Case study nstemi

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University of Perpetual Help System DALTA

Alabang – Zapote Rd. Pamplona, Las Pinas City

COLLEGE OF NURSING

BSN III-A Group 3 Batch 2010 - 2011

A Case Study on Non –

ST Elevation Myocardial

Infarction

Submitted By: Galauran, ChristinaGarcia; Edgar

Raymond; Gatela, Leizl; Gozun, Bianca Marie;

Ibanez, Levilyn; Kho, Krista Ann; Lucido, Justin

Joseph; Mapanao, Jamie Therese; Padua, Ma.

Mercedita; Perez, Sherrylyn; Pinlac, Sheila; Ragas,

Allen Rey

Submitted To: Mrs. Zenaida Vinagrera RN

12/16/2010

A Case Study on Non – ST Elevation Myocardial Infarction

INTRODUCTION

Everything in the world today is in constant change. The present era is far different from what our

ancestors were used to. There are several innovations and today’s technology creates a new and

modern culture far beyond what we have before. This transformation is accompanied by changes

in how we live our lives thus, making us more susceptible to diseases brought about by our

lifestyle. One of these diseases is Myocardial Infarction.

This is a case of Patient BAY from Las Pinas City. He was admitted at the UPHDMC - JONELTA

with a diagnosis of Non ST Elevation Myocardial Infarction: Killips I: Pneumonia in the elderly

to be considered aspiration pneumonia UGIB.

Myocardial infarction (MI) or acute myocardial infarction (AMI), commonly known as a heart

attack is the interruption of blood supply to a part of the heart, causing heart cells to die. This is

most commonly due to blockage of a coronary artery following the rupture of a atherosclerotic

plaque, which is an unstable collection of fatty acids and white blood cells in the wall of an artery.

The resulting ischemia due to restriction in blood supply and oxygen shortage, if left untreated for

a sufficient period of time, can cause damage or death (infarction) of heart muscle tissue.

Classical symptoms of acute myocardial infarction include sudden chest pain (typically radiating

to the left arm or left side of the neck), shortness of breath, nausea, vomiting, palpitations,

sweating, and anxiety.

Clinically, a myocardial infarction can be further sub classified into a ST elevation MI (STEMI)

versus a non-ST elevation MI (non-STEMI) based on ECG changes.

In a NSTEMI, the blood clot only partly occludes the artery, and as a result only a portion of the

heart muscle being supplied by the affected artery dies. In contrast to the more severe form of heart

attack (the STEMI), the NSTEMI does not produce characteristic elevation in the "ST segment"

portion of the ECG. (ST segment elevation indicates that a relatively large amount of heart muscle

damage is occurring, because the coronary artery is totally blocked). This means that in a NSTEMI,

the artery is only partially blocked. A common problem when a patient has an acute coronary

syndrome without ST segment elevation is deciding whether an actual heart attack is occurring or

instead whether the patient is simply having unstable angina. Measuring cardiac enzymes, which

reflect heart muscle damage, is an important tool in making this distinction.

The Killip classification is a system used in individuals with an acute myocardial infarction or

heart attack, in order to risk stratifies them. Individuals with a low Killip class are less likely to die

within the first 30 days after their myocardial infarction than individuals with a high Killip class.

Patients were ranked by Killip class in the following way:

 Killip class I Includes individuals with no clinical signs of heart failure.

 Killip class II Includes individuals with rales or crackles in the lungs, an S

, and elevated

jugular venous pressure.

 Killip class III Describes individuals with frank acute pulmonary edema.

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INTRODUCTION Everything in the world today is in constant change. The present era is far different from what our ancestors were used to. There are several innovations and today’s technology creates a new and modern culture far beyond what we have before. This transformation is accompanied by changes in how we live our lives thus, making us more susceptible to diseases brought about by our lifestyle. One of these diseases is Myocardial Infarction. This is a case of Patient BAY from Las Pinas City. He was admitted at the UPHDMC - JONELTA with a diagnosis of Non ST Elevation Myocardial Infarction: Killips I: Pneumonia in the elderly to be considered aspiration pneumonia UGIB. Myocardial infarction (MI) or acute myocardial infarction (AMI), commonly known as a heart attack is the interruption of blood supply to a part of the heart, causing heart cells to die. This is most commonly due to blockage of a coronary artery following the rupture of a atherosclerotic plaque, which is an unstable collection of fatty acids and white blood cells in the wall of an artery. The resulting ischemia due to restriction in blood supply and oxygen shortage, if left untreated for a sufficient period of time, can cause damage or death (infarction) of heart muscle tissue. Classical symptoms of acute myocardial infarction include sudden chest pain (typically radiating to the left arm or left side of the neck), shortness of breath, nausea, vomiting, palpitations, sweating, ...
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