Myocardial Infarction (MI)।Symptoms and Signs।Treatment।

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Myocardial Infarction (MI)

Disease Description:

Myocardial infarction (MI) occurs when there is necrosis (death) of the heart muscle due to an imbalance between the oxygen demand of the myocardium and blood flow through the coronary arteries.

Symptoms and Signs:

Symptoms:

Pain more intense than angina and not relieved by glyceryl trinitrate.

Shortness of breath.

Vomiting.

Syncope (fainting).

Profuse sweating and extreme tiredness.

Signs to Observe:

1.      Signs of Sympathetic Activation:

Pallor.

Sweating.

Increased heart rate.

2.      Signs of Vagal Stimulation:

Vomiting.

Decreased heart rate.

3.      Signs of Myocardial Dysfunction:

Raised jugular venous pressure (JVP).

Diminished first heart sound.

Presence of a third heart sound.

4.      Signs of Tissue Damage:

Fever.

Pericardial friction rub.

5.      Signs of Complications:

Arrhythmias.

Murmurs (VSD and MR).

Investigations:

ECG: No changes within the first 6 hours. Later changes include:

S-T elevation.

Pathological Q wave.

Inverted T wave.

Enzyme tests.

Blood tests.

Chest X-ray.

Echocardiography.

Coronary angiography.

Treatment:

Immediate hospitalization.

Complete rest.

Pain relief and sedation using inj. Pethedine (2 mg per kg body weight).

Oxygen if needed.

Glyceryl trinitrate under the tongue or intravenously.

Beta-blockers (5 mg intravenously).

Isosorbide dinitrate (10 mg, orally, 2-3 times daily).

Liquid diet.

Aspirin: Initial dose of 300 mg, then 75-150 mg daily.

ACE inhibitors if indicated.

Treat complications if they arise.

Advice:

Rest for 1-3 weeks.

Liquid diet for 4 weeks.

Manage complications after 7 days, if present.

Completely stop smoking.

Control high blood pressure.

Avoid fatty foods.

Regular exercise and weight reduction.