Myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw.

1. HEART ATTACK /
MYOCARDIAL INFARCTION

2. WHAT IS HEART ATTACK?
A heart attack occurs when the flow of blood to the heart
is blocked, most often by a build-up of fat, cholesterol
and other substances, which form a plaque in the
arteries that feed the heart. The interrupted blood flow
can damage or destroy part of the heart muscle.
A heart attack, also called a myocardial infarction, a
destruction of cardiac tissues due to reduced coronary
blood flow. This can be fatal and a life-threatening
condition.

3. CAUSES
A heart attack occurs when one or
more of your coronary arteries
become blocked. Over time, a
coronary artery can narrow from the
buildup of various substances,
including cholesterol. This
condition, known as coronary artery
disease, causes most heart attacks.

4. CAUSES
During heart attack, one of these
plaques can rupture and spill
cholesterol and other substances
into the bloodstream. A blood clot
can form at the site of the rupture. If
large enough, the clot can
completely block the flow of blood
through the coronary artery.

5. SIGNS AND SYMPTOMS
- Chest pain is the most common symptom of
myocardial infarction
- Often described as a sensation of tightness,
pressure or squeezing.
- Pain radiates most often to the left arm, but may
also radiate to the lower jaw, neck, right arm, back
and upper abdomen.

6. SIGNS AND SYMPTOMS
- Characterized by “Levine’s sign” (chest hand-
clutching). This is the universal sign of distress in
angina pectoris (chest pain) and myocardial
infarction.
- This pain last for more than 20 minutes.

7. SIGNS AND SYMPTOMS
- Nausea or vomiting, indigestion, heartburn or abdominal pain
- Low grade fever
- Shortness of breath
- Pale appearance and fatigue
- Cold sweat
- Lightheadedness or sudden dizziness
- Palpitations
- Abnormalities in heart rate or blood pressure

8. RISK FACTORS

9. AGE
Men age 45 or older and women
age 55 or older are more likely
to have a heart attack than are
younger men and women.

10. TOBACCO/ CIGARETTES
Smoking and long-term exposure to
second-hand smoke

11. HIGH BLOOD PRESSURE
Over time, high blood pressure can damage
arteries that feed your heart by accelerating
atherosclerosis.

12. HIGH BLOOD
CHOLESTEROL
A high level of low-density lipoprotein (LDL) cholesterol (the
“BAD” cholesterol) is most likely to narrow arteries. A high
level of triglycerides, a type of blood fat related to your diet,
also ups your risk of heart attack.

13. DIABETES MELLITUS
Insulin, a hormone secreted by your pancreas allows
your body to use glucose, a form of sugar. Having a
diabetes – not producing enough insulin or not
responding to insulin properly – causes your body’s
blood sugar levels to rise.

14. FAMILY
HISTORY OF
HEART
ATTACK
If your siblings, parents or
grandparents have had early
heart attacks (by age 55 for
male relatives and by age 65
for female relatives), you may
be at increased risk.

15. LACK OF
PHYSICAL
ACTIVITY
An inactive lifestyle
contributes to high
blood cholesterol levels
and obesity.

16. OBESITY
Obesity is associated with
high blood cholesterol levels,
high triglyceride levels, high
blood pressure and diabetes.

17. STRESS
You may respond to
stress in ways that can
increase your risk of a
heart attack.

18. ILLEGAL
DRUG USE
Using stimulant drugs, such as
cocaine or amphetamines, can
trigger a spasm of your
coronary arteries that can cause
a heart attack.

19. A HISTORY OF
PRE-ECLAMPSIA
This condition causes
high blood pressure
during pregnancy and
increases the lifetime
risk of heart disease.

20. CAREGIVER MANAGEMENT

21. Becoming a caregiver requires a long-term
commitment of time and energy, but with a clear
plan and good support it can also be a fulfilling and
rewarding experience.
As a caregiver, you have to play many roles all at
once, including being a friend, confidant, nurse and
assistant. This will involve helping, supporting and
coaching to help adjust their lifestyle.

22. HOSPITAL,
NURSING HOME
& HOME
SETTINGS

23. PROMOTING
OXYGENATION AND
TISSUE PERFUSION
Instruct the patient to avoid over fatigue, stop activity
immediately in the presence of chest pain, dyspnea,
lightheadedness or faintness.

24. PROMOTING
OXYGENATION AND
TISSUE PERFUSION
Position the client in Semi-Fowler’s to allow greater diaphragm
expansion thereby lung expansion and better carbon dioxide –
oxygen exchange promoting adequate cardiac output.

25. PROMOTING
OXYGENATION AND
TISSUE PERFUSION
MONITOR THE FOLLOWING PARAMETERS:
Dysrhythmias on ECG tracings (with nurse’s guidance)
Vital Signs, effects of daily activities on cardiac status and rate &
rhythm of pulse

26. PROVIDE
COMFORT
Relieve pain. Administer morphine sulfate as ordered. This is to
decrease sympathetic stimulation which increases myocardial
oxygen demand. This will prevent shock which may result from
severe pain.

27. PROVIDING
REST
Provide psychosocial support to the client and his family.
Calmness and competency are extremely reassuring.

28. PROVIDING
REST
The client is usually placed on bed rest with commode
privileges for 24 to 48 hours

29. PROVIDING
REST
- Explain the continuous monitoring and safety during the
early recovery period.
- Promote rest and minimize unnecessary disturbances.

30. PROMOTING
ACTIVITY
Increase in activity is encouraged. After the first 24 to 48 hours, the
client may be allowed to sit on a chair for increasing periods of time
and begins ambulation on the 4th or 5th day.

31. PROMOTING
ACTIVITY
- Monitor the sign of chest pain and changes in vital signs during
activity.
- Encourage the client to verbalize feelings regarding MI.

32. PROMOTING
NUTRITION
AND
ELIMINATION
- Provide small, frequent feedings.
- Provide low calorie, low cholesterol, low sodium diet

33. PROMOTING
NUTRITION
AND
ELIMINATION
- Avoid stimulants. A substance that raises levels of
physiological or nervous activity in the body.
- Avoid taking very hot or very cold foods. Vasovagal stimulation
may occur. This may lead to bradycardia and cardiac arrest.

34. Using of bedpan
and straining at
stool should be
avoided.

35. Valsalva maneuver
causes changes in
blood pressure and
heart rate, which may
trigger ischemia,
dysrhythmias,
pulmonary embolism
or cardiac arrest.

36. Use bedside commode.

37. Administer stool
softener as
ordered.

38. PROMOTING
RELIEF OF
ANXIETY AND
FEELING OF
WELL-BEING
Provide an opportunity for the client and family to
explore their concerns and to identify alternative
methods of coping as necessary.

39. FACILITATING
LEARNING
- Teaching is started once the client is free of pain and excessive
anxiety.
- Promote a positive attitude and active participation of the client
and the family.

40. SELF-MANAGEMENT
EDUCATION GUIDE
* Discontinue smoking
* Control hypertension with continued medical supervision.
* Eat a diet low in calories, saturated fats and cholesterol,
decrease in salt intake.
* Participate in weight reduction program
* Progressive exercise based the doctor’s instructions and
under medical supervision.
* Take prescribed medications at regular basis.

41. SELF-MANAGEMENT
EDUCATION GUIDE
* Stress management techniques
* Return to usual home activities,
relationships, and to work at earliest
opportunity would be beneficial.

42. AS A CAREGIVER, YOU ARE A
PATIENT ADVOCATE
AS A CAREGIVER, YOU ARE
HERE TO HELP THE CLIENT TO
TAKE CARE HIMSELF/HERSELF

43. TAKE OVER HEAVIER
HOUSEHOLD AND YARD
CHORES OR HELPING WITH
DAILY ACTIVITIES
AS A CAREGIVER, YOU ARE
IMPORTANT SOURCE OF
EMOTIONAL AND SOCIAL
SUPPORT

44. WHAT TO DO IF YOU SEE SOMEONE
HAVING A HEART ATTACK?
- Have patient stop what he/she is doing
and sit or lie him/ her down in a
comfortable position. Do not let him/ her
to move around.
- Call for emergency medical help or have
someone call the ambulance for help.
- If the patient is under medical care, ask
the patient in taking the prescribe
medicine.

45. - If nitroglycerin, assist the patient while
awaiting emergency help. This helps to
improve blood flow to the heart.
- If aspirin, taking aspirin during a heart
attack could reduce heart damage by
helping to keep your blood from clotting.
- Talk to the patient and reassure that the
ambulance will arrive asap.
- If you don’t have access to emergency
medical services, the caregiver can drive
the patient to the nearest hospital.

46. If you encounter someone who
is unconscious, first call for
emergency medical help. Then
begin CPR to keep blood
flowing. Push hard and fast on
the person’s chest in a fairly
rapid rhythm – about 100 to
120 compressions a minute.

47. If the Automated External
Defibrillator (AED) is available,
AEDs are computerized devices
that are attached to a pulseless
victim with adhesive pads. They
will recommend shock delivery
only if the victim’s heart rhythm is
one that a shock can treat. AEDs
give rescuers visual and voice
prompts to guide rescuer actions.

48. THANK
YOU!