Acute myocardial infarction is a myocardial necrosis due to interruption of blood flow to the heart muscle, the myocardium cell death occurs as a result of prolonged oxygen deprivation.
Factors that cause Acute Myocardial Infarction is the blood supply to myocardial oxygen is reduced (atherosclerosis, spasm, arteritis, aortic stenosis, cardiac insufficiency, anemia, hypoxemia), cardiac output increased (emotion, excessive activity, hyperthyroidism), and myocardial oxygen demand increased (myocardial damage, myocardial hypertrophy, diastolic hypertension). The most common cause is the occurrence of coronary blockage resulting in disruption of blood flow. The blockage occurs due to plaque rupture which induce platelet aggregation, thrombus formation, and coronary spasm. Rare cause of myocardial infarction are inflammatory vascular disease, embolism (endocarditis, prosthetic valves), severe coronary spasm (eg after using cocaine), increase in blood viscosity as well as a significant increase in the need O2 at rest.
Typical complaint is chest pain, chest pain typical (angina) is a cardinal symptom of patients IMA. The nature of chest pain of angina as follows:
Location: substernal, retrosternal, and precordial.
The nature of pain: like squeezing, pressure, punctured, crushed hot or heavy items.
The pain may spread to the arms (usually the left), shoulder, neck, lower jaw teeth, back / interscapular, stomach and also to the right arm.
Pain improve or disappear with rest and responsive to nitrate.
Precipitating factors: physical exercise, emotional stress, cold air and after eating symptoms that can accompany such as nausea, vomiting, difficulty breathing, sweating, anxiety and fatigue.
Nursing Diagnosis for Myocardial Infarction
- Acute Pain related to ischemic tissue, secondary to clogged arteries.
- Decreased Cardiac Output related to changes in power factors, reduction miocard characteristics.
- Activity Intolerance related to the imbalance between oxygen supply and demand miocard, the ischemic / necrotic tissue miocard.
- Imbalanced Nutrition: Less than Body Requirements related to decreased renal perfusion, increased sodium / water retention, increased hydrostatic pressure, decreased plasma proteins.
- Ineffective Tissue Perfusion related to ischemic heart muscle damage, narrowing / blockage of coronary arteries.
- Anxiety related to actual threats to biological integrity.
- Ineffective Coping
- Ineffective Sexuality Patterns