Myocardial Infarction

Irreversible ischemic event, resulting in decreased oxygenated blood supply to the myocardium.

Signs and symptoms#

substernal pain – “crushing”, “heavy”, “squeezing”, “tight band”
radiating pain to the left shoulders, arms, or mandible
confusion, apprehension, fear, flushed or chilled feeling, sweating, nausea, palpitations
hypotension
symptoms do not subside with anti-anginal medications
symptoms are atypical in women and diabetics

be calm and reassuring
discontinue dental treatment
clear the mouth of all foreign objects
assess responsiveness
place the patient in a slightly upright position
evaluate breathing, airway and circulation
monitor blood pressure, pulse and respiratory rate every 5 min
administer supplemental oxygen, 6-8 L/min
administer 0.3 mg nitroglycerin sublingually; repeat up to 3 times every 5 minutes
consider IM morphine 2 – 4 mg
give an aspirin (325 mg), chew and swallow
alert emergency medical services (EMS)
if patient loses consciousness, initiate basic life support (BLS) and start cardiopulmonary resuscitation (CPR).
use an automated external defibrillator (AED)