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11063844
NSTEMI
Description
Mind Map on NSTEMI, created by Jessica Caswell on 25/10/2017.
Mind Map by
Jessica Caswell
, updated more than 1 year ago
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Created by
Jessica Caswell
almost 7 years ago
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Resource summary
NSTEMI
Pathophysiology
Occurs as a result of sustained ischemia, which leads to irreversible myocardial cell death (text book)
Partial or complete coronary artery blockage (White & Chew, 2008)
80-90% of MI's occur secondary to thrombus formation (Textbook)
This thrombotic process decreases circulation to to coronary arteries leading to necrosis (White & Chew, 2008)
The heart stops contracting in these necrotic areas (Textbook)
Cardiac cells can last up to 20 minutes before cellular death takes place (Textbook)
The most inner layer of the heart, subendocardium, becomes ischemic first (Textbook)
If this ischemia continues the entire thickness of the heart will become necrossed in roughly 5 to 6 hours (Textbook)
Atherosclerosis is a build of plaque in the artery wall (Heart & Stroke, ?)
Artery can narrow and become blocked
Can lead to blood clots, which can block the blood from getting to the heart
Diagnostic Studies
Electrocardiogram
12 Lead ECG
Will reveal ST segement depression
Primary tool in detecting Myocardial Infarctions
Reveals the time sequence of ischemia, infarction and the resolution of the infarction
No pathalogical Q waves are developed (Text)
Serum Cardiac Markers
Creatine Kinase (CK-MB)
In an MI, plasma CK-MB levels rise about 4-6 after the onset of chest pain and typically peaks 12-24 hours after (Coven, 2016)
Levels typically return to baseline after 24-48 hours (Coven, 2016)
Troponin
Regulatory protiens that are found in skeletal and cardiac muscle (Coven, 2016)
A positive result is noted 4-8 hours after the onset of symptoms, and remains elevated for 7-10 days after (Coven, 2016)
Cardiac Specific troponin is a myocardial muscle protein released into circulation after an myocardial injury (Text)
Two different sub types: cardiac specific troponin I (cTnI) & cardiac specific troponin T (cTnT) (Text)
Highly specific indicators of MI and have a greater sensitivity to detect (text)
Coronary Angiography
Is an X-ray to determine if there are any blockages in the coronary arteries (NLH, 2016)
A small catheter is inserted through an artery
Determines most therapeutic treatment (text)
Percutaneous Intervention (PCI) may be performed at this time (Text)
intervention used to treat CAD
A catheter with a balloon on the end is insterted and the inflated into the artery that is narrowed (Text)
Elective procedure once the patient is stabilized (Text)
Nursing Assessments
Subjective Data
Important health history
Current health history
Family history of heart disease (text)
a sedentary lifestyle
Use of tobacco
Past health history/ history of
CAD
Hypertension
Aortic Stenosis
Diabetes
MI
Angina
Heart failure
Lung disease
Hyperlipidemia
Medications
The use of:
Aspirin
Nitrates
Beta Blockers and Calcium Channel Blockers
ACE Inhibitors
Herbal supplements or vitamins
Anti-Hypertensive and Cholesterol Lowering medications
Symptoms
Chest pressure or pain
May radiate to jaw, neck, shoulders, arms or back
Heartburn, N/V, indigestion
Dyspnea
Dizziness and weakness
Anxiety, heart palpatations and tiredness
Objective Data
General
Anxiety
Restlessness
Fear
Integumentary System
Cool, clammy and pale (text)
Cardiac System
Bradycardia or Tachycardia
Pulses will alternate from weak to strong
S3 & S4
High or Low Blood Pressure
Potential Findings
Non-elevated or elevated cardiac serum markers
Increased WBCs and serum lipids
Cardiac enlargement
Positive stress test results
ECG abnormalities
Pulmonary congestion or calcification seen on chest radiograph
Positive findings on the coronary angiogram
Media attachments
Normal Ecg (binary/octet-stream)
Nstemi (binary/octet-stream)
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