MYOCARDIAL INFARCTION TREATMENT STEMI

STEMI is one of the diseasees most often presented at the ER. And since we or our relatives may experience an episode of acute coronary disease it is very important to know what to do at first. And for those who are doctors knowing this more than a must :P This medical treatment is easily performed so  everybody should know it.

Aspirin 150mg is essential in acute coronary syndrome. It’s function is  to prevent txa2 and type I cyclooccygenasis from production resulting in vasodilatation and prohibition of thrombus formation.  Within minutes, aspirin prevents additional platelet activation and interferes with platelet adhesion and cohesion. It is given oraly in capsules from 160-325 mg.

Nitroglycerina 2.5-6.5mg should be given in a period of time every 5 minutes. It  is given sublingual to  manage the chest pain by lowering the need of the miocard for O2 and by raising myocard performance. If not resulting in managing the situation than consider giving them iv. Should not be giving it to a person who has low BP, or has taken phosphodiesterase inhibitors in the last 24 hours. Izosorbit dinitrati 5mg sublingual cdo 5-10 min deri ne max 5 tableta .

Morphin  5mg wasted in sol NACL 0.9% .  it is used as an analgesic to  treat the chest pain. Pay attention with the venous pooling since it may lower the cardiac output. Be aware that it can cause hypotension and different degrees of heart bloc which can be treated with atropine. (0.5mg iv). Morphine is given  every two minutes to receive a better  absorption.

Oxygen 40% -> it is indicated when the patient is experiencing hypoxemia and should be given for6- 12 hours after infarction.  

IV BETABLOCKERS were proven adequate to manage chest pain and to reduce the risk of reinfarction or ventricular fibrilation. They  should be started within 24 hours from the infarction and the patient should not have signs of heart failure. Caution-> It  increases the risk of cardiogenic shock, lowers cardiac output. METOPROLOL 5mg every 2-3 minutes for three times.

It is a critically important treatment but then further analysis and interventions can and should be made to totally treat the problem :such as fybrinolysis, reperfusion,percutaneus coronary reperfusion.