Myocardial infarction Z. Rozkydal •Irreversible necrosis of a part of hearth muscle •due to insufficient supply of blood • •The causes: •blockage of coronary artery •- by trombus ( 80%) •- by long lasting spams of narrowed • coronary artery (20%) •Myocardial infarction •Symptoms • •Sudden intensive pain underneath the sternum •lasting several minutes •The pain irradiates often to the left shoulder •or to the abdomen •Weakness, flat breathing, dyspnoe •Pale, sweating, dizziness •Tachycardia, low BP, faitness •Cardiogenic shock •Myocardial infarction • •Transmural – the whole thickness of the wall • •Nontransmural – subendocardial lesion • •Threatening of life: •Large extent of ischemia •Damage to nerves running the rythm •Fibrilation of ventricles •Severe bradycardia •Rupture of the hearth wall •First aid • •Rest, fresh air •Position in half sitting •Morphin, Phentanyl •Tablet or spray of nitroglycerin under the tonque •Isosorbit – dinitrate spray in lung eodema •Aspirin • •CPR • •Transport to coronary unit •Management • •Admission to coronary unit •Stent •PTCA- percutaneus transluminal coronary • angioplasty •Trombolysis •Oxygen, antiarytmics, diuretics • •Surgery later on- coronary bypass Hearth failure •Disorder of effective mechanical function •of the hearth • •Acute and chronic • •In rest or during activity • •Left side or right side • • •Left side failure • •Ischemic hearth disease •Hypertension, congenital anomalies •Stenosis of insufficiency of valves •Disorder of myocardial muscle •Arythmia •Overloading of circuit •Symptoms • •Weakness, dyspnoe in rest •Hyperventilation, tachycardia, cyanosis •Sputum of pink colour •Lung oedema •Asthma cardiale – bronchospasmus a vrzoty •Right side failure • •Pulmonary embolism •Stenosis of pulmonary artery •Mitral stenosis •Ischemic hearth disease •Symptoms • •Fatique, weakness, dyspnoe, cyanosis •Oedema of low extremities •Entlargement of liver, ascites •Dilation of neck veins •Cor pulmonale • •Acute- pulmonary embolism •Chronic - emphysema of lungs, bronchitis •First aid • •Fowler position •Fresh air, oxygen •Rest, drugs for the hearth • •Managent: •Admission to medical ward •