NURS 6501 Week 3 Assignment; MindMap - Myocardial Infarction
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3. What are other potential diagnosis that present in a similar way to this diagnosis (differentials)? Differential diagnoses include: Angina Pectoris, pericarditis, pulmonary embolism, aortic dissection, Gastroesophageal reflux disease, peptic ulcers, costochondritis, and panic attacks. 4. What diagnostic tests or labs would you order to rule out the differentials for this patient or confirm the primary diagnosis? Electrocardiogram (ECG), Cardiac Biomarkers such as troponin I, Chest X-ray, Echocardiogram, CT Angiogram, D-dimer, CK-MB, upper GI endoscopy, abdominal ultrasound, abdominal CT, and a psychological assessment. 5. What treatment options would you consider? Include possible referrals and medications. Any patient with concerns of chest pain should immediately be given supplemental oxygen, aspirin, nitroglycerin, and morphine (MONA, as we learned in nursing school). Reperfusion therapy needs to be considered. A cardiac catheterization with percutaneous coronary intervention to mechanically open any blocked arteries and thrombolytic therapy to dissolve blood clots. Medications include Antiplatelet therapy such as aspirin, Plavix, or ticagrelor to prevent further clot formation. Anticoagulant therapy such as heparin. Beta-blockers to reduce myocardial demand. Angiotensin-converting enzyme (ACE) inhibitors or Angiotensin receptor blockers (ARBs) for patients with left ventricular dysfunction, heart failure, or hypertension. Statins such as atorvastatin reduce cholesterol levels. Nitrates should be considered as well. Calcium Channel blockers to lower blood pressure. Antiarrhythmics might also be needed. Referrals to be considered: Cardiac rehabilitation, Mental health referral including drug or alcohol rehab if indicated, Cardiology, Nephrology, and GI. Patients who have been diagnosed with a myocardial infarction require a multidisciplinary team to manage care encompassing acute medical management, reperfusion, pharmacological interventions, lifestyle modifications, and rehabilitation to optimize outcomes and prevent recurring events.
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