Roger, Go, Lloyd-Jones, et al. states “Cardiovascular disease is the leading cause of death in the United States for men and women of all racial and ethnic groups.” (As cited in Hinkle & Cheever 2014, p. 729). There are different types cardiovascular diseases and they have a lot in common in terms of characteristics. This paper will focus on discussing acute coronary syndrome and myocardial infarction. To distinguish the two from each other, it is important to know the similarities and differences in etiology, clinical manifestations, medical management, collaborative care and nursing management for these two diseases.
Acute coronary syndrome pertains to a sudden changes in the heart’s blood supply. It can range from the development of
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Myocardial infarction and acute coronary syndrome require the same medications such as: “aspirin, nitroglycerin, morphine, beta blockers, and thrombolytics” (Smeltzer, pp. 744, 2010) Oxygen administration and a 12-lead electrocardiogram is also required upon arrival to the hospital. A PCIS is a procedure for “opening the occluded artery and providing perfusion to the area of the heart that has been deprived of oxygen” and should be done in less than one hour of patient arrival (Smeltzer, pp. 745, 2010). When a PCI is contraindicated or unavailable at a certain facility, thrombolytics are admistered to “dissolve the thrombus in a coronary artery” in order for reperfusion to the deoxygenated area of the heart to occur (Smeltzer, pp. 745, 2010). After the initial medical treatment for acute coronary syndrome and a myocardial infarction, “continuous cardiac monitoring” is required to ensure that another episode is not going to occur (Smeltzer, 745, 2010). Monitoring is preferably done on an intensive care unit because of the severity of the complications that could occur. Medications such as “aspirin, beta-blockers, and an ACE inhibitor” is included in the ongoing treatment (Smeltzer, pp. 745, 2010). Cardiac rehabilitation is initiated after the patient with acute coronary
The primary concern for Mr. Miller would be preventing further ischemia and necrosis of the myocardial tissues, preventing serious complications such as cardiac dysrhythmias and heart failure, as well as relieving his chest pain that radiates to his left arm. Preventing further ischemia and necrosis of the myocardial tissue will help prevent the development of heart failure due to myocardial infarction, whereas relieving his pain will help reduce his episodes of shortness of breath, and will also help to reduce any anxiety and restlessness he may be having from being in pain and short of breath.
The purpose for the stent was to hold the coronary artery open to allow the blood to flow more freely.
Heart disease is one of the most common causes of the mortality and morbidity in most well developed countries. They come in different forms such as stroke and other cardiovascular diseases and it’s the number one cause of death in the state of America. In the year 2011 alone nearly 787,000 people were killed as a result of this epidemic. And this included Hispanic, Africans, whites and Americans. As for the Asian Americans or pacific Islanders, American Indians and the natives of Alaska, the concept to them was a second only to cancer. However, statistics has proved that a person gets heart attack every 34 seconds and in every 60 seconds, someone dies out of it which include other related event. Additionally, majority of the women are the
After review of the clinical information provided by North Central Bronx Hospital, the Medical Director has denied your admission to North Central Bronx Hospital. It was determined that the clinical information did not justify an inpatient stay. Acute inpatient hospitalization was not medically necessary. You are a 56 year old female with complaints of worsening pressure-like chest pain on the left sided that radiated to your left arm and neck. The symptoms began when you were at rest and woke you from your sleep. Based on the Interqual guideline (a decision based program to determine medical need) criteria to for acute coronary syndrome the clinical guidelines were not met because troponins were negative, there was no diagnostic testing such as a stress test, or documentation of ischemia in the clinical information that was submitted.
My clinical rotation for NURN 236 is unique in that all patients I care for at Union Memorial Hospital in Baltimore, Maryland have a diagnosis of heart failure (HF). HF occurs when the heart is unable to pump adequate blood supply, resulting in insufficient oxygen and nutrients to the tissues of the body (Smeltzer, Bare, Hinkle, and Cheever, 2012). Approximately 670,000 Americans are diagnosed with HF each year and is the most common hospital discharge diagnosis among the elderly (Simpson, 2014). Moreover, according to the Centers for Medicare and Medicaid Services (CMS), HF is the leading cause of 30-day hospital readmission followed by acute myocardial infarction (AMI) and pneumonia (medicare.gov|Hospital Compare, 2013).
Keep the patient NPO, and establish two IV access sites with a large bore catheters running one IV with NS at KVO and morphine sulfate for pain. Initial laboratory testing including a complete blood cell count (CBC), basic metabolic panel (BMP), cardiac enzymes (creatine kinase, creatine kinase-MB, and cardiac Troponin) and repeat in 90 min. Administer antiplatelet ASA 324mg PO (Sen, B., McNab, A., & Burdess, C., 2009, p. 18). Before administering nitroglycerin 0.4 mg SL (every 5 minutes up to three doses) reassess blood pressure if systolic <90 mmHg, patient has used cocaine in the last 24 hours, or taking PDE-5 inhibitors do not administer. Thrombolytic therapy should be implemented within 30 minutes from the patient’s arrival to the emergency department, and if they are a candidate for cardiac catheterization it should be done within 90 minutes from the patient being admitted to the hospital. Delay on either therapy option increases the risk of mortality (Kosowsky, Yiadom, Hermann, & Jagoda, 2009, p. 10).
Coronary artery disease (CAD) is the most common type of multifactorial chronic heart disease. It is a consequence of plaque buildup in coronary arteries. The arterial blood vessels, which begin out smooth and elastic become narrow and rigid, curtailing blood flow resulting in deprived of oxygen and nutrients to the heart [1].
In a conclusion, although cardiovascular disease remains the major concern to many citizens, the survival rate is still high for those who admitted to hospital as the improvement in medical care and emergency treatment plan. However, one should instantly seek for medical aid when developing symptoms of myocardial infarction such as chest pain, shortness of breath and nausea. Precautions are always better than cure, one should maintain a healthy diet, exercise regularly and quit smoking in order to avoid the occurring of cardiovascular disease.
This assignment is a case study that aims to explore the biospychosocial impacts of a myocardial infarction on a service user. It will focus on the interventions used by healthcare professionals throughout the patient’s journey to recovery. To abide by the NMC’s code of conduct (2015) which states that all nurses owe a duty of confidentiality to all those who are receiving care, the service user used in this case study will be referred to as Julie. Julie is a 67 year old lady who was rushed to her local accident and emergency following an episode of acute chest pain and was suspected to have suffered from a myocardial infarction. Julie who lives alone reported she had been experiencing shortness of breath and
Coronary heart disease is defined by the hardening of the epicardial coronary arteries. The buildup of plaque in the arteries slowly narrows the coronary artery lumen. In order to better understand the physiology of the disease, it is important to first know the basic anatomy of the human heart. The aorta, located in the superior region of the heart, branches off into two main coronary blood vessels, otherwise known as arteries. The arteries are located on the left and right side of the heart and span its surface. They subsequently branch off into smaller arteries which supply oxygen-rich blood to the entire heart (Texas Heart Institute, 2013). Therefore, the narrowing of these arteries due to plaque buildup significantly impairs blood flow throughout the heart.
Since 1960 the age-adjusted mortality rates for cardiovascular disease (CVD) has declined steadily in the U.S. due to multiple factors, but still remains one of the primary causes of morbidity and premature mortality worldwide. Greater control of risk factors and improved treatments for cardiovascular disease has significantly contributed to this decline (Centers for Disease Control and Prevention, 2011). In the U.S. alone it claims approximately 830,000 each year and accounts for 1/6 of all deaths under the age of 65 (Weiss and Lonnquist, 2011). Based on the 2007 mortality rate data an average of 1 death every 37 seconds is due to cardiovascular disease (Lloyd-Jones et al., 2009). Controlling and reducing risk factors is crucial for saving lives. There are a number of contributing risk factors for cardiovascular disease, which may appear in the form of hereditary, behavioral, and psychological, all of which ultimately converge in social or cultural factors.
...ds a supply of its own blood to function properly. These arteries, called the coronary arteries, are responsible for this. The blockage of these arteries prevents oxygen from reach the heart tissue and leads to what is known as a heart attack.
Today, cardiovascular disease is “the number one killer in the United States and the developed world” (Sapolsky, 2004, p. 41). Coronary heart disease (CHD) is the most common form of cardiovascular disease, and is responsible for claiming an unreasonable amount of lives every year. CHD can begin to accumulate in young adults, but is prominently found in both men and women in their later adult lives. As a result of CHD, men typically experience heart attacks, whereas women present with chest pains, known as angina (Matthews, 2005).
One of the leading causes of death in the United States is heart disease. “Approximately every 29 seconds one American will have a heart attack, and once a minute one American will die from a heart attack” (Ford-Martin and Odle, 915). According to the Gale Encyclopedia of Alternative Medicine men over the age of 45 and women over the age of 55 are considered at risk for heart disease. Heart disease is a major cause of death. It is beneficial to individuals who seek to prevent heart disease to recognize the risks leading to heart attacks as they are one of the primary indications of developing heart disease; especially those that fall into the at risk age groups. These risks consist of some that cannot be changed such as heredity risks, or those that can change such as smoking habits. It is very important to know these specific risks for prevention and to understand the symptoms of heart attacks, such as sweating or the feeling of weakness so if these or other symptoms occur people are aware. Finally heart disease treatment is of vital importance if you experience a heart attack so you can learn how to prevent another one from occurring.
Oxygen was first admitted to the client with chest pain over 100 years ago (Metcalfe, 2011). Chest pain is a large bracket that can contain many different conditions, but for the purpose of this analysis it is focused manly upon a myocardial infarction. A myocardial infarction is mainly referred to as a heart attack, and occurs when one or more coronary arteries leading to the heart reduce or completely stop blood flow (Tuipulotu, 2013 ). Administering high concentrations of oxygen to patients with chest pain is now embedded in guidelines, protocols and care pathways, even with a lack of clear supporting evidence (Nicholson, 2004 ). High concentration of oxygen means that up to 60% is administered (Knott, 2012). More recent research has suggested that the use of oxygen in this scenario is unnecessary and can lead to unwanted side effects, especially in normoxic cardiac patients (Moradkham & Sinoway, 2010 ). The aim of this comparative analysis is to dismantle and understand both the benefits and risks of the commonly known practice of administration of oxygen to the client with chest pain. Through completing this analysis using recent and appropriate evidence a more improved practice can be given and understood.