Nursing

The diagnosis is Coronary artery disease . Acute low infarction There are several pathognomic symptoms , which merchant ship be used as the diagnostic criteria : chest pain , electrocardiogram changes (ST fosterage in the inferior take to the woodss . Other information (hypotony and bradycardia ) was provided in the case study provide be useful for sagaciousness of the severity of the conditionThe risk of death is ( touchwood rate x [age /10]2 /SBP 16 .9 , consequently the risk of death in the first 24 hours is up to 0 .4 / death at the hospital -1 .5 and in 30 days - 1 .9 (see Annex , tab . 1By the interpretation using in the MESH database , the myocardial infarction is a gross necrosis of the myocardium , as a result of disturbance of the furrow come forth to the area . The interruption of blood supply often is caused by the thrombus appearing in the watercrafts damaged by the atherosclerotic process . The occlusion by the blood turn can be subchanges mechanical resistance and elasticity of the vessel . This narrow spot will make the blockage of blood supply more likely . Thrombus resorption whitethorn be followed by collagen accumulation and smooth muscle cell step-up . Thus the blood clot will form on the atheroma easier Sometimes a clot forms in the cavity of the heart and goes in a coronary thrombosis artery with the bleed of bloodRarely myocardial ischemia can be caused by the spasm of the coronary arteries . Slowly accruing stenosis of epicardial coronary arteries may proceed to exonerate occlusion but do not usu bothy lead to the myocardial infarction because of the development over time of a rich collateral network . With time the resultant thrombus can completely occlude the epicardial infarct artery . If there is an lacking(p) collateral supply , a wave front of myocardial necrosis begins within 15 minutes and spreads from the endocardium toward the epicardium .

This may be modulated by the extent of collateral flow and determinants of myocardial oxygen consumption , affording opportunity for significant myocardial salvageDepending on the evidence of the myocardial lesion we can distribute all causes of an acute coronary syndrome in the following diagnoses unstable angina , myocardial infarction without ST elevation (NSTE-MI and myocardial infarction with ST elevation (STEMI (see Annex , fig . 1 .The main determinants of acute myocardial infarctions are an acute parietal vascular lesion local coronary vasoconstriction and a platelet and fibrin thrombus . The coronary spasm and the thrombotic cascade can be triggered by the parietal fissurationA key concept in the pathophysiology of acute myocardial infarction is ventricular remodeling - changing coat , shape , and thickness of the ventricle walls involving both the damaged and inherent segments of the ventricle . Acute dilatation and thinning of the area of infarction that is not due to additional myocardial necrosis is referred to as infarct expansion . An extraload is placed on the residual procedure myocardium , which results in compensatory hypertrophy . Thus inhibition of the renin-angiotensin-aldosterone system is is a key therapeutic maneuver in patients with infarction . spare important pathophysiological concepts in patients with infarct include cardiac arrhythmias such as those...If you want to get a full essay, regulate it on our website: Orderessay

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