Myocardial infarction (MI), colloquially known as “heart

Myocardial infarction (MI), colloquially known as “heart attack,” is caused by decreased or complete cessation of blood flow to a portion of the myocardium. Myocardial infarction may be”silent,” and go undetected, or it could be a catastrophic event leading to hemodynamic deterioration and sudden death. Most myocardial infarctions are due to underlying coronary artery disease, the leading cause of death in the United States. With coronary artery occlusion, the myocardium is deprived of oxygen. Prolonged deprivation of oxygen supply to the myocardium can lead to myocardial cell death and necrosis. Patients can present with chest discomfort or pressure that can radiate to the neck, jaw, shoulder, or arm. In addition to the history and physical exam, myocardial ischemia may be associated with ECG changes and elevated biochemical markers such as cardiac troponins. This activity describes the pathophysiology, evaluation, and management of myocardial infarction and highlights the role of the interprofessional team in improving care for affected patients.Allergies: NKDA ROS: Unable to complete at this time due to increasing SOB and distress. PHYSICAL EXAM: VS: HR 112, BP 88/60, Temperature 37.0, O2 90% on RA, RR 26 GENERAL: A&OX3, mild distress HEENT: PERRLA/EOMI NECK: Supple, no lymphadenopathy, no JVD CV: no murmurs, rubs, or gallops, tachycardia, no PMI displacement PULM: Tachipneic, Diffuse rales all lung fields ABD: Soft, NT/ND, + BSx4 EXT: No clubbing or cyanosis, palpable 2+ pulses all extremities NEURO: 5/5 BUE and BLE, CN II-VII grossly intact Diagnostics: EKG shows ST elevation in leads V1-V6, I and aVL, Chest X-Ray indicates cardiogenic pulmonary edema, troponin and cardiac enzymes pending Your Discussion should address the following: What are your top three differentials for this cardiac patient with rationale? What is your final diagnosis with rationale? While awaiting Cardiology’s arrival, how will you manage and stabilize this patient? What tests, labs and procedures do you expect Cardiology to order? What benefit did being in the hospital give Mr. Jones in the outcome of this event?

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