Abstract: . . .  death n ECG changes: ST depression, T wave inversion , and ST segment elevation n Infarction leads to cell death & irreversible damage n Clinical presentation: angina, vasovagal reflexes, cool, pale, diaphoretic n ECG changes: p.1015 Ischemia (ST depression) Zone of injury (ST elevation) Zone of infarction/necrosis (abnormal Q wave) Page 8 22 Myocardial Infarction A Complication of CHD n Ischemia with death to myocardium d/t lack of blood supply from the occlusion of coronary artery and its branches (Hartshorn, 1997) n imbalance between myocardial oxygen supply and demand n imbalance is result of atherosclerosis, coronary artery vasospasm, thrombus, or dysrhythmias n prolonged ischemia is called an infarction evolves over 3 hours & causes irreversible cellular damage and muscle death (necrosis) 23 Myocardial Infarction Clinical Symptoms n > Cardiac Enzymes d/t myocardial ischemia n CK: creatine kinase onset = 2-6 hrs after MI n LDH: lactate dehydrogenase = 12 hrs after MI n AST: asparate transaminase + 6-8 hrs after MI n Troponin: protein marker for early detection of MI n MI: 20 - 60% are silent (signs and symptoms) n skin is cool, clammy, pale, & diaphoretic n Color of skin is dusky, ashen, hyperthermic n SOB, dyspnea, tachypnea, hypotension, n anxious, denial, depression, impending doom or death, nausea, vomiting 24 Congestive Heart Failure n The heart is unable to sufficiently pump blood in order to meet the metabolic needs of the body. n This inability to pump causes decreased perfusion & decreased cardiac output n Acute: Pulmonary edema n Chronic: Heart failure n Left-sided; Right-sided; Both Page 9 25 CHF n Etiology n Myocardial Infarction n Hypertension n Coronary Artery Disease n Kidney failure n Cardiomyopathies n Side effects of medications e.g. Corticoidsteroids n Valve disease 26 CHF n Left-sided n Failure of the left ventricle to pump blood received from the R side of the heart n Pulmonary circuit becomes congested with blood n Remember: Left and Lung n Etiology-  . . .
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