CHAPTER 1 Cardiovascular System^11
- Explain to patient:
- Rest when pain begins to decrease oxygen demands.
- Take nitroglycerin when any pain begins—it helps dilate coronary arter-
ies and get more oxygen to heart muscle. - Avoid stress and activities that bring on an angina attack.
- Call 911 if the pain continues for more than 10 minutes or as the patient
is taking the third nitroglycerine dose (1 sublingual dose every 5 minutes,
if BP allows, for maximum of 3 doses). - Stop smoking! Smoking is associated with heart disease.
- Adhere to the prescribed diet and exercise plan. Lower cholesterol and fat
intake to decrease further plaque build-up, and decrease excess salt intake
to help BP control. Slowly increase exercise to build up activity tolerance.
Possibly exercise with cardiac rehabilitation. - How to recognize the symptoms of a myocardial infarction: Pay attention
to chest pains as well as changes in patterns of pain and response to treat-
ment. Be aware of changes in respiratory patterns, increase in shortness
of breath, swelling, and general feelings of malaise.
Myocardial Infarction (MI)
WHAT WENT WRONG?
Blood supply to the myocardium is interrupted for a prolonged time due to the block-
age of coronary arteries. This results in insufficient oxygen reaching cardiac muscle,
causing cardiac muscles to die (necrosis). MI is commonly known as a heart attack.
The area of infarction is often due to build-up of plaque over time (atheroscle-
rosis). It may also be due to a clot that develops in association with the athero-
sclerosis within the vessel. Patients are typically (not always) symptomatic, but some
patients will not be aware of the event; they will have what is called a silent MI.
PROGNOSIS
The outcome depends on the coronary artery that is affected. The earlier the per-
son enters the healthcare system, the better the prognosis is, because emergency
measures will be available for otherwise fatal arrhythmias.
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