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Unformatted text preview: ► Pain may radiate to the jaw, neck, arms, back, and epigastrium. The left arm is affected more frequently; however, a patient may experience pain in both arms. ► Dyspnea, which may accompany chest pain or occur as an isolated complaint, indicates poor ventricular compliance in the setting of acute ischemia. ► Dyspnea may be the patient's anginal equivalent, and in an elderly person or the diabetic patient, it may be the only complaint. Elderly patients and those with diabetes may have particularly subtle presentations and may complain of fatigue, syncope, or weakness. The elderly may also present with only altered mental status. Those with pre­existing altered mental status or dementia may have no recollection of recent symptoms and may have no complaints whatsoever. ► Nausea and/or abdominal pain often are present in infarcts involving the inferior or posterior wall. ► Anxiety ► Lightheadedness with or without syncope ► Cough ► Nausea with or without vomiting ► Diaphoresis ► Wheezing As many as half of MIs are clinically silent in that they do not cause the classic symptoms and go unrecognized by the patient. There should be a high index of suspicion for MI ­ especially when evaluating women, diabetics, older patients, patients with dementia, and those with a history of heart failure. ► Causes: The most frequent cause of MI is rupture of an atherosclerotic plaque within a coronary artery with subsequent arterial spasm and thrombus formation. Other causes include the following Other causes include the following ► Coronary artery vasospasm ► Ventricular hypertrophy (e.g., left ventricular hypertrophy [LVH], idiopathic hypertrophic subaortic stenosis [IHSS], underlying valve disease) ► Hypoxia due to carbon monoxide poisoning or acute pulmonary disorders (Infarcts due to pulmonary disease usually occur when demand on the myocardium dramatically increases relative to the available blood supply.) Other causes include the following Other causes include th...
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This document was uploaded on 03/22/2014.

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