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Heart attack

  • Labs

    • cardiac enzymes (troponin, CKMB)
    • consider CXR (r/o aortic dissection, bcz aspirin will kill pt with AD)
    • EKG 12 lead
  • Tx

    • cath + stent once MI confirmed
    • give aspirin po 160-325 mg
    • NTG sublingual q 2-5 min x3 doses
      • NTG IV 5-10 mcg/min if sublingual no alleviates
    • O2 10 LPM via NRM
    • morphine IV 2-8mg q5-15min prn for pain
    • clopidogrel po 300mg, then 75mg qday
    • metoprolol IV 5mg q2 min x3 doses, then 50mg PO q6h for 48h, then 100mg bid (contraindicated in heart block/failure)
    • atorvastatin po 80mg qday
  • Other orders

    • monitor BP
    • telemetry
  • ROS

    • dyspnea, nausea, diaphoresis
    • currently symptomatic
    • aspirin allergy
    • Viagra or Cialis usage
    • PMH, past episodes
  • Px

    • JVD
    • S4 gallop

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.