Myocardial Infarction is defined as irreversible heart tissue necrosis due to lack of oxygen supply. The common symptoms are, severe chest pain, sweating, breathlessness, dizziness or syncope, vomiting, pallor, tachycardia, new cardiac murmur on examination.
ECG changes:
- ST segment elevation or depression of 1 mm or more in 2 or more contiguous leads
- T wave inversion
- Q wave
- New left bundle branch block
Medications:
- Check and maintain airway, breathing and circulation.
- Oxygen supplementation.
- Tab. Disprin (Aspirin 350 mg) 1 tablet to be chewed immediately.
- Tab. Myonit insta (Nitroglycerin 0.5 mg) 1 tablet sublingually immediately.
- Tab. Lipikind 40 (Atorvastatin 40 mg) 1 tablet orally once a day immediately.
Immediate reperfusion measures:
Angioplasty is the preferred measure. Consider thrombolysis if angioplasty not possible within 2 hours:
Inj. Elaxim 40 (Tenecteplase 40 mg) dose based on patient weight as below:
- Less than 60 kg – 30 mg I.V. bolus
- 60 to 70 kg – 35 mg I.V. bolus
- 70 to 80 kg – 40 mg I.V. bolus
- 80 to 90 kg – 45 mg I.V. bolus
- 90 kg or greater – 50 mg I.V. bolus
Referral :
Urgent referral to cardiac unit with immediate access to cardiologist for treatment.