Thursday, December 20, 2012

Locating an MI

How are we able to tell which part of the heart is having an MI? Besides looking for ST elevation in two consecutive leads, you should really know which artery is being affected by the infarct. Not only will this help better your patient's care, but this will make you a better paramedic. Why? Because you are understanding how MI's work, and how to treat an MI based on its location.

Created by: BTA Learning |

> Lets say you have  ST elevation in leads II, III, and avF. This means that you are having an inferior MI. An inferior MI affects the right-side of the heart, which includes the right coronary artery. So to treat this patient, you do not want to give a Nitro, but instead you want to give a limit fluid bolus. The reason for not giving the Nitro is because we do not want to decrease the pre-load to the heart; which will cause the patient's blood pressure to drop drastically.

> Now lets say you have ST elevation in leads V1 and V2. This means that you are having a septal MI. A septal MI affects the middle of the heart (more left), which includes the left anterior descending artery. So to treat this patient, you would want to give your patient Aspirin (324mg) and Nitro (0.4mg). Make sure that you have a systolic blood pressure reading of >100 when giving the Nitro. The reason for this is because Nitro will decrease the preload to the heart, causing the BP to drop. We do not want to bottom out the patient's BP, which could cause a lot more harm to our patient.

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