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Case
continued: Enroute to the ER, the patient's acute symptoms
had been relieved by the prompt action of the emergency care
personnel. Vital signs had stabilized, his chest pain was
relieved by nitroglycerin, and breathing was made easier by the
increased oxygen flow.
Arriving
at the hospital emergency room, the patient was immediately
surrounded by medical professionals including critical care
nurses, ER physicians and others. Blood was drawn and sent to the
laboratory (along with the initial blood drawn by the EMTs,) for
STAT (immediate!) analysis of cardiac serum markers, a CBC and
electrolytes. A chest radiograph (x-ray) and echocardiogram
were also performed. The patient's
EKG
findings were
carefully reviewed by the ER physician and the on-call
cardiologist was summoned. In the
Case Study Workbook, Module 6, review the Conduction System of
the Heart.
17.
What is an electrocardiogram?
Instructor's
Note:
This is a critical decision point for the cardiologist. There are
several algorithms (flow chart protocols) for treating patients
with chest pain suggestive of an acute heart attack. They
include the patient's symptoms and history; the
interpretation of the 12-lead EKG; the results of cardiac enzyme
markers and cardiac-specific proteins, the echocardiogram results
and others. Based on available evidence, the cardiologist
implemented the following treatments:
1.
Intravenous beta blockers for
decreasing oxygen demand to the heart, as well as other
symptoms.
2. Intravenous streptokinase to dissolve
clots and promote vascular healing.
3. Admission to the
coronary care unit (CCU) for careful observation and additional
testing.
4. Continued
aspirin therapy (300
mg twice a day)
Treatment
of heart attack patients depend on several factors: The
cardiologist's assessment, results of diagnostic testing and the
patient's overall response to initial therapy. More aggressive
options may be needed. There are several websites listed under
"additional links of interest" that will give the
interested student an overview of heart attack treatments such as
angioplasty and coronary bypass surgery.
18.
Describe how beta blockers, streptokinase, and aspirin therapy
are effective heart attack treatments.
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