The Cardiovascular Disorders Essay Assignment

n this exercise, you will complete a MindMap Template to gauge your understanding of this week’s content. Select one of the possible topics provided to complete your MindMap Template. * myocardial infarction *

Primary Diagnosis: Myocardial infarction (MI)
1. MI’s pathophysiology and the patient’s risk factors
Pathophysiology
MI, commonly known as heart attack, occurs due to myocardial blood flow and related ischemia. Pathologically, MI is characterized by the death of myocardial cells caused by prolonged ischemia (Takahashi et al., 2024). An underlying coronary artery disease (CAD) is the most significant cause of MI. A thrombus is formed due to plaque disruption (Takahashi et al., 2024)The Cardiovascular Disorders Essay Assignment.

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The thrombus releases concomitant multiple chemical mediators, causing refractory spasms and peripheral embolization in the coronary circulation, which leads to the development of MI. The flow of oxygen to the myocardium is deprived following occlusion of the coronary artery. A limited supply of oxygen to the myocardium for a longer period kills myocardial cells (Takahashi et al., 2024).
Causes Risk Factors of MI
MI is usually caused by a coronary vessel’s thrombotic occlusion, which occurs when a vulnerable plaque ruptures. Systolic function in the affected myocardium is depressed due to ionic and metabolic perturbations induced by ischemia (Takahashi et al., 2024). Acardiomyocyte death “wavefront” is activated if the myocardial ischemia is prolonged (Takahashi et al., 2024). Genetic risk factors: MI is a hereditary disorder. Individuals with a positive family history of CAD are at a relatively high MI risk than those with a negative history (Shao et al., 2020)The Cardiovascular Disorders Essay Assignment.
Ethnic risk factors: MI is a common diagnosis among black adults. According to Fukuoka and Oh (2022), the prevalence of heart attack-related deaths is significantly higher among black adults than white adults. In contrast, the risk of CAD is significantly lower among Asian adults than among other racial groups (Fukuoka & Oh, 2022).
Physical risk factors: Multiple physical factors, including smoking history, elevated lipid profile, hypertension, hyperlipidemia, obesity, diabetes, air pollution, and physical inactivity, are significant risk factors for MI (Flora & Nayak, 2019)The Cardiovascular Disorders Essay Assignment.

2. Signs and symptoms of MI and its impact on body systems
Common Clinical Presentation of MI Complications Associated with MI
i. Chest tightness or pain that radiates into the jaw or the left arm.
ii. Fatigue or malaise some days before the event
iii. Cardiac arrest is the most dramatic clinical manifestation of MI. i. Circulatory system: MI affects this system since heart attack occurs due to inadequate oxygen supply in the heart muscle due to blockage in blood vessels leading to the heart’s cardiac muscle (Takahashi et al., 2024). Consequently, the functioning capacity of the heart muscle is compromised.
ii. Respiratory system: MI is associated with a significant decline in air flow’s vital capacity and rates of airflow. These changes reduce the functioning capacity of “small airways,” reducing ventilation to parts of the lungs dependent on the process. Besides, the total lung capacity might be reduced with an increase in residual volume.
iii. Skeletal system: MI is associated with increased inflammation and significant bone density loss.
iv. Immune system: The body’s immune cells are triggered to damage the heart and blood vessels in the event of a heart attack. This incident might cause further harm, exposing an individual to future risk of heart attack, heart failure, or stroke. The Cardiovascular Disorders Essay Assignment
v. Nervous system: Heart failure activates the sympathetic nervous system (SNS). It also imbalances the SNS activities and causes vagal activity interaction, worsening heart failure.
vi. Muscular system: Myostatin controls skeletal muscle mass in persons with chronic heart failure. These individuals are more likely to have muscle wasting and weakness, compromising their capacity to perform daily activities.

3. Potential differentials
Acute gastritis: This medical condition is characterized by inflammation of the stomach lining. The most significant symptom is upper abdominal pain, similar to cardiac-related chest pain. Nonetheless, gastritis is differentiated from MI due to other pertinent positives, such as loss of appetite, black stools, indigestion, bloody vomit, and feeling full in the upper abdomen after meals (Shah et al., 2022).
Acute pericarditis: The most significant symptom of this disorder is chest pain, similar to a heart attack-related angina. However, acute pericarditis is attributed to several clinical manifestations absent in MI, including difficulty breathing when lying down, a dry cough, palpitations, fever, anxiety or fatigue, and swelling of the legs (McNamara et al., 2019)The Cardiovascular Disorders Essay Assignment.

4. Diagnostic tests and labs for MI
Cardiac biomarkers: MI is mainly detected through cardiac troponins (I and T). These chemicals are exclusively released in the heart when myocardial cells contract. A pattern of rise/fall in the cardiac troponins (cTn) levels with one of these values exceeding 99 percentiles of the “upper reference limit” (URL) depicts myocardial ischemia symptoms, implying that an acute MI is positive (Tilea et al., 2022).
Electrocardiography (ECG): Imaging detects various components of MI, including myocardial perfusion, thickness, viability, motion, and myocyte loss effect (Tilea et al., 2022)The Cardiovascular Disorders Essay Assignment.

5. Treatment plan and possible referrals
Acute Management of MI
i. Pain relievers: Intravenous opioids, particularly morphine, are used to manage acute pain in MI patients (Hegazy et al., 2022).
ii. Nitrates: MI patients are given intravenous nitrates to relieve symptoms and suppress ST depression. The dose is increased until symptoms are under control. Normal blood pressure must be achieved in hypertensive patients (Hegazy et al., 2022)The Cardiovascular Disorders Essay Assignment.
iii. Beta-blockers: These medications are administered to minimize myocardial oxygen consumption by reducing heart rate, myocardial contractility, and blood pressure (Hegazy et al., 2022).
MI’s Long-Term Treatment
i. Lipid-lowering treatment: The MI patient is prescribed high-intensity statins, such as Atorvastatin, to stabilize atherosclerotic plaques and lower LDL levels (Hegazy et al., 2022).
ii. ACE inhibitors: These medications are prescribed to MI patients with systolic left ventricular dysfunction, hypertension, heart failure, or diabetes (Hegazy et al., 2022)The Cardiovascular Disorders Essay Assignment.

iii. Beta-blockers: These drugs are given to MI patients whose LVEF is below 40%, provided no contraindications are present (Hegazy et al., 2022).
Lifestyle Modifications
The patient is advised to quit smoking and modify their lifestyle, including eating a healthy diet and engaging in aerobic exercises regularly (Hegazy et al., 2022).
Referrals
The patient would be referred to a nutritionist who would develop the most appropriate meal plan to reduce atherosclerosis and myocardial infarction risk. Studies show that a diet with low saturated fat and rich in whole grain products, fruits, vegetables, and fish is cardioprotective, reducing MI risk (Badimon et al., 2019)The Cardiovascular Disorders Essay Assignment.

References
Badimon, L., Chagas, P., & Chiva-Blanch, G. (2019). Diet and cardiovascular disease: effects of foods and nutrients in classical and emerging cardiovascular risk factors. Current Medicinal Chemistry, 26(19), 3639-3651. DOI: https://doi.org/10.2174/0929867324666170428103206
Flora, G. D., & Nayak, M. K. (2019). A brief review of cardiovascular diseases, associated risk factors and current treatment regimes. Current pharmaceutical design, 25(38), 4063-4084. DOI: https://doi.org/10.2174/1381612825666190925163827
Fukuoka, Y., & Oh, Y. J. (2022). Perceived heart attack likelihood in adults with a high diabetes risk. Heart & Lung, 52, 42-47. https://www.sciencedirect.com/science/article/abs/pii/S014795632100282X
Hegazy, M. A., Mansour, K. S., Alzyat, A. M., Mohammad, M. A., & Hegazy, A. A. (2022). Myocardial infarction: risk factors, pathophysiology, classification, assessment and management. Cardiol Res Rep, 4, 1-11. DOI: https://doi.org/10.31579/2692-9759/056
McNamara, N., Ibrahim, A., Satti, Z., Ibrahim, M., & Kiernan, T. J. (2019). Acute pericarditis: a review of current diagnostic and management guidelines. Future Cardiology, 15(02), 119-126. https://doi.org/10.2217/fca-2017-0102
Shah, S. C., Piazuelo, M. B., Kuipers, E. J., & Li, D. (2021). AGA clinical practice update on the diagnosis and management of atrophic gastritis: expert review. Gastroenterology, 161(4), 1325-1332.

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https://www.sciencedirect.com/science/article/pii/S0016508521032364
Shao, C., Wang, J., Tian, J., & Tang, Y. D. (2020). Coronary artery disease: from mechanism to clinical practice. Coronary Artery Disease: Therapeutics and Drug Discovery, 1-36. https://link.springer.com/chapter/10.1007/978-981-15-2517-9_1
Takahashi, J., Onuma, S., Hao, K., Godo, S., Shiroto, T., & Yasuda, S. (2024). Pathophysiology and diagnostic pathway of myocardial infarction with non-obstructive coronary arteries. Journal of Cardiology, 83(1), 17-24. https://doi.org/10.1016/j.jjcc.2023.07.014
Tilea, I., Varga, A., & Serban, R. C. (2021). Past, present, and future of blood biomarkers for the diagnosis of acute myocardial infarction—promises and challenges. Diagnostics, 11(5), 881. https://doi.org/10.3390/diagnostics11050881 The Cardiovascular Disorders Essay Assignment