ТРЕТМАН, ДИЈАГНОЗА И МОНИТОРИНГ НА ПАЦИЕНТ СО АКУТЕН МИОКАРДЕН ИНФАРКТ ВО ЕДИНИЦА ЗА ИНТЕНЗИВНО ЛЕКУВАЊЕ
TREATMENT, DIAGNOSIS AND MONITORING OF A PATIENT WITH ACUTE MYOCARDIAL INFARCTION IN AN INTENSIVE CARE UNIT

Summary/Abstract: Acute myocardial infarction is an emergency and life-threatening condition and is the most common cause of death from cardiovascular disease. Research in the United Kingdom shows that half of people who have a myocardial infarction die within the first 28 days of the infarction, of which three quarters die within the first 24 hours. Myocardial infarction is necrosis of part of the myocardium, most often due to interruption of blood flow through the coronary artery. In myocardial infarction, the death of heart muscle cells occurs due to lack of oxygen caused by complete occlusion of one of the coronary arteries. The heart muscle needs to be constantly supplied with blood that is rich in oxygen. The coronary arteries that nourish the heart muscle become narrowed if there is coronary artery disease. Not enough blood can pass through the narrowed blood vessels. Patients with acute myocardial infarction are at risk of numerous acute and late complications, which often determine the outcome of the disease: Arrhythmias – ventricular tachycardia, ventricular fibrillation, bradycardia and atrioventricular blocks, which can be life-threatening. Heart failure and cardiogenic shock – a consequence of significant myocardial damage, in which the heart cannot provide sufficient perfusion to the organs. Mechanical complications – rupture of the ventricular wall, papillary muscle or interventricular septum, leading to acute hemodynamic instability. Pericarditis – inflammation of the pericardium that can occur several days after the infarction. Thromboembolic diseases – formation of a thrombus in the ventricle with the possibility of embolization in the systemic circulation. Prognosis The prognosis after acute myocardial infarction depends on several factors: Time from the onset of symptoms to medical intervention – the sooner flow is established through the occluded artery, the less myocardial damage and the better the long-term prognosis. Location and size of the infarct – anterior infarction has a worse prognosis than inferior wall artery infarction. Comorbidities – the presence of diabetes, hypertension, chronic kidney disease or chronic heart failure significantly worsen the prognosis. Rehabilitation and lifestyle changes – adherence to recommendations for diet, physical activity, smoking cessation and regular therapy improve the long-term prognosis and reduce the risk of recurrent infarction.

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