Myocardial infarction pain is similar to anginal pain but differ in:
- Being more severe and prolonged and there may be sweeting, nausea and vomiting.
- Not relieved by rest or sublingual nitrates.
Treatment:
R/ Morphine ampoule diluted in 10 ml saline → give 2 ml intravenous slowly immediately
Then refer the patient to a cardiologist or a hospital with a cardiology department for thrombolytic and anticoagulant therapy.
ICCU = Intensive Cardiac Care Unit is needed.
NB:
- There are some bad things about MI.
1- It may be silent myocardial infarction and the patient complains only of dyspnea and or vomiting that is why cardiac assessment is important in any patient with dyspnea → ECG.
2- Myocardial infarction may present with epigastric pain → the doctor may think it is a gastric problem so it is important to differentiate.
If gastric cause → there may be tenderness in epigastric area and the pain improves with zantac.
If cardiac cause → there is no tenderness in epigastric area as the pain is referred and the pain does not improve with zantac → ECG.
- Nubain or Nalufin (Nalbuphine) has similar efficacy to morphine but with fewer side effects and less abuse potential.
- Being more severe and prolonged and there may be sweeting, nausea and vomiting.
- Not relieved by rest or sublingual nitrates.
Treatment:
R/ Morphine ampoule diluted in 10 ml saline → give 2 ml intravenous slowly immediately
Then refer the patient to a cardiologist or a hospital with a cardiology department for thrombolytic and anticoagulant therapy.
ICCU = Intensive Cardiac Care Unit is needed.
NB:
- There are some bad things about MI.
1- It may be silent myocardial infarction and the patient complains only of dyspnea and or vomiting that is why cardiac assessment is important in any patient with dyspnea → ECG.
2- Myocardial infarction may present with epigastric pain → the doctor may think it is a gastric problem so it is important to differentiate.
If gastric cause → there may be tenderness in epigastric area and the pain improves with zantac.
If cardiac cause → there is no tenderness in epigastric area as the pain is referred and the pain does not improve with zantac → ECG.
- Nubain or Nalufin (Nalbuphine) has similar efficacy to morphine but with fewer side effects and less abuse potential.
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