Treatment of acute myocardial infarction

The article was consulted professionally by Master, Dr Pham Thanh Van, Cardiologist Center – Share99 Times City International Health Hub

Acute myocardial infarction is the necrosis of any amount of myocardial muscle due to is an is issy current cause. The treatment of acute myocardial infarction should be carried out urgently and properly in order to minimize mortality and complications caused by this pathology.

1. Signs of acute myocardial infarction

Patients can recognize acute myocardial infarction through specific signs such as:

  • Typical angina: symptoms of pain such as strangulation in the back of the sternum or the area before the heart, pain that spreads to the left shoulder and face in the left hand up to the ring finger and the little finger;

Acute myocardial infarction

Angina is a characteristic sign of acute myocardial infarction
  • The pain usually appears suddenly, usually lasting more than 20 minutes and does not decrease even when taking nitroglycerin;
  • Pain can spread to the neck, shoulders, chin, back, right hand, or endeman region;
  • There are cases when the patient has a myocardial infarction without or little pain sensation (common in post-surgery patients, the elderly, people with diabetes or hypertension);
  • Other symptoms: sweating, shortness of breath, palpitations, vomiting or nausea, confusion, paleness of the skin, cold head and spiration … These symptoms reflect hypotension or cardiovascular failure;

2. Treatment of acute myocardial infarction

  • Acute myocardial infarction is a super emergency, the patient needs to be immediately taken to a medical facility as soon as possible to be properly and quickly handled;
  • With the initial treatment, the patient is lying unconscious in bed, breathing oxygen, taking necessary drugs such as analgesicals, anti-tinged drugs, nitroglycerin, anti-freezing drugs;
  • In addition, patients can also take measures such as thrombolysis, coronary artery intervention through the skin, surgery to bridge the owner – emergency rim to re-perfuss the myocardial blood;
  • After a successful emergency, patients continue to be monitored, taken medicines along with appropriate diet and exercise.

2.1 Initial treatment

Urgently assess the patient's condition and immediately transfer to facilities where re-perfusive treatment is possible. The initial, general measures for every patient are:

  • The patient must be unable to move at the bed;
  • Oxygen breathing: at a dose of 2 – 4 liters / min through the nasal route because an acute myocardial infarction is usually accompanied by hypoxia. In some cases severe respiratory failure requires in-administration and proper mechanical breathing;
  • Analgesic: Morphine sulphat is the top choice, dosage from 2 – 4 mg intravenously, repeated after 5-10 minutes if the patient still hurts. Pay attention to the patient's breathing rate and heart rate;
  • Nitroglycerin (0.4 mg) is sucked under the tongue, which can be repeated every 5 minutes. Blood pressure should be noted: if the maximum blood pressure is > 90 mmHg as well. Next establish intravenous transmission and Nitroglycerin infusion at a rate of 10 mcg/min, which can be adjusted according to the blood pressure figure of the patient; if blood pressure drops, do not take Nitroglycerin, it is necessary to immediately apply vascular measures. Note that Nitroglycerin can cause a slow rhythm and is not used in the case of right right isathcardiary myocardial infarction;
  • Anti-tingiosis drugs: immediately give Aspirin orally in a non-wrapped form, at a dosage of 160 – 325 mg or can be given by intravenously 500mg, can be in the form of an Aspegic powder package. If the patient has a history of progressive peptic ulcer, Ticlopidine (Ticlid) can be replaced by 250 mg x 2 capsules daily or Clopidogrel (Plavix) for immediately 300 mg then maintained 75 mg daily;
  • Antiaxic: Intravenous heparin dose 65 – 70 units/kg then maintain dose 15-18 units/kg/hour;
  • Sympathetic beta blockers: The drug is 5mg intravenous metoprolol, repeated every 5 minutes until the total dose is 15mg, continue to give 25 – 50 mg. Other drugs that can be used are: Atenolol, Esmolol. Do not take these medications when the patient shows signs: severe heart failure, bradycardia <60 lần/phút, huyết áp tâm thu <90 mmHg, blốc nhĩ thất độ cao, bệnh phổi tắc nghẽn, bệnh mạch ngoại vi nặng.

2.2 Re-perfusive treatment

Coronary artery intervention in the emergency stage (nong, stent placement):

Acute myocardial infarction

Treatment of folded myocardial infarction with coronary artery intervention

In the case of:

  • Emergency coronary artery intervention should be in patients with contrainediction of thrombolytic drugs or with unstable hemolysis (cardiac shock) or with arrhythmias;
  • Intervention when taking thrombolytic drugs fails: i.e. after taking thrombolytic drugs, the patient still has chest pain, clinically unstable, the ST segment is still different on the electrolysis, coronary artery intervention is in place.

When intervening in an emergency coronary artery should be used in combination with the following drugs:

  • Aspirin dose 325mg/day: prolonged duration, in combination with Ticlopidine (Ticlid) 250mg twice daily for half a month or Clopidogrel (Plavix) 75 mg/day;
  • GP IIb/IIIa receptor inhibitors (ReoPro, Aggrastat…) are radical anti-tinglet aination drugs. When used together with emergency coronary artery intervention significantly reduces the incidence of accidents caused by intervention and the rate of post-interventional embolitis;
  • Heparin is necessary during intervention. If the intervention results successfully, heparin may be considered after the intervention.

Surgery as a bridge between the owner and the emergency rim:

In the case of:

  • When patients with recurrent chest pain after thrombolysis or coronary artery are not suitable for intervention (multiple torso damage, general body damage, complex lesions …), or failed interventions, patients have mechanical complications …

3. How to prevent recurrence of myocardial infarction?

To prevent recurrence of acute myocardial infarction,patients after being discharged from the hospital should take the following precautions:

3.1 Nutrition

  • It is necessary to add to the diet of seafood: fish, shrimp, sea oysters …;
  • Increased use of greens, fibers, fresh fruits;
  • It is recommended to eat diluted porridges, stewed porridges; snacks such as: yogurt products, easy-to-eat soups, crushed, boiled, steamed vegetable juices; abstain from fried, fried and greasy dishes…;

3.2 Increased physical activity

  • Based on the instructions of the physician when doing electrolysic exercises and the patient himself should listen to his body, practice lightly at the level that the body feels pleasant, not abuse because it does not have to practice as quickly as possible.

Acute myocardial infarction

Self-training is mild to the extent that the body finds it pleasant while supplementing nutrition, increasing the use of greens, fiber, fresh fruits

3.3 Lifestyle changes

  • Monitor weight regularly, prevent overweight, obesity, quit smoking, control blood pressure well and form a brave mentality faced when living with the heart with infarction with a peaceful, peaceful mentality;
  • Build a time-mode orderly lifestyle (eating, sleeping, working, resting…).

If the person with myocardial infarction is not treated, the mortality rate in the first 4 weeks is about 30-40% depending on the country, of these deaths, about 1/2 of the deaths in the first hour, usually not hospitalized, mainly due to fibrillity and arrhythmias. Therefore, it is necessary to pay attention to the examination and treatment of the disease as soon as possible.

To protect cardiovascular health in general and detect early signs of myocardial infarction in particular, you can sign up for the Cardiovascular Screening Package – Basic Cardiovascular Examination package of Share99 International Health Hub. The examination package helps to detect cardiovascular problems early through tests and modern imaging methods. The examination package is for all ages, genders and is especially necessary for people with cardiovascular disease risk factors.

In addition, Share99's Cardiologist Department has always received many praises and satisfactions from domestic and international customers, who are pioneers in successfully applying the world's most advanced techniques in the treatment of cardiovascular diseases.

  • A team of highly professional and experiencedprofessionals: doctors with qualifications from Masters to Professors, Doctors, reputable in medical treatment, surgery, interventional cardiac information, intensive training at home / abroad. In particular, Prof. TS.BS. Vo Thanh Nhan – Director of Cardiovascular Diseases Share99 Central Park wasrecognized as the first and only vietnamese expert to be awarded the "Proctor" certificate in TAVI.
  • State-of-the-art equipment, comparable to major hospitals in the world: The most modern operating room in the world; The most modern noiseless mra resonating camera in Southeast Asia; The CT machine has a super-fast shooting speed of only 0.275s/ring without the use of a heart rate lowering drug; 16-sequence PET/CT and SPECT/CT systems help detect early damage to cardiovascular muscles even if there are no symptoms.
  • Application of the most advanced cardiovascular techniques in the world in treatment: Painless open heart surgery; Skin aortic intervention without body anesthesia; Treatment of 2-leaf valve opening through cathethe pipeline has a success rate of 95%; Artificial heart transplants that support the heart for patients with end-stage heart failure extend quality life for more than 7 years.
  • Cooperating with leading cardiovascular centers in Vietnam and the world suchas The National Institute of Cardiary Medicine, Cardiary Department of Hanoi Medical University, University of Paris Descartes – Georges Pompidou Health Hub (France), University of Pennsylvania (USA) … with the aim of updating the most modern cardiovascular treatments in the world.

For examination and treatment with leading cardiovascular experts, please make an online visit to the website or contact Share99 Health System nationwide for service.

For direct advice, please click hotline number or register online HERE. In addition, you can register for remote consultation HERE

SEE MORE:

  • Diagnosis of myocardial infarction by electrocardiary
  • What role does coronary arteries play in the body?
  • Functions of the muscular system in the body

About: John Smith

b1ffdb54307529964874ff53a5c5de33?s=90&r=gI am the author of Share99.net. I had been working in Vinmec International General Hospital for over 10 years. I dedicate my passion on every post in this site.

RELATED POSTS:

Leave a Comment

0 SHARES
Share
Tweet
Pin