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Perfusion: AMI - Coggle Diagram
Perfusion: AMI
S&S
Pain: sever, usually sudden onset, unrelieved by rest/nitroglycerin,
described as crushing, constricting, suffocating
location: commonly sub sternal radiating to left arm. May also present as neck/jaw pain (more common location for women), back pain, epigastric pain
Respiratory: SOB, productive cough w/ pink frothy sputum
GI: N&V/epigastric distress, sometimes confused for heartburn
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tachycardia, restlessness, anxiety, feeling of doom
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Treatment
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PCI: PTCA, stent placement, thrombectomy, atherectomy
Pharm: O2, beta-blocker, nitroglycerin, morphine, analgesics, aspirin or clopidogrel
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Diagnostics
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EKG: several changes will occur depending on the damage and severity, T wave inversion (early) ST segment depression (NSTEMI/non-transmural) ST elevation (transmural/STEMI), abnormal Q waves
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Rupture of an atherosclerosis plaque results in tissue factor expression, ultimately leading to a coagulation cascade and thrombus formation w/ occlusion in the coronary artery. As the thrombus forms and occludes the vessel UA occurs as myocardial cells start to become ischemic. As the occlusion worsens with thrombus formation NSTEMI occurs as cells start to die and release intracellular contents (troponins ect.) This eventually progresses to complete occlusion via thrombus and STEMI occurs as cell death becomes transmural (full-thickness). As damage accumulates dysrhythmias can develop as the heart experiences conduction abnormalities seen in EKGs. These dysrhythmias can ultimately cause death.