COMPLETE MANAGEMENT OF AMI Coronary Care Unit (CCU)

COMPLETE MANAGEMENT OF AMI Coronary Care Unit (CCU)

Patients of AMI are admitted to CCU for monitoring of all vital parameters, management of arrhythmias,
thrombolytic therapy.

For more management-of-acute-myocardial-infarction-ami and acute-myocardial-infarction-management-regime-for-management-of-ami

Sedation

Diet

Liquids for 1S^t 12 hours.
Fat <30 % of total calories, carbohydrate – 50% of total calories, cholesterol <300 mg/day.
Small frequent foods with potassium, magnesium, fibre, vitamins.
Low sodium.
Avoid sweets.
Bowels
Bedside commode
p Stool softener
Laxative.

Activity

Bed rest for 12 hours.
Then dangling the legs on the side of the bed, sitting up in a chair – in 24 hrs – this reduces pulmonary capillary wedge pressure.
On 3^r^d day patients can take bath.
Thereafter patients can start walking few paces.

Anti-thrombotic agents

Aspirin.
GP lIb I IlIa antagonist.
UFH – Unfractionated heparin helps to maintain patency of infarct related artery.
(Low molecular weight heparins LMW ) may be used instead of UFH as it has advantages:
Is given subcutaneously
Stable anticoagulant effect Prevent thromboembolization.
Clopidogrel – A combination of clopidogrel + Aspirin is -superior to Aspirin alone to prevent IHD.
Anyone or more, even upto four of the above can be given together.

Indications of LMW

Beta Adrenoceptor Blockers:

IV blockers are given to : Relieve pain Prevent arrhythmias. Decrease oxygen demand Decrease ischemia Decrease mortality Metoprolol is given 5mg every 5 min 3 times. Then 50mg is given ever 6 hours for 48 hours. Then 100mg every 12 hours.

Angiotensin converting enzyme inhibitors (ACEI)

Special indications: