Early Management of AMI Key points Recognition of symptoms by the patient and prompt seeking of medical attention Rapid deployment of emergency medical team capable of performing resuscitative measures Expeditious transport of patient to hospital Early treatment without more delay

Early Management of AMI Goals of Management Control of cardiac discomfort Rapid identification of patients in need of urgent reperfusion therapy

Early Management of AMI Treatment: 1. Aspirin- rapidly inhibits COX-1 in platelets and reduces thromboxane A2. - chewed mg tablet 2. Presence of hypoxemia- Oxygen supplementation (2-4 L/ min) 3. Nitroglycerin(sublingual) – 3 doses of 0.4 mg at 5 min intervals to relieve chest pain and decrease preload and dilate infarcted coronary or collateral vessels.

Early Management of AMI 4. Nitroglycerin (intravenous)- given when there is return of chest pain accompanied with ST- segment of T-wave shifts. 5. Beta-blockers- diminish myocardial O2 demand and ischemia, reduces the risk of ventricular fibrillation. 6. Reperfusion therapy- by fibrinolysis or primary Percutaneous Coronary Intervention. - done if ST- segment elevation is at least 2mm in 2 contiguous precordial leads and 1 mm in 2 adjacent limb leads present