Heart attack, MI & AMI are common terms you might have heard all being associated to the heart. Each nursing or any medical care provider ought to be able to recognize myocardial infarction and take action as soon as possible because it is a life threatening emergency. Time and speed saves heart muscle damage.
Acute myocardial infarction (AMI) is a medical emergency requiring immediate hospitalization; patients suspected of having AMI should be admitted immediately to the coronary or intensive care unit for evaluation and potentially life-saving treatment. (Do you know how AMI is treated? Please tell us in comments section below)
The clinical presentation of AMI is characterized by chest pain, ECG changes, and serial elevation of cardiac biomarkers. (Do you know specific ECG/EKG changes indicate myocardial infarction? Tell us in comments section)
Serum cardiac enzymes and specific cardiac biomarkers may be elevated, indicating cardiac muscle damage, ischemia, necrosis, thereby aiding in the diagnosis of AMI.
Cardiac troponins level are considered the gold standard for diagnosing AMI. Why? Because two of the proteins that compose cardiac troponins have the greatest sensitivity and specificity for detecting myocardial damage. By sensitivity, it means even the slightest damage will show changes and with specificity, it means that the change can only be cardiac related and not any other part of the body. troponin levels are now considered the world criteria for defining and diagnosing AMI according to American College of Cardiology, the American Heart Association, the European Society of Cardiology, and the World Heart Federation
Creatine kinase (CK) & CK isoenzymes , specifically CK-MB (CK-2), found in cardiac muscle, are specific markers for myocardial damage or necrosis and are considered to be sensitive early markers of AMI if troponin assays are not available. That means if these biomarker levels start getting elevated, early intervention and evaluation should be started while troponin levels are pending.
Myoglobin levels have high sensitivity but poor specificity for detecting AMI. However, when used in conjunction with other studies, elevated myoglobin levels may be a useful marker. Normal myoglobin values are < 90 ng/L. Myoglobin level elevation to anyone presenting with chest pains whether radiating to the arms, shoulders, elbows and lower back or NOT should be considered positive unless otherwise ruled out.
- Discuss by posting a comment how you should treat AMI as soon as you suspect is
- Not all ECG/EKG changes indicate AMI. What EKG changes would alarm you that the patient could be having AMI?
- Do you have any mnemonics related to myocardial infarction?
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