COMPLETE MANAGEMENT OF AMI Coronary Care Unit (CCU)

COMPLETE MANAGEMENT OF AMIAcute Myocardial Infarction (AMI) Causes PATHOPHYSIOLOGY and Etiology. Read more ... » Coronary Care Unit (CCU)

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Sedation

  • DiazeRam
  • Lorazepam
  • Reassurance
  • Quiet surroundings.

Diet

  • Liquids for 1St 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 3rd 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 anticoagulantDeep Vein Thrombosis Embolizations Antiplatelet Anticoagulant Treatment Therapy. Read more ... » 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

   

  • LV dysfunction
  • Anterior MI
  • CHF
  • H/O embolism
  • Mural thrombous
  • Atria fibrillation.

 

Beta Adrenoceptor Blockers:

 

Angiotensin converting enzyme inhibitors (ACEI)

 

Special indications: