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MI with LVF

Protocols

Clinical Features:
  • 1)Shortness of breath (dyspnea)
  • 2)Fatigue and weakness.
  • 3)Swelling (edema) in your legs, ankles and feet.
  • 4)Rapid or irregular heartbeat.
  • 5)Reduced ability to exercise.
  • 6)Persistent cough or wheezing with white or pink blood-tinged phlegm.

Cardinal Feature:

  • 1)Orthopnea
  • 2)Gallop rhytm
  • 3)Bilateral basal Crepitations
Investigation:
  • 1)ECG
  • 2)CXR P/A View
  • 3)Urea
  • 4)Serum Electrolyte
  • 5)CBC
  • 6)Thyroid function
  • 7)Echocardiography


Rx:

1. complete bed reast-Propped up position 

2. High flow O2 inhalation

3. Diet: liquid

Medical Rx:

1. Tab.[post id="860" title="Aspirin"](Carva/Ecosprin)(75mg)4 tab p/o stat By crushing/চিবিয়ে খাবে then 

0+1+0(A/M)...চলবে(continue)

2. Tab.[post id="861" title="Clopidogrel"](Anclog/Clopid) (75mg) 4tab stat By চিবিয়ে খাবে (crushing)

then 

0+1+0.(A/M)....চলবে(continue)

3. [post id="862" title="Nitroglycerin"] (Nidocard/Anril) spray 2 চাপ sub-lingual stat and sos ( if pain)


4.inj.[post id="863" title="Morphine"](1cc+14cc D/W =15 cc)4 cc I/V stat and sos (5 min interval) upto pain subside

+

Inj.Prochlorperazine Maleate (Vergon)(12.5 mg)

1amp I/V stat 

(morphine এ BP কমে, BPকম থাকলে inj.pethidine দিবো।)

5.Tab.[post id="864" title="Atorvastatin"](ATV/atova)(40 mg) 

0+0+1(B/M)...stat 

then Tab.ATV(10mg) 0+0+1…..চলবে(continue)


6.Tab.Pantonix([post id="393" title="Pantoprazole"])(20mg)

1+0+1..(30 min b/m)…..চলবে(continue)


7. Tab.[post id="862" title="Nitroglycerin"]  (GTN SR)(2.6 mg)

1+0+1…….চলবে(continue)


8.Tab.[post id="865" title="Trimetazidine"](Angivous MR)(35mg)

1+0+1……………চলবে(continue)


9.Tab.[post id="474" title="Clonazepam"](Revotril/Rivo/Clonatril)(0.5mg)

0+0+1………….1month


10. inj.Enoxaparin Sodium(Cleven/Alexa/Cardinex)(60mg) 

1 PFS S/C around umbilicus(Sub cuteneous-left to right alternatively).. BD 3-7 days(always done by doctors)

If patient Diabetic then continue previous drugs 

with 💉Inj.[post id="478" title="Frusemide (Furosemide)"] (Lasix )2 amp I/V- stat & sos

If BP Low 

  • Inj.Dopamine 2 amp + 500 ml N/S @ 32 microdrop/min

If Brady cardia:

Heart Rate> 40 b/min: 

Heart Rate < 40 b/min: 

  • 2amp atropine I/v- stat & sos