Acute Myocardial Infarction

Abstract

Myocardial infarction in young people (under 45), representing 6% 10% of all strokes in the United States. Approximately 1,500,000 patients experience acute myocardial infarction annually in the United States, and approximately 250,000 die before reaching the hospital. Cardiac risk factors were active cigarette smoking (2 pack-years), obesity (BMI 33.3 kg/m2) and a sedentary life-style. The research analyzes the condition of a 29year old women who suffered an acute myocardial infraction. She was admitted to the medical facility with a complain of epigastric pain, continous colic, nausea and vomiting. An old anterior wall myocardial infraction was shown in her ECG. After the start, of the treatment she had sudden inset orthipnea, which was followed by respiratory and cardiac arrest. She was shifted to ICU. The research further analysed how she was treated and what were the procedures involved in her treatment. In the end, solution for the case study has been briefly described.

Table of Contents

Case Study4

Acute Myocardial Infarction5

Epidemiology5

Pathophysiology6

Symptoms and Signs8

Clinical Presentation10

Laboratory Findings11

Diagnosis11

Associated Disease13

Treatment13

Prevention15

Complications15

Case Study Solutions16

References18

Acute Myocardial Infarction

Case Study

A 29-year-old female patient was admitted to the internal medicine department with epigastric pain, continuous colic, nausea, and vomiting. The ECG demonstrated an old anterior wall myocardial infarction. The serum creatine phosphokinase (CK) and cardiac troponin T (TnT) levels were normal. Seven days later, the patient had sudden onset orthopnea, followed by respiratory and cardiac arrest. The patient was transferred to the ICU after cardiopulmonary resuscitation. The patient's BP was 80/40 mm Hg; the pulse was 130 bpm. The shock was corrected via the application of the pressor and respirator supported ventilation. During the ICU monitoring, the ACUSON P10TM ultrasound system was used on the patient for daily monitoring. Respiration enhanced pain, while leaning forward alleviated it and she described left arm radiation. She also complained of nausea, vomiting and diarrhoea for the past week. She had no past medical or surgical history (Ashikaga, 2007, Pp 962).

Cardiac risk factors were active cigarette smoking (2 pack-years), obesity (BMI 33.3 kg/m2) and a sedentary life-style. Usual medication was oral estroprogestative contraception introduced 2 weeks prior to admission and paracetamol. History was inconsistent with past or present drug abuse. A physical examination revealed elevated blood pressure at 160/80 mm Hg and regular tachycardia at 110 beats per minute. Respiratory frequency, temperature, and oxygen saturation, were however normal. Pulmonary and cardiac auscultation was normal, as well an abdominal examination. A chest X ray was unremarkable. Initial ECG showed sinus tachycardia with anterolateral ST elevation as well as inferior ST depression. Laboratory reports revealed an elevated troponine Ic at 0.69 µg/l, CK was within normal limits and CRP was slightly elevated at 19 mg/l; the rest of the workup, including a complete toxicological-screen, was normal, and a pregnancy test was negative.

Acute Myocardial Infarction

Acute Myocardial Infarction is irreversible myocardial cell death resulting from ischemia. The key diagnostic feature of acute myocardial infarction for rapid assessment purposes is the finding of sustained regional ST elevation by ECG. Based on subsequently obtained cardiac enzyme studies and evolution of the ECG, ...