The Care Of A 68 Year Old Female With An Acute Infarction

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This case study details the care of a 68-year-old female with an acute myocardial infarction (MI) and other comorbidities from the original presentation of symptoms through outpatient rehabilitation. A physiologic basis of an acute myocardial infarction and relation to chronic comorbidities will be explored followed by the various stages of patient care. The CDC estimates that roughly 610,000 Americans die each year from an acute myocardial infarction and is the number one cause of death amongst men and women.1 Myocardial infarction (MI) stems from the occlusion of one or more coronary arteries, resulting in hypoxia and eventual death of the myocytes downstream.2 As oxygenated blood leaves the left ventricle traveling into the aorta, the left and right coronary arteries branch off almost immediately. These coronary arteries and their branches provide oxygen and nutrients to the epicardium and myocardium.3 Gradual depositions of fatty streaks in the arteries progress to unstable fibrofatty plaques that cause luminal narrowing.2 The etiology of an acute MI occurs when an atherosclerotic plaque breaks free inside a coronary artery, initiating a thrombotic event referred to as atherothrombosis4. This leads to the partial or total occlusion of a coronary artery, and can occur in a proximal or distal segment of the artery5. The location of this occlusion is often evident from patient’s symptoms and is used to determine course of treatment.5 Risk factors for atherothrombosis

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