Typical chest pain in acute MI has the following characteristics:
Diagnosis - Laboratory studies
Prehospital care For patients with chest pain, prehospital care includes the following:
The patient's vital signs may demonstrate the following in MI:
Signs and symptoms
1.- The patient's heart rate is often increased (tachycardic) secondary to a high sympathoadrenal discharge 2.- The pulse may be irregular because of ventricular ectopy, an accelerated idioventricular rhythm, ventricular tachycardia, atrial fibrillation or flutter, or other supraventricular arrhythmias; bradyarrhythmias may be present 3.- In general, the patient's blood pressure is initially elevated because of peripheral arterial vasoconstriction resulting from an adrenergic response to pain and ventricular dysfunction 4.- However, with right ventricular MI or severe left ventricular dysfunction, hypotension and cardiogenic shock can be seen
1.- Intense and unremitting for 30-60 minutes 2.- Susternal, and often radiates up to the neck, shoulder, and jaw, and down the left arm 3.- Usually described as a substernal pressure sensation that also may be characterized as squeezing, aching, burning, or even sharp 4.- In some patients, the symptom is epigastric, with a feeling of indigestion or of fullness and gas
1.- Cardiac biomarkers/enzymes 2.- Electrocardiography 3.- Cardiac imaging
1.- Fatigue 2.- Chest discomfort 3.- Malaise
1.- Intravenous access, supplemental oxygen if SaO2 is less than 90%, pulse oximetry 2.- Immediate administration of nonenteric-coated chewable aspirin 3.- Nitroglycerin for active chest pain, given sublingually or by spray 4.-Telemetry and prehospital ECG, if available
