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MI Case Study: Myocardial Infarction
At 10:05 A.M., the blockage that had been silently growing in Paul
Parker's left coronary artery made its sinister presence known. The 54-year-old accounting executive had arrived with his family at the Denver zoo feeling fine, but suddenly a dull ache started in the center of his chest and he became nauseated. At first he brushed it off as the aftereffects of a company dinner the night before. However, when it
persisted, he told his wife who suggested that he go to the Aid Station.
"I'm not felling very well," he told the EMT at the station. "I think it may be indigestion." The EMT, on hearing Paul's symptoms and seeing his pale, sweaty face, immediately thought of a heart attack. "Let's get you over to the hospital and get this checked out."
The blockage in Paul's coronary artery had restricted blood flow to his heart muscle and his cells were beginning to die from lack of oxygen
(hypoxia). When someone has a heart attack, medical intervention is
critical to prevent additional damage and possibly save the patient's life. While waiting for the ambulance, the EMT gave Paul oxygen, hooked him to a heart monitor, and started an intravenous (IV) injection of normal (isotonic) saline.
Question 1: Why did the EMT give Paul an...
The reason for this is both for patient support (the oxygen) and for possible administration of medications during treatment (especially after arrival in the emergency room). Not only does establishing an IV line allow for the administration of medication enroute, but it also can help save valuable time in the emergency room should a MI be concluded.
Question 2: Explain to his (nonmedically oriented) family what is happening.
"Let me explain to you about what is going on with Paul right now. It seems that Paul is indeed having a heart attack, or what we call a "Myocardial Infarction." Although this is a serious condition, let me first say that we are doing everything possible to assure a successful outcome for him. In simple terms, there has for some reason been a lack of oxygen and other nutrients to some of the muscle cells in his heart. Typically, this is caused by the closing or narrowing of the artery that supplies the effected part with blood. Although in some cases the outcome is not good, in cases such as Paul's, where the problem was detected and is being actively treated, there is a very good chance…
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