Myocardial infarction (MI): Nursing process (ADPIE)

Miguel Garcia is a 60-year-old Hispanic male with a history of hypertension who was brought to the emergency department, or ED, for chest pain.

The pain began two hours ago and he states it feels like an elephant is sitting on his chest.

The physician just confirmed with an electrocardiogram, or ECG, that Mr. Garcia is experiencing a STEMI, which stands for ST segment elevation myocardial infarction.

The team is acting swiftly to prepare him for an emergent percutaneous coronary intervention, known as a PCI.

A myocardial infarction, also known as an MI or heart attack, refers to the death of cardiac muscle tissue from prolonged ischemia.

Risk factors include being over 40 years old or male; having diabetes mellitus, dyslipidemia, hypertension, or a family history of MIs; smoking tobacco; obesity; a sedentary lifestyle; and eating a high fat diet.

The most common cause of MI is atherosclerosis. This is when lipid containing plaque builds up in the coronary arteries.

When the coronary artery is occluded, blood and oxygen supply cannot meet the demands of the myocardium, causing ischemia.

This leads to angina, or a type of chest pain. Angina can either be stable or unstable.

Stable angina is provoked by activities that increase oxygen demand, such as exercise, lasts up to 15 minutes, and is relieved by rest or vasodilators like nitroglycerin.

This is because the occlusion limits blood flow while the oxygen demand of the myocardium increases, but when demand decreases or if the artery becomes dilated, the pain resolves

On the other hand, unstable angina can occur without exertion or even at rest, persists longer than 15 minutes, is a more severe pain than stable angina, and is not relieved by rest or vasodilators.