The course of the disease, therefore, varies with the cause of the MI, the area of the heart involved and the treatment that is given to the patient. COMPLICATIONS: The complications of Acute Myocardial Infarction are ventricular arrhythmias, cardiac rupture (Rosamond et
For ST elevation, primary percutaneous coronary intervention or fibrinolysis is used. For non-ST elevation, invasive investigation and revascularization has been declared as a good treatment (White & Chew, 2008) PREVENTION: Acute Myocardial Infarction can be prevented by keeping all the risk factors under control
Hypertension, otherwise known as high blood pressure, is a silent condition that can cause blood vessel changes in the retina of the eye, a fattening of the heart muscle, kidney failure and brain damage. "Many people with hypertension are unaware of their condition, and many more are untreated or inadequately treated" (Burt, 1995, p
Therefore, defining those core measures becomes a political issue. Under the Hospital Value-Based Purchasing program, Medicare will pay hospitals based on the quality of care, not just the quantity of services provided (Administration Implements Affordable Care Act Provision to Improve Care, Lower Costs, 2011)
In one study, atypical AMI was found in 20% of patients (Chowta, Prijith & Chowta, 2005). In another study, more than half of all patients reported initial atypical symptoms (such as gastric pain accompanied by vomiting) followed by a more typical indicator of AMI (Body, et al
First, a large number of AMI patients present with atypical symptoms. In one study, atypical AMI was found in 20% of patients (Chowta, Prijith & Chowta, 2005)
A patient that complains of an atypical symptom that could be a result of AMI is less likely to be treated, under typical protocol for AMI. This could result in further damage to or the death of the patient (Laine, Grisoli & Bonello, 2011)
Not checking and then causing further damage could result in litigation (Laine, Grisoli & Bonello, 2011). Hospitals that comply with standards are eligible for incentives (Leighty, 2007)
"Accommodation is a lose-win strategy that you can use to preserve relationships. This strategy tries to resolve conflict by giving in to the other person, neglecting your own needs" (Lippincott, Williams & Wilkins, Inc
However, the reality is that early intervention is key to helping patients suffering from acute myocardial infarction (AMI). In fact, the Joint Commission has implemented required core measures for acute myocardial infarction (AMI) (Moore, 2012)
566) In fact, it is reported that aspirin alone resulted in a reduction in post myocardial infarct (MI) mortality "at five weeks by 23% in the Second International Study of Infarct Survival (ISIS-2)." (Chan et al
Plaque vulnerability depends on the size and consistency of the atheromatous core, the fibrous cap thickness and the existence of ongoing inflammation with activated macrophagues and T-lympocytes." (Sakethou et al
Anticoagulant therapy was routine management of patients with myocardial infarction in the 1950s however, this management "fell into disrepute because of the fear of bleeding complications and doubt about its effectiveness." (Stein, 1998, p
Given these comparisons, evidence of an additional survival benefit of thrombolysis above that of aspirin depends entirely on ISIS-2 and whether ISIS-2 data is consistent with findings of the other trials." (Cundiff, 2002) It is stated that ISIS-2 "randomized 17,187 patients with suspected AMI, comparing aspirin, SK, both, and neither
In the chronic dosing study, ASA dose-response curves for platelet function, including cycloosygenase activity were determined for various doses (20-1300 mg) of the controlled release (enteric coated pellets) ASA formulation taken by volunteers daily for one week." (Roberts, McLeod, Cossum and Vial, 1984) It is stated that platelet function was assessed by the "
" (Roberts, McLeod, Cossum and Vial, 1984) The work of McConnell (2002) entitled: "Aspirin Protection Reaffirmed for High Risk Myocardial Infarction or Stroke" states that aspirin or other antiplatelet drugs "protect patients who are at high risk of serious vascular events and should be considered routinely for all such patients." (McConnell, 2002, p
Figure 20 Source: Price (nd) The VerifyNow assay is stated to be a "true point-of-care assay that can measure patient response to aspirin, clopidogrel and GP IIb/IIa inhibitors." (Price, nd) Aspirin non-responsiveness as measured by the VerifyNow assay is stated to be "associated with post-PCI myocardial infarction
4%, several reviews estimate, based on a large number of studies, that the incidence of aspirin resistance is between 5% and 45%." (Hillman, 2009) There are stated to be serious limitations in the Tantry et al
ST segment Elevation Myocardial Infarction (STEMI) There are two types of heart attacks: a ST segment Elevation Myocardial Infarction (STEMI) is the most lethal kind. " Myocardial infarctions (heart attacks) occur when a coronary artery suddenly becomes at least partially blocked by a blood clot, causing at least some of the heart muscle being supplied by that artery to become infarcted (that is, to die)" (Fogoros 2014)
g., plaque rupture, thrombotic occlusion); Type 2 is secondary to ischemia from a supply-and-demand mismatch; Type 3 is a myocardial infarction resulting in sudden cardiac death; Type 4a is a myocardial infarction that is associated with percutaneous coronary intervention; Type 4b is associated with in-stent thrombosis; and, Type 5 is a myocardial infarction that is associated with coronary artery bypass surgery (Balooki & Askari, 2010, para