Concept Map – Myocardial Infarction(MI)
Primary Diagnosis: Myocardial Infarction (MI) ______________________________________
Describe the pathophysiology of the primary diagnosis in your own words. What are the patient’s risk factors for this diagnosis?
| Pathophysiology of Primary Diagnosis | |
| Ojha and Dhamoon (2023) opine that myocardial infarction is a condition whereby there is prolonged impaired blood flow to part of the muscle of the heart, which leads to impaired or dead cardiac cells. Usually, this results from an atherosclerotic plaque rupture causing thrombus development in a coronary artery. Without adequate oxygen, cardiac muscle cells become ischemic. If deprived for an extended period, infarction is a healing process that replaces the dead tissue with a permanent scar. | |
| Causes | Risk Factors (genetic/ethnic/physical) |
| Atherosclerosis: It is mainly due to the deposition of plaques inside the coronary arteries, which may be formed from fatty deposits.
Coronary artery spasms are less common and may temporarily cut or reduce blood supply to the heart. Thrombosis: A blood clot may result from a rupture in one of the plaques, obstructing the artery. Coronary embolism: Sometimes, an embolus originating from some other part of the body may lodge itself inside the coronary arteries, cutting off the blood supply. Vascular inflammation: In conditions like vasculitis, inflammation can involve the coronary arteries and narrow or block them. |
Risk factors for MI are most common in individuals over 45 for men and 55 for women; men are more susceptible than women, though postmenopausal women are equally at risk; African Americans tend to have a higher risk due to higher incidences of hypertension. Genetic predisposition, as well as lifestyle factors, including smoking, sedentary behavior, poor diet, and diseases associated with obesity, hypertension, hyperlipidemia, and diabetes mellitus, all exacerbate the risk of MI (Mechanic et al., 2023). |
What are the patient’s signs and symptoms for this diagnosis? How does the diagnosis impact other body systems and what are the possible complications?
| Signs and Symptoms – Common presentation | How does the diagnosis impact each body system? Complications? |
| Male Symptoms: Men have the “classic” symptoms of myocardial infarction; that is, chest pain or discomfort associated with angina may radiate across the left arm, jaw, neck, or back. They might also feel shortness of breath, sweating, or nausea.
Female Symptoms: The symptoms for females are more atypical and include fatigue, indigestion, shortness of breath, and discomfort in the upper back or jaw. |
The affected primary system is the cardiovascular system. Still, MI may also lead to complications involving other systems, including arrhythmias due to nervous system involvement, heart failure due to involvement of respiratory and renal systems secondary to poor oxygenation, and stroke. MI may induce multi-organ failure secondary to systemic hypoperfusion as well. |
What are other potential diagnosis that present in a similar way to this diagnosis (differentials)?
| Some of the differential diagnoses for MI may be aortic dissection, pericarditis, unstable angina, pulmonary embolism, and gastro-esophageal reflux diseases. These disorders present with symptoms of chest pain but differ in their causes and management. |
What diagnostic tests or labs would you order to rule out the differentials for this patient or confirm the primary diagnosis?
| Typically, an ECG is executed first to rule out differentials and confirm MI, which may indicate ST elevation or other changes, as stated by Foth et al. (2023). Blood tests for cardiac enzymes, especially troponins, are critical because increased troponin levels signal the presence of myocardial injury. Other investigations include echocardiography to establish the heart function and coronary angiography to delineate occlusions of the coronary arteries. Chest X-rays help exclude pulmonary causes, and D-dimer levels can be measured to exclude pulmonary embolism. |
What treatment options would you consider? Include possible referrals and medications.
| Treatment Options
The critical points of MI treatment include restoring blood flow to the heart muscle and preventing further injury (Sachdeva et al., 2023). This includes medication such as aspirin to reduce clot formation; beta-blockers, which reduce heart workload; nitrates, which dilate coronary vessels; and thrombolytics or anticoagulants. Other revascularization procedures can also be employed, namely coronary artery bypass grafting and percutaneous coronary intervention. Referrals Patients may need to be referred to cardiologists for follow-up, rehabilitation specialists for cardiac rehab, and possibly nephrologists or pulmonologists if there are complications involving other organ systems. |
References
Foth, C., Mountfort, S., Akbar, H., & Kahloon, R. A. (2023, July 31). Acute myocardial infarction ST elevation (STEMI). National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK532281/
Mechanic, O. J., Grossman, S. A., & Gavin, M. (2023). Acute myocardial infarction. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459269/
Ojha, N., & Dhamoon, A. S. (2023). Myocardial infarction. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537076/#:~:text=Myocardial%20infarction%20(MI)%2C%20colloquially
Sachdeva, P., Kaur, K., Fatima, S., Mahak, F., Noman, M., Siddenthi, S. M., Surksha, M. A., Munir, M., Fatima, F., Sultana, S. S., Varrassi, G., Khatri, M., Kumar, S., Elder, M., & Mohamad, T. (2023). Advancements in myocardial infarction management: Exploring novel approaches and strategies. Cureus, 15(9). https://doi.org/10.7759/cureus.45578
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Question 
In this exercise, you will complete a MindMap Template to gauge your understanding of this week’s content. Select one of the possible topics provided to complete your MindMap Template.
– Topic is myocardial infarction
Concept Map – Myocardial Infarction(MI)
The temple is attached .
1) Describe the pathophysiology of the primary diagnosis in your own words. What are the patient’s risk factors for this diagnosis? (race, gender, age)
2) What are the patient’s signs and symptoms for this diagnosis? (female vs male) How does the diagnosis impact other body systems and what are the possible complications?
3) What are other potential diagnosis that present in a similar way to this diagnosis (differentials)?
4) What diagnostic tests or labs would you order to rule out the differentials for this patient or confirm the primary diagnosis?
5) What treatment options would you consider? Include possible referrals and medications.