Myocardial Infarction Treatment

Myocardial Infarction Treatment and Management:

• Analgesic – Pain causes shock
• Thrombolytic Therapy
- Streptokinase, urokinase, and tissue plasminogen activator
- Should be administered between 0 to 6 hours after the onset of pain

• Supplemental Oxygen for 24 to 48 hours to prevent or treat hypoxia
• ECG monitoring
• PTCA
• Diet: Low cholesterol, low salt
• Bed rest 24 – 48 hours
• Avoid straining at stool
• Ambulation on the 4th to 5th day post MI
• Resumption of coitus after 3-4 weeks post discharge as prescribed, non-MI should take the ACTIVE role, take NTG before coitus.


Myocardial Infarction Treatment: Revascularization Procedure

• Coronary angioplasty
• Coronary stenting
• Coronary antherectomy
• Coronary artery bypass grafting


Food Supplement to lower cholesterol and bloop pressure:

Manifestations of Myocardial Infarction

• Fever that extends 3 to 7 days
• Indigestion
• Acute Pulmonary Edema
• ECG Changes
• Laboratory study abnormalities


Myocardial Infarction Laboratories

1. Creatinine Kinase:

– Male: 5 - 35 μg/ml
– Female: 5 to 25 μg/ml
– Onset: 4 hours, Peak: 12 – 24 hours and may last up to 3 to 4 days
– Enzyme found in the skeletal muscle (CK-MM), heart muscle (CK-MB) and brain tissue (CK-BB)
– Medications that may increase CK levels include: high-dose aspirin, ampicillin, carbenicillin, or dexamethasone

Nursing Implications for Creatinine Kinase

– Hold IM injections if CK levels are expected to drawn


2. Lactic Dehydrogenase

– Total LDH: 100 to 190 IU/L
– Onset: 12 hours, Peak: 48 hours and may last up to 10 to 14 days
– Intracellular enzyme important for cellular metabolism.
– LDH 1 and 2: cardiac cells
– LDH 3: pulmonary cells
– LDH 4 and 5: hepatic cells
– Medications that may increase LDH levels:
a. Narcotics and frequent IM injections


3. Troponin T and Troponin I(serum)

– Normal: < 1.0 ng/ml
– Diagnostic for MI: 2.2 ng/ml
– Cardiac specific protein marker for myocardial injury
– Elevation begins 4 to 6 hours after the onset of chest pain and peaks at approximately 10 to 24 hours, and return to normal values in 10 to 15 days making it a very useful diagnostic tool for determining myocardial injury



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