mouth, shoulder, jaws and the arms. Unlike the pain endured by the patient suffering from angina, patients suffering from Myocardial Infarction the pain are prolonged and are more severe (Singh & Holmes, 2007). The patient also experiences shortness of breath, nausea, vomiting, vomiting, dizziness and even a fast heart rate. The symptoms are caused by the irreversible damage of the heart tissues that is caused by hypoxia, a condition where there is an insufficient supply of oxygen to the body organs. Another cause of the failure is prolonged ischemia. The supply is disrupted when the main supply of oxygen to the heart, the coronary artery, is obstructed by atherosclerosis plaque. Atherosclerosis occurs when the endothelium of the blood vessels is destroyed due to such contributing factors as high level of cholesterol, smoking and even high blood pressure (Tcheng, 2009). The bursting of the vessels leads to the formation of a clot, therefore obstructing their ability to supply of oxygen. The myocardium that is supplied with oxygenated blood become hypoxic and ischemic once the arterial blood vessels completely blocked. Myocardial Infarction is caused when the blockage of the coronary arteries persists for more than 20 minutes since it causes in irreversible cell damage (Tcheng, 2009). The oxygen starvation results in the death of the myocardial cells in the area of myocardium that is to the outside of the arterial blood supply also known as the endocardium. With the increase in the blockage, the area of cell death extends from just the endocardium to the myocardium. The reduced oxygen levels lead to the area extending to the epicardium. If such a blockage lasts for 6 to 8 hours, the damage extends to other areas of collateral perfusion resulting to the failure of other body parts to function (Heat, 2012). The magnitude of the Myocardial Infarction can be defined by measuring the extent to which the myocardial cells have died. Topic 3: Describe two common classes of drugs used for patients with the identified condition including the physiological effect of each class on the body. One of the classes of drugs used for the treatment of myocardial infarction is the vasodilator group of drugs. These drugs help to boost the flow of blood by relaxing the blood vessels. By making the blood vessels to expand, the drugs help in relieving the blood pressure. Apart from treating blood pressure, the vasodilators can be used in treating heart failure and angina (Harman, 2012 ). There are different types of vasodilators drug. Some of the vasodilators drugs affect the arterial vessels while the other ones affect the venous vessels, therefore, reducing the system vascular resistance and the venous blood pressure respectively. Although most of the vasodilator drugs can be applied for hypertension, heart failure and angina due to their ability to dilate arteries and veins, the effectiveness of each drug varies (Acton, 2012). Some arterial vessels are unsuitable for angina, unlike venous dilators that are most effective in its treatment but also unsuitable for use as primary therapy. Arterial dilators help in reducing the systemic vascular resistance, therefore, making it useful in the treatment of systemic and pulmonary hypertension, angina and heart failure. The drugs are effective in treating myocardial infarction by afterload experienced on the left ventricle of the heart. By minimizing the afterload, the strokes and the volume of output of blood are enhanced therefore increasing the amount of oxygenated blood supplied to the body tissues (Ranji, 2007). Patients suffering from angina may benefit from the class of drugs since by reducing the afterload, the amount of oxygen demanded by the heart decreases and in turn boosting the supply and demand ratio. The other group of vasodilator drugs is the venous dilators that are used in treating cardiovascular disorders. They are used for two main functions. One of the main functions of the venous dilators is by dilating the venous capacitance vessels, therefore, reducing the venous pressure (Blicher, 2015). Once the venous pressure is relieved, the preload is minimized and the subsequent cardiac output declined. By achieving a minimum preload, the ventricular wall stress is reduced thus help in keeping the total oxygen demanded by the heart at a minimum and in turn increasing the supply/demand ratio (Moelker, 2007). However, the use of vasodilator has some negative effects that need to be taken into consideration. They include contributing to an increased heart rate and leading to rental retention of sodium and water. The other group of drugs is the cardioinhibitory drugs that reduce the heart rate and the myocardial contractility (Blicher, 2015). By reducing the heart rate, the drugs help in decreasing the cardiac output and the arterial pressure. When the heart is undergoing through minimum activity, the amount of oxygen needed is kept at a minimum. These drugs are therefore suitable for the treatment of hypertension, angina and myocardial infarction. Topic 4: Identify and explain, in order of priority the nursing care strategies you, as the registered nurse, should use within the first 24 hours post admission for this patient. After the admission to a healthcare facility and the tests having been carried, the next step is to try and restore the balance between the oxygen demand and the amount supplied thus aiming to prevent further ischemia. Various methods of oxygen administration that can be applied may include the use of a mask or nasal cannula. Aspirin should also be administered as a pain relief method in the dose of at least 162 to 325 mg (Harman, 2012 ). The patient should, however, be assessed to determine whether they have a history of reacting to use of aspirin. The painkiller should be administered by chewing since it help enhances the rapid absorption of the aspirin into the bloodstream thus achieving a faster effect. After the administration of aspirin, the next step is to give the patient thrombolytic also known as clot busters. This group of drugs helps in removing the blockage of the smooth flow of blood by dissolving a blood clot. Antiplatelet agents should also be issued due to their effectiveness in preventing the formation of new blood clots while also ensuring that the existing clot does not enlarge (Harman, 2012 ). Other drugs that have an effect of reducing the clotting of the drugs are also administered during the initial 24 hours of care (Schneider, 2007). The next stage that a nurse should take is to help in the reduction of the cardiac pain. Such can be achieved through administering nitrates that act as potent vasodilators (Hutchison, 2009). Nitrates help in dilating the blood vessels thus reducing the ventricular preload. With a lower preload, the heart is not overworked thus the oxygen demand is kept to a minimum and also reducing the ischemic pain. A dosage of 0.4 mg in a sublingual tablet should be administered to the patient within the initial stages of care (Blanchard & Loeb Publishers, 2007). It also helps in reducing the pain associated with ischemia. If the patient still endures the huge amount of pain, IV nitrates are recommended and the dose ranging from 5 to 10 is issued until the intended relief has been achieved (Heat, 2012). A Surgical treatment called angioplasty can then be used in treating myocardial infarction. The treatment method is used to repair the blockage preventing the coronary arteries from supplying oxygenated blood to the heart (Bays, 2007). The procedure should be carried out by an authorized surgeon due to the complex and critical nature of the processes. During the surgical treatment, a catheter is inserted through the artery into a blocked coronary artery in the heart. The catheter is inserted with a balloon that is inflated once inside the artery to remove the blood clot. References Acton, Q. A. (2012). Myocardial infarction: New insights for the healthcare professional : 2011 edition. Bays, L. A. (2007). The 12 Lead ECG in ST Elevation Myocardial Infarction. Oxford: John Wiley & Sons. Blanchard & Loeb Publishers. (2007). Myocardial infarction. New Cumberland, PA: Blanchard & Loeb Publishers. Blicher, T. M. (2015). Chronic kidney disease and myocardial infarction: Danish nationwide cohort studies. Kbh.: Faculty of Health Sciences, University of Copenhagen. Cui, J. (2007). Study of genetic risk factors for myocardial infarction in the Newfoundland population. Harman, G. (2012). Myocardial infarction. New Cumberland, PA: Blanchard & Loeb Publishers. Heat Inc. (2012). Pathophysiology for nurses: Myocardial infarction. Mechanicsburg, PA: Blanchard & Loeb. Hutchison, S. J. (2009). Complications of myocardial infarction: Clinical diagnostic imaging atlas. Philadelphia, PA: Saunders/Elsevier. Martens, E. J. (2007). The complex nature of depression after acute myocardial infarction: Evolution and consequences. S.l: s.n. Moelker, A. D. (2007). Stem cell therapy for myocardial infarction. S.l: s.n.. Ranji, M. (2007). Fluorescence spectroscopy and imaging of myocardial infarction. Schneider, D., & Audio-Digest Foundation. (2012). Myocardial infarction. Glendale, Calif: Audio Digest. Singh, M., & Holmes, D. R. (2007). Acute myocardial infarction. Philadelphia, PA: Saunders. Tcheng, J. E. (2009). Primary angioplasty in acute myocardial infarction. New York: Springer. Read More