MANAGEMENT of Acute Myocardial Infarction (AMI) -1

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MANAGEMENT of Acute Myocardial Infarction (AMI)

 

MANAGEMENT Management involves

  • Prompt attention and diagnosis.
  • Reperfusion therapy
  • Management of pain.

MI is a medical emergency; Typical treatment for the patient includes:

  • diagnosis and treatment should not be delayed.
  • administering oxygen immediately, and giving aspirin and beta blockers, unless there are strong contraindications.
  • ordering fibrinolytic drugs (e.g., tissue plasminogen activator) unless contraindicated or emergency angioplasty (where it is available).
  • giving angiotensin converting enzyme inhibitors.
  • giving statins.
  • giving nitrates and morphine for vasodilation and pain relief. giving antiplatelet agents such as heparins or glycoprotein IIb/IIIa inhibitors.

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MANAGEMENT of Acute Myocardial Infarction (AMI) -1

 

Management of Pain

 

Morphine :

  • For pain Morphine is given to :
    • Decrease sympathetic drive
    • Decrease cardiac output
    • Decrease arterial pressure
    • Decrease cardiac work load
    • Decrease vasoconstriction
    • Symptomatic relief.

 

Side effects of Morphine ..

  • Severe hypotension – elevate legs and give IV saline
  • Bradycardia – give atropine IV
  • Heart block – give atropine 0.5 mg IV – repeat if
  • necessary
  • Diaphoresis and Nausea
  • Vomiting – give antiemetics.
  • Dose
    • Injection Morphine is given- 2 to 5 mg IV at a time. –

 

Nitroglycerine:

  • Sublingual NTG is given 0.4 mg sublingual at 5 minute intervals. –

 

Nitrate :

  • are given to decrease myocardial oxygen ?emand, a*nd increase myocardial oxygen supply.
  • IV NTG is given if BP is more than 100 mmHg . Not to be given in RV infarction.

 

Beta 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.

 

Contraindications of Beta Blocker —

  • Heart rate <60 per minute
  • Systolic blood pressure < 100 mmHg
  • PR Interval >0.24 sees.
  • Rales > 10 em above the diaphragm

 

Calcium Channel blockers

  • have little role. It raises the threshold for angina.
  • read more about management AMI —

Fore more detail acute-myocardial-infarction-management-regime-for-management-of-ami

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