MYOCARDIAL
INFARCTION
BY DIKSHA RAWAT
ANATOMY :-
. HEART IS A MUSCULAR ORGAN.
. LOCATED IN THORACIC CAVITY,POSTERIOR TO STERNUM,SUPREIOR TO
DIAPHRAGM,BETWEEN THE LUGES.
. HEART HAS 3 LAYERS ‘PERICARDIUM’ ENDOCRDIUM ,MYOCARDIUM.
. 4 CHAMBERS 2 ATRIUM 2 VENTRICLES.
. VALVES MITRAL,AORTIC,TRICUSPID,PULMONARY.
PHYSIOLOPGY
HEART PUMPS BLOOD THROUGHTOUT THE BODY VIA.
THE CIRCULATORY SYSTEM SUPPLYING OXYGEN AND
NUTRIENTS TO THE TISSUES AND REMOVING CARBON DIOXIDE
AND OTHER WASTES .
HEART CONTAINS ELECTRICAL ‘PACEMAKER’ CELLS WHICH
CAUSE IT TO CONTRACT PRODUCING HEARTBEAT.
DEFINITION
MYOCARDIAL INFARCTION IS A DISEASED CONDITION WHICH IS
CAUSED BY
REDUCED BLOOD FLOW IN A CORONARY ARTERY DUE TO
ATHEROSCLEROSIS AND OCCLUSION OF AN ARTERY BY
AN EMBOLUS OR THROBUS.
CLASSIFICATION(DEGREE OF
DAMAGE)
1 ZONE OF INFRCTION DEATH OF HEART MS ,( COMPLETE
O2 DEPRIVATION,IRREVRSIBLE.
2 ZONE OF INJURY MUSCLES SURROUNDING AREA OF
NECROSIS,INJURED,STILL VIABLE .
2 ZONE OF ISHEMIA MUSCLE SURROUNDING AREA OF
INJURY,ISCHEMIC ,VIABLE .
ACCORDING TO LAYERS OF HEART
MUSCLES INVOLED
1 TRANSNURAL INFARCTION (STEMT ) INVOLVES FULL
THICKNESS OF HEART MUSCLES COMLETE OBSTSUCTION OF
CORONARY ARTERY .
2 SUBENDOCARDIAL (NON TRANSWALL) INVOLVES SMALL
AREA IN THE SUBENDOCARDIAL WALL OF THE LEFT
VENTRICAL ,VENTRICALAR SEPTUM OR POPILLARY MUSCLE .
REGION OF MI
CORONARY ATHEROSCLEROSIS
CORONARY THROMBOSIS OR EMBOLISM
CORONARY VASOSPASM
DECREASE BLOOD FLOW C SHOCKN OR HAEMAREHAGE.
REDUCED MYOCARDIAL BLOOD SUPPLY & INCREASED MYOCARDIAL
OXYGEN DEMAND .
MYOCARDIAL ISCHEMIA
PLAQUE SUPTURE &THROMBOGENESIS
LONG TERM
MYOCARDIAL
ISCHEMIA
PERMANENT THROMBUS
MYOCARDIAL CELL NECROSIS
MYOCARDIAL INFACTION
CLINICAL MANIFESTATION
CHEST PAIN: NOT RELIEVED BY GTN AND LAST LONGER THAN 30
MINT.
ANXIOUS & RESTLESSNESS.
DIAPHOSESIS,COOL,CLANING,MOIST SKIN & FACIAL PALLER.
FASTER THEN NORMAL HEART RATE & RESPIRATORY RATE .
DECREASE CARDIAC CONTRACTILITY & HEART RATE .
EPIGASTSIC OR ABDOMINAL DISTRESS
DISORIENTATION ,CONFEUSION,FAINTING.
FEVER
COMPLICATIONS OF MI
DYSHYTHMIAS
HEART FAILURE
PULMONARY EDEMA
CARDIOGENIC SHOCK
VENTRICULAR RUPTURE
MITRAL VOLVE INSUFFICENCY
DIAGNOSTIC EVALVATION OF MI
DETAILED MEDICAL HISTORY PHYSICAL EXAMINATION
ELECTROCARDIOGRAM (ECG/EKG).
ECHOCARDIOGRAM
ANGIOGROPHY
STRESS TEST
POSITION EMISSION TONOGRAPHY (PET)
SCAN
CT SCAN,MRI
BLOOD TEST
FATS ,CHOLESTEROL LEVEL
CARDIAC BIOMARKESS –
TROPONIN ,CK-MP, MYOGLOBIN,C- REACTIVE
PROTEIN & HOMOCYSTEINE ,
MANAGEMENT OF MI
MEDICAL MGI
OXYGEN THERAPY – 3 LITERS BY NASAL CONNULA
THROMBOLYTIC THERAPHY – UROKINASE, STREPTOKINOSE & TISSUE
PLASMINOGEN ACTIVATOR.
ANALGESICS – MORPHINE ,MEPERIDINE
VASODILATOR THERAPY – NITROGLYCRIN (GTN)
SURGICAL MGF OF MI
CORONARY ARTERY BYPASS SURFARY ( CABG).
CORONARY STENT
ATHERECTOMY
TRANSMYOCARDIAL LASES REVASCULAIZATION
PHYSIOTHERAPIST ROLE IN
MYOCARDIAL INFARCTION
THE HELP PATIENTS REGAIN PHYSICAL FUNCTION ,IMPROVE
CARDIOVASCULAR HEALT ,AND PREVENT FUTURE CARDIAC EVENTS
THROUGH TAILORED EXERCISE PROGRAMS ,EDUCATION ,AND
GUIDANCE .
1 CARDIAC REHABILITATION
2 SPECIFIC INTERVENTIONS
3 MONITORING AND MANAGEMENT
Thank You
