HPI: 45 yom brought to the ER with excruciating stabbing pain on chest/inner arm for 20 min. No history of previous attack, but hypertensive c BP 190/ 96 when last taken. He is conscious but looks anxious. VS: temp-97, pulse-86/min,resp. rate-33/min,
Step I : Emergent management: A, B, C, D- O2, IV access
Step II : Focused PE: Heent/Neck, Chest/Lungs, Heart/Cv, Abdomen, Extremities
Step III : Diagnostics: EKG, CXR, CK-mb, Troponin-I, CBC, Chem –7, Continuous cardiac monitoring
Treatment:MONA 1. NTG 0.4mg sl 2. Aspirin 3. Morphine if patient is in pain 4. ACE Inhibitor (onopril) 5. Depending on time since onset (if 3 h or less), consider t-PA if not contraindicated or cardiac cath. 6. Consider NTG drip. Other antihypertensive you may consider is labatelol or nipride( more severe cases).
Step IV: Changing pt’s location 1. Admit Pt. to CCU, if patient is symptomatic send to ward. 2. Repeat cardiac markers 3. D/C cardiac monitor after 24 hours if patient is stable 4. When stable, consider sub-maximal exercise test 5. All Pts. with MI should go home on B-blockers 6. Check lipid profile 7. Counsel on healthy life style prior to discharge 8. Make appointment to see him in about a week
STEP V: Educate Pt’s family, Console patient, stop smoking, diet, excercise.
STEP VI: Final Diagnosis.AMI
WikiMD Sponsors - W8MD Weight Loss, Sleep and MedSpa Centers
Pronounced weightMD, our state of the art W8MD weight loss, sleep, holistic IV nutrition and aesthetic medicine programs can help you not only to lose weight, and sleep better but also look your best! Since its inception in 2011, W8MD’s insurance physician weight loss program has successfully helped thousands of patients.
W8MD Weight Loss
W8MD’s Physician weight loss is unique in many ways with a comprehensive multidisciplinary approach to weight loss. Weight Loss Success Stories....
W8MD Sleep Services
Sleep medicine program uses state of the art technology to diagnose and treat over 80 different sleep disorders. W8MD Sleep Services…
W8MD Medical Aesthetic Services
Medical aesthetic program offers a wide variety of advanced laser skin treatments including oxygen super facials, photofacials and Affordable Botox. W8MD Aesthetic Services…
IM and IV nutrition therapy includes booster shots for B12, vitamin B complex, Vitamin C, Detox treatments and IV nutrition therapy. W8MD IV Nutrition…
W8MD weight loss | Philadelphia medical weight loss | NYC medical weight loss | NJ medical weight loss
Intro to W8MD Weight Loss, Sleep & Medical Aesthetics
Disclaimer: The entire contents of WIKIMD.ORG are for informational purposes only and do not render medical advice or professional services. If you have a medical emergency, you should CALL 911 immediately! Given the nature of the wiki, the information provided may not be accurate and or incorrect. Use the information on this wiki at your own risk! See full Disclaimers.WikiMD is supported by W8MD Weight loss, Poly-Tech Sleep & Medical Aesthetic Centers of America.