Clinical features: It is ischemic necrosis of the heart muscle due to occlusion of coronary arteries by thrombus or sub-intimal hemorrhage at the site of atheromatous narrowing. The cardinal symptom of MI is pain but breathlessness, vomiting and extreme tiredness and syncope may be present. The pain occurs in the same sites as for angina pectoris but is usually more severe and lasts longer.

Treatment guidelines

The main immediate needs are for the relief of pain and prevention or treatment of arrhythmias and other complications.

Oxygen should be given

Morphine sulphate (IV) 2-4 mg every 5 minutes until pain subs ides.

Add

Diazepam (IV) 5 mg every 6 hours until the crisis is over.

Add

Heparin (IV) 5,000 IU, every 8 hours in the acute phase and then

Warfarin (O) 2.5 mg every 24 hours