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Myocardial Infarction. By Katie Beretich. James Klosterman. 61 yr old German male Lutheran minister- works 40 hrs/week Low activity level- walks his dog 15 mins/day Hospitalized after sudden onset of severe precordial pain on the way home from work
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Myocardial Infarction By Katie Beretich
James Klosterman • 61 yr old German male • Lutheran minister- works 40 hrs/week • Low activity level- walks his dog 15 mins/day • Hospitalized after sudden onset of severe precordial pain on the way home from work • Pain described as pressure-like pain radiating to the jaw and left arm • He was found to have suffered a myocardial infarction • Treated with an emergency angioplasty of the infarct-related artery
What is a Myocardial Infarction? • Also known as a heart attack • Occurs when blood flow to heart is blocked • Most MI’s caused by blood clot • Blood clot blocks coronary arteries • Plaque • cholesterol
Risk Factors • Age • Men > 45 • Tobacco use • Diabetes • High blood pressure • High blood cholesterol • Family history • Lack of physical activity • Obesity • Stress
Signs & Symptoms Pain extending beyond chest to shoulder, arm, back, or even to teeth and jaw Nausea and vomiting Increasing episodes of chest pain Shortness of breath Sweating Fainting
Diagnosis • Electrocardiogram (ECG) • Blood tests • LDH • AST • CPK • Troponin I & T
Surgical Treatment • Angioplasty • Procedure opens blocked vessels • Stent placement • Small mesh tube inserted to expand coronary artery
Medical Treatment • Lopressor 50 mg daily • Prevent angina • Improve survival of MI • Lisinopril 10 mg daily • Improve survival of MI • Nitro-Bid 9.0 mg twice daily • Treatment/ prevention of angina/ MI • NTG 0.4 mg sl prn chest pain • Prevents angina • ASA 81 mg daily • Help prevent second MI
Medical Nutrition Therapy • During immediate post-MI period, may limit initial oral intake • Pain • Anxiety • Fatigue • Shortness of breath • Therapeutic Lifestyle Changes Diet
TLC Diet Less than 7% of daily calories from saturated fat 25-35% of daily calories from fat Less than 200 mg cholesterol per day Limit sodium to 2400 mg per day Include 2 g plant sterols
Prognosis Mr. Klosterman has an increased risk of suffering from a second MI. Individuals who survive an MI are 1.5 to 15 times more likely than the general population of death or illness. At age 40 or older, 18% of men will die within the first 5 years of suffering a first MI. However, a lifestyle change can decrease the likelihood of a second MI and death.
References Askari, A., & Bolooki, H. (2012). Acute myocardial infarction. Cleveland clinic, http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/cardiology/acute-myocardial-infarction/ Coronary angioplasty and stents, 2012. Mayo clinic, http://www.mayoclinic.com/health/angioplasty/MY00352 Heart attack, 2012. Pubmed health, http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001246/ Nelms, M., Sucher, K, P., Lacey, K., Roth, S. L. (2011). Nutrition therapy & Pathophysiology. (2 ed.). Belmont, CA: Wadsworth, Cengage Learning. Pronsky, Z. M. (2006). Food-Medication Interactions, 14th Edition. Birchrunville, PA: Food-Medication Interactions. Cardiac Medications At-A-Glance. 2009, September 21. http://www.americanheart.org/presenter.jhtml?identifier=3038846#diuretics U.S. Department of Health and Human Services, National Institutes of Health. (2005). Your guide to lowering your cholesterol with tlc. Retrieved from website: http://www.nhlbi.nih.gov/health/public/heart/chol/chol_tlc.pdf
