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Objectives e Define and understand the epidemiology of MI’s and how they are classified e Will be able to identify the risk factors associated with MI’s e Will be able to recognize signs and symptoms of MI and what the appropriate interventions are. e Understand the treatment options available to treat MI. e Nursing responsibilities e Follow up care Epidemiology @©MI’s are the leading cause of death in the United States, affecting one in five men and one in six women. ® 450,000 people in the US die from coronary disease each year. MI’s can be subcategorized by anatomy and clinical diagnostic information. Anatomic Transmural - atherosclerosis involving a major coronary artery, it is usually as a result of complete occlusion of the artery in addition on ECG ST elevation and q waves are seen(STEMI) (epicardium, myo,endocardium) Subendocardial - small area in the subendocardial wall of the left ventricle, ventricular septum, or papillary muscles. It is particularly susceptible to ischemia,in addition to ST depression is seen on ecg(NSTEMI) Diagnostic ST elevations (STEMI)-ECG must show new ST elevation in two or more adjacent ECG leads or new LBBB , it must be greater than 2 mm in leads V2 and V3 or greater than 1 mm in all other leads. non ST elevations (NSTEMI)-ST segment depression =0.5mm or dynamic T- wave inversion with pain or discomfort , and cardio specific proteins troponin are rises in blood in NSTEMI. Left coronary artery - divides into two branches: the circumflex artery and the left anterior descending artery Right coronary Circumflex artery (RCA) artery supphes blood to supplies blood the right atbrum, to the left right ventncle, @trum and the bettom portion of side and back the left ventricle and / _ ‘ of the lef back of the septum j . : ., = . ventride Left anterior descending Coronary veins artery (LAD) {in Blue) bi the ant and pase i ‘ bottorn of the that has already been left oe “used” by muscles of seed the Front of the heart ard retirnn to the septum the right atraam Tunica Intima Tunica media Ly T. Adventitia Normal cut - section of i artery Tear in artery wall plaques a 4 ON Thrombus yw Narrowed artery ; becomes f blocked by a blood clot F atty material $9 is deposited - in vessel wall Atherosclerosis -is a narrowing of the arteries caused by a buildup of plaque MODIFIABLE RI FACTORS | es SDE Ete RISK— a : AGE FAMILY _ HISTORY — SEX IGH DENSI peated EIN SMOKING _ s Smoking can damage the walls of your arteries.( toxic substances in cigarette) ' Atherosclerosis ¥v narrowed & thickened arterial walls ae Risk of M.I. ~ PHYSICAL INACTIVITY | Improper lipid metabolism LDL level increases | © Original Artist weit Re eaitonsto aa je fro Starts accumulating "7 =~ in blood = Risk of M.I. “Doctor says Py ve e got an oe imo procrastinate.” Diabetes increases the risk of MI because it increases the rate of atherosclerotic progression and adversely affects the lipid profile | Risk of having M.I. Release stress hormones like scree te, noradrenaline, and cortiso increase in heart rate, > elevated blood pressure it’s causing damage over time to all your blood vessel That damage increases the risk of plaque buildup in coronary arteries or can even cause a rupture of plaque MI The way you handle stress also matters. If you respond to it in unhealthy ways -- such as simone, overeating,or not exercising - that makes matters worse. 
