Acute Myocardial Infarction
Acute myocardial infarction is one of the major causes of morbidity and mortality in developed countries. Every year, at least three million people die from the disease globally. In America, it is estimated that about one million deaths result from this non-communicable disease. Acute myocardial infarction is considered as a severe coronary disease. It is categorized into two segments, elevated myocardial infarction (STEMI) and non-ST segment elevation myocardial (NSTEMI), depending on the findings of electrocardiography (Morrow, 2017). Myocardial infarction is commonly regarded as heart attack. However, the condition is different and is characterized by cardiac arrest, especially when the heart is not functioning properly. Therefore, the condition can lead to death if other organs fail to function.
Acute myocardial infarction is a condition that usually occurs as a result of an imbalance in the supply and demand of oxygen. In other words, the amount of oxygen that is supplied in the body cannot meet the demand, which results in cardiac ischemia. Atherosclerotic plague may break, leading to a blood clot in the veins, also known as thrombosis (Jaski, 2015). When blood clots in the circulatory system, it leads to a reduced level of blood flow in the coronary, which in turn lowers the amount of oxygenated blood circulating in the body organs.
Certain factors contribute to the onset of this cardiovascular condition. Those factors may include:
- Age- men who are 45 years and above are more likely to develop acute myocardial infarction compared to women of the same age or above (Mechanic & Grossman, 2019).
- Tobacco- long-term exposure to firsthand and secondhand smoke increases the likelihood of acute myocardial infarction.
- High blood rates- individuals with chronic hypertension may have damaged arteries, which are responsible for “feeding” the heart. Other conditions, such as diabetes and obesity, increase the risk even more.
- Stress- stress increases the risks of the condition because people respond to stress in a variety of ways. Those who respond in a manner that increases heart rates have an elevated risk of acute myocardial infarction.
- Other risk factors include a history of acute myocardial infarction in the family, use of illicit drugs, autoimmune conditions, history of preeclampsia in the family, lack of physical activity, and metabolic syndrome.
The most commonly known signs may include left arm and chest pain. In addition, the pain may originate from the backbone towards the neck, while patients may experience sweating, nausea, and faint in the process. Women may experience different signs, and only 50 percent of women will indicate having experienced chest pain (Jaski, 2015).
All patients with STEMI and NSTEMI conditions require aspirin of between 160 mg to 325mg. They should be provided with arterial access and oxygen supplementation (Mechanic & Grossman, 2019). Hence, to relieve them from pain in the chest and other parts of the body, opioids may be administered. Sublingual nitroglycerin should also be administered if the blood pressure is stable.
Atherosclerotic breakage causes inflammation of the macrophages and monocytes. It also leads to thrombosis and accumulation of platelets. As a result, the amount of oxygen delivered in the coronary artery is decreased due to the reduced blood flow (Mechanic & Grossman, 2019). The lack of capacity to produce adenosine triphosphate in the mitochondria, which is a chemical that gives energy to the numerous processes of living cells, causes ischemic cascades that kill cells of the endocardium, also known as myocardial infarction.
In the provided case study, Ms. Lyra suffers from stress attributable to her working conditions. She works as a full-time teacher, an occupation that requires her to be actively involved with the learners. She used to take wine and stopped smoking four years ago. She is physically active and weighs 135 lbs.
As it is palpable from the case study, Ms. Lyra experiences recurrent discomfort in the jaw that has lasted for two hours alongside heaviness in the arms. She complains of discomfort and appears pale, sweaty, and feels nauseated. To confirm if Ms. Lyra is having an acute myocardial infarction, it is imperative that the doctor performs differential diagnosis since other conditions can have similar signs and symptoms. Examples of these conditions include pneumothorax, myocarditis, asthma, aortic dissection, pericarditis, and acute cholecystitis. Ms. Lyra’s current condition and her history show that indeed she is suffering from acute myocardial infarction. As indicated, stress is one of the risk factors of this cardiovascular disease. Ms. Lyra has been experiencing heightened stress, which she indicates that she is unable to handle. Another pre-existing risk factor is the use of cigarettes. She asserts that she has been smoking until the last four years. Besides, her current signs are consistent with the signs and symptoms of this illness as indicated by Mechanic and Grossman (2019). Ms. Lyra is pale, nauseated, has recurrent pain in the jaw, and is experiencing heaviness in both forearms, which are signs consistent with the findings on acute myocardial infarction.