1. Discuss the risk factors for a myocardial infarction .
According to Ibanez et al., (2017), Myocardial Infarction occurs when at least one coronary is blocked. Risk factors associated with MI include age, stress, smoking, obesity, HTN, previous heart surgery, genetics, diet, diabetes, and high level of cholesterol. Patients with a family history of cardiac disease are seven times likely to have heart disease compared to patients that have no history in cardiac disease ( Bonaca et al., 2015) .
2. As per your analysis, what type of cell injury did Mr. Smith sustain and why?
Mr. Smith sustained a hypoxic injury which is caused by ischemia. Lack of oxygen or Hypoxia is the common cause of cellular injury ( Ibanez et al., 2017) . The patient had a coronary angiography performed on him, and occlusion was discovered in the descending branch of the left coronary artery that accords with ischemia ( Bonaca et al., 2015) . Injury caused by ischemia is as a result of gradually narrowing of arteries to total blockage caused by clots. Similarly, Ibanez et al., (2017) noted that acute obstruction could result in myocardial infarction within minutes in a scenario where the supply of blood is no restored.
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3. Differentiate between reversible and non-reversible cell injury.
According to Cabello, Burls, Emparanza, Bayliss, & Quinn (2016) , non- reversible injury can occur in incidences where a cell is exposed to toxic chemicals, hypoxia, and infections. The severity of cell damage depends on the type of severity and duration of the injury as well as the level of increased susceptibility and cell differentiation to fully differentiated cells and adaptive procedure of the cells.
4. Discuss the pathophysiological changes that occur during a myocardial infarction.
If coronary circulation cannot be sustained, the demand for oxygen and nutrients in the myocardium will be inadequate and may lead to myocardial ischemia. The main cause of the decrease of coronary blood flow is the establishment of atherosclerotic plaques in coronary arteries ( Cabello, Burls, Emparanza, Bayliss, & Quinn, 2016) . When the plaque upsurges in size, it leads to partial occlusion of the arteries and therefore, limiting the flow of blood and hence, cause ischemia. Ibanez et al., (2017) noted that when thrombus formation develops, it may block blood to flow to the heart muscle; therefore, a patient experiences acute myocardial infarction. Supposed the vessel obstruction is not able to be reversed infarction might occur, eventually leading to patient death.
Cabello, Burls, Emparanza, Bayliss, & Quinn (2016) observed that myocardial cells become ischemic within ten seconds of coronary occlusion since the cardiac inflow decrease which causes the cells to lose their ability to contract. According to Ibanez et al., (2017) whereas anaerobic processes occur, and lactic acid accumulates the cardiac cells remain variable for close to twenty minutes under ischemic conditions, however, in the event where coronary artery occlusion continues past 20 minutes, MI occurs ( Bonaca et al., 2015) . If the flow of blood is reinstated, aerobic metabolism recommences, contractility is reestablished, and cellular repair commences.
5. Correlate the subjective and objective findings of myocardial infarction with the disease
The subjective findings of MI are the sudden instance of chest pain which feel like pressure or squeezing. Also, Mr. Smith has shortness in breath and perfuse sweating which are diagnostics of an MI ( Cabello, Burls, Emparanza, Bayliss, & Quinn, 2016) .
The objective findings of MI are blood sugar, elevated CRP, rise, and fall of cardiac biomarkers like troponin, development of pathologic Q wave, and electrocardiographic change ( Ibanez et al., 2017) . Mr. Smith’s EKG was diagnostic of myocardial infarction ( Bonaca et al., 2015) . Angiography of the patients coronary was conducted, and the occlusion was determined in the descending branch of the left coronary artery.
References
Bonaca, M. P., Bhatt, D. L., Cohen, M., Steg, P. G., Storey, R. F., Jensen, E. C., & Bengtsson, O. (2015). Long-term use of ticagrelor in patients with prior myocardial infarction. New England Journal of Medicine, 372(19), 1791-1800.
Cabello, J. B., Burls, A., Emparanza, J. I., Bayliss, S. E., & Quinn, T. (2016). Oxygen therapy for acute myocardial infarction. Cochrane Database of Systematic Reviews, (12).
Ibanez, B., James, S., Agewall, S., Antunes, M. J., Bucciarelli-Ducci, C., Bueno, H., & Hindricks, G. (2017). 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). European heart journal, 39(2), 119-177.
