Any help welcome?!
Question: Scenario. You have a patient who is 4 days post inferior MI. They have just got back to the ward after being in CCU and step down unit. They report feeling unwell, have slight chest pain and are breathless and pale.
What could be wrong? I realise there is more than 1 possibilty. What tests / interventions would you implement?
Answers: Scenario. You have a patient who is 4 days post inferior MI. They have just got back to the ward after being in CCU and step down unit. They report feeling unwell, have slight chest pain and are breathless and pale.
What could be wrong? I realise there is more than 1 possibilty. What tests / interventions would you implement?
Give them Nitropaste, or the sublingual nitro, order a STAT EKG, and a chest xray, and based on the result of the chest xray, if it appears normal move on to getting a lung scan, to see if there is a blood clot in the lungs. If the chest xray shows the lungs are full of fluids, then you put the patient on diuretics, and potassium for congestive heart failure. And if the patient isn't already on it, also prescribe Digoxin, to help the heart pump more efficiently.
If the EKG is abnormal then it is back to the Cardiac cath lab to see if another artery is blocked. Most likely the patient will go back to the cath lab prior to a lung scan, depending on if the Nitro helps the pain go away, or not.
The shortness of breath is what makes me think CXR, and lung scan. The CXR is very important, because inferior MI's are the hardest on the heart, and can cause a lot of tissue damage, making the heart unable to pump as well, which could cause the Congestive Heart Failure.
chest x-ray, do they have asthma, try a nebuliser