Myocardial Infarction (MI) (USLOs 1, 2, 3, 4)

Financial Implications

• Healthcare costs: MI can lead to significant financial burdens due to hospitalization, medications, and long-term care.
• Lost income: MI may result in time off work, which can impact earnings and financial stability.
• Insurance coverage: The availability and coverage of health insurance can influence access to care and treatment outcomes.

Source: American Heart Association. (2023). Heart Attack. https://www.heart.org/en/health-topics/heart-attack/understand-your-risks-to-prevent-a-heart-attack  

Environmental Implications

• Exposure to pollutants: Exposure to air pollution, secondhand smoke, and other environmental toxins can increase the risk of heart disease.
• Stress and social factors: Environmental factors such as stress, social isolation, and limited access to healthy food can contribute to heart disease.

Source: World Health Organization. (2019). Cardiovascular Diseases. https://www.who.int/health-topics/cardiovascular-diseases

Priority Nursing Interventions in the Emergency Department

1. Monitor vital signs: Continuously monitor heart rate, blood pressure, oxygen saturation, and respiratory rate.
2. Administer medications: As ordered by the physician, administer medications such as aspirin, nitroglycerin, and beta-blockers to improve blood flow and reduce heart workload.
3. Prepare for diagnostic testing: Assist with preparing the patient for diagnostic tests such as electrocardiogram (ECG), echocardiogram, and cardiac markers.
4. Provide emotional support: Offer emotional support and reassurance to the patient and their family.
5. Manage pain: Assess pain and administer analgesics as needed.

Labs and Diagnostic Testing

• ECG: To identify the location and extent of the MI.
• Cardiac markers: Troponin, CK-MB, and myoglobin levels to confirm a diagnosis of MI.
• Echocardiogram: To assess heart function and identify any structural abnormalities.
• Complete blood count (CBC): To evaluate blood cell counts and identify any underlying conditions.
• Basic metabolic panel (BMP): To assess kidney function and electrolyte balance.

Critical indicators:

• Decreasing blood pressure: Indicates worsening cardiac function or shock.
• Increasing heart rate: May indicate heart failure or other complications.
• Decreasing oxygen saturation: Suggests respiratory distress or inadequate oxygen delivery to the heart.
• Abnormal cardiac markers: Elevated levels of troponin, CK-MB, and myoglobin are indicative of MI.

Source: American College of Cardiology. (2023). Heart Attack. https://www.cdc.gov/heart-disease/about/heart-attack.html

Interdisciplinary Team Members

• Cardiologist: To provide specialized medical management and treatment.
• Cardiac surgeon: If surgical intervention is necessary, such as angioplasty or bypass surgery.
• Respiratory therapist: To manage respiratory symptoms and assist with oxygen therapy.
• Registered dietitian: To provide nutritional guidance and support.
• Social worker: To address social and emotional needs and assist with discharge planning.
• Physical therapist:
  To help with rehabilitation and improve functional capacity.

Source: American Heart Association. (2023). Heart Attack Treatment. https://www.heart.org/en/health-topics/heart-attack