Non-ST Elevation Myocardial Infarction There are three different types of an acute coronary syndrome. There is unstable angina, a non-ST elevation myocardial infarction (NSTEMI), and there is a ST elevation myocardial infarction (STEMI). A STEMI and NSTEMI are both deciphered as a myocardial infarction, or better known as a heart attack. The difference between the two is that a STEMI is a fully blocked coronary artery, and a NSTEMI is a partially blocked one. “A heart attack occurs when the blood flow that brings oxygen to the heart muscle is reduced or cut off” (Heart Attack, 2017). The acute coronary syndrome, NSTEMI, will be discussed in this paper including these topics: description of the condition, medical/surgical treatment, …show more content…
Complications of diabetes such as cardiovascular disease, peripheral artery disease, stroke, renal disease, and atherosclerosis all can be leading factors to having a heart attack (Heart Attack, 2017). Signs and Symptoms Everyone who has a NSTEMI, their signs and symptoms (s/s) can vary. Symptoms are what a patient experiences. Chest discomfort or pain can be felt with most heart attacks. This discomfort is usually “…in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable chest pressure, squeezing, fullness or pain” (Heart Attack, 2017). Besides the chest, there can be other areas of discomfort. Per AHA from the article Heart Attack in 2017, this pain can radiate to neck, back, jaw, one or both arms/shoulders, or even to the stomach. Another telltale symptom that a patient complains of would be shortness of breath, and this could be with or without pain. What is detected by someone else such as the caregiver are signs. Signs of having a non-ST-elevation MI could include diaphoresis, dizziness, or nausea. Looking further into signs of a NSTEMI would be at diagnostic tests. Common confirming signs include, but are not limited to: electrocardiogram changes (ST depression, transient ST elevation, or new T-wave inversion) and elevation of cardiac biomarkers from
To determine if the patient’s chest pain is related to cardiac ischemia, you would look for ST-segment depression and/or T wave inversion. If the ST-segment depression is at least 1mm (one small box) below the isoelectric line, it is significant and occurs in response to inadequate supply of blood and oxygen, which leads to an electrical disturbance. Once this is treated, adequate blood flow is restored, the ECG changes will resolve, and the ECG will return back to patient’s baseline.
Cardiovascular disease- Diabetes drastically increases the risk of different cardiovascular manifestations, such as coronary artery disease and affiliated chest pain (angina), stroke, tightening of arteries (atherosclerosis), and heart attack. Having diabetes mellitus, raises the likely hood of having heart disease or stroke.
Hyperglycemia is a very serious risk for heart disease and strokes. Complications from hyperglycemic diabetes may include coronary heart disease (CHD), heart failure, stroke, arrhythmias, or even death. High blood glucose (sugar) levels over time can lead to excess fatty deposits on the insides of your blood vessel walls. These deposits often affect blood flow, which increases the possibility of blood vessels clogging and/or hardening. As a result, this leads to heart disease. Furthermore, those with diabetic heart disease (DHD) may have less success with heart disease treatments, such as angioplasty or artery bypass grafting. “The common clustering of these risk factors in a single individual has been called the metabolic syndrome.” (Scott 1134) Uncontrolled diabetes, the biggest contributor to heart disease, is almost four times higher for adults than those without diabetes. The best way to prevent diabetic heart disease is to control it by way of reducing the risk factors through diet and lifestyle changes.
Heart disease - uncontrolled diabetes can put the diabetic at a high risk for stroke, heart attack, and high blood pressure.
An interesting case I attended to involved an elderly man in his 80s who is a non-smoker and non-alcoholic. He looked grayish, pale and sweaty, which is the typical appearance of a cardiac patient. He presented with chest pain that he gave a pain score of 8/10, and which worsened upon inspiration. He also presented with vomiting and shortness of breath. Electrocardiogram (ECG) indicated a ST Elevation Myocardial Infarction (STEMI). Paramedic believes it was an anterior infarct with elevation in V2, V3, V4 leads and reciprocal depression in Leads II, III and aVF. The patient had several risk factors for heart disease such as high blood pressure, being overweight and living a sedentary lifestyle. He has had chest pain previously, but it was
Primary percutaneous coronary intervention (PCI) and PCI with fibrinolysis are current therapy options used for patients who have had an acute ST elevation myocardial infarction (STEMI). These six article discuss multiple elements involved in the discussion comparing the many factors that affect which forms of therapy is preferred to which patients. Concerns regarding the safety and effectiveness of primary PCI have risen. Factors include the optimal time for therapy, the important of hospital staff and volume, and the efficiency of PCI after fibrinolysis.
Perhaps the most deadly of all the heart’s complications is a heart attack. A heart attack is the leading killer in men and women in the United States, with an estimate 1 million heart attacks alone in the United States (NHLBI). A heart attack occurs when the heart is unable to obtain oxygen, due to a section of heart muscle becoming blocked and preventing oxygen-rich blood to flow properly. The leading cause of heart attacks is coronary heart disease, also known as coronary artery disease. Coronary heart disease is a result of plague, a waxy like substance, building up inside the coronary arteries, the arteries that are responsible for providing blood to the heart (NHLBI). Overtime, the built up plaque can rupture inside of an artery causing a blood clot to form, which prevents blood from reaching heart muscles. Portions of heart muscle once fed by this now blocked artery begin to die if blockage is not treated in time.
A non-ST elevation acute coronary syndrome (NSTE-ACS) is a very common presentation to emergency departments everywhere, as well as primary care practices. Therefore, it is important that all providers be well informed on the effectivity of certain treatment regimens.
Rebecca Futo Kennedy is a woman who studies the controversies of the formation of the identity of Classical Athens. She works at Denison University as a professor of classics. Her primary interests are imperialism, the problems with foreignness, and geography theories pertaining to Athens. She is an ancient Greek historian who is trying to find the relationship between these theories and the history of race and ethnicity in ancient Greek culture. Her thesis statement in Elite Citizen Women and the Origins of the Hetaira in Classical Athens is to argue that the word hetaira does not mean a status but a person associated with a set of behaviors that are typical in the culture of the Greek elite. Her article is relevant when trying to understand the woman’s role in classical Athens.
There are many different complications that are caused by diabetes. If you have diabetes, you are up to five times more likely to develop heart disease or have a stroke (WHO). When the blood glucose levels are increasing it results in the furring and narrowing of your blood vessels which may result in a poor blood supply to the heart. This can lead to a heart attack or a stroke. This doesn’t only put the patient’s life at risk but it also results in a huge cost on the NHS. It can also affect the patient’s family a friends hugely emotionally but also physically if they are in need of care after the event. It can change the patient’s life style dramatically. It is not only the blood vessels near the heart that are affected it is also the blood vessels in the nerves. This
Contradictory to what is often shown on movies, not all heart attacks start with the sudden and crushing chest pain. The symptoms vary among people. Some people especially diabetic have mild pain, and others suffer severe pain. Moreover, one person may have different symptoms in every heart attack. The earliest sign may be angina which is a temporary decrease in blood flow to the heart that is caused by exertion and relieved by rest. Another sign could be tightness or a squeezing sensation in your chest or arms which may spread to your neck, jaw or back. Others are cold sweat, fatigue, shortness of breath, nausea, indigestion, or abdominal
Even at this day and age, African Americans aren’t taking pride in the fact that we have the right to vote now. For example, racial minorities, especially black Americans, played a pivotal role in Barack Obama’s 2008 and 2012 presidential wins. Skip forward to this year’s election of Clinton and Trump. The Census Bureau confirmed what most of us already knew, that both minority and black voter turnout took a decided downturn in last November’s elections. We did not always have a choice or even a say so in most matters, if any. Now we have a voice in the say in how things were governed and now that we do, I would hope to see all African Americans jumping at the chance to be a part of the decision making.
“Time is muscle” when it comes to cardiac. Heart attack patients are either non-STEMI or STEMI. STEMI stands for ST-Segment Elevation Myocardial Infarction. In patients who are non-STEMI’s, aggressive antiplatelet therapy is the primary treatment due to a soft clot or platelet plug. In patients that are a STEMI, reperfusion is the primary treatment due to a stable clot. There are two methods of reperfusion that are used: fibrinolytic’s or PCI (Percutaneous Coronary Intervention). For either STEMI or non-STEMI there is supportive medical therapy is used which includes Oxygen, Nitroglycerin, Morphine, Beta Blockers and ACE inhibitors.
Diabetes is also linked to developing cardiovascular disease more often. Hypertension and diabetes are usually linked together and if a patient has both, their risks of cardiovascular disease doubles. People with diabetes can also have abnormal cholesterol amounts ranging from high to low. Smokers with diabetes should immediately stop smoking if they want to save their bodies. Smoking increases your chance of having a stroke and cardiovascular disease with
Diabetes can affect the entire body. Two-thirds of adults with diabetes have high blood pressure, or hypertension. This condition is serious because it leads to an increased risk of stroke, heart disease, kidney and eye problems.