Cardiac Chest Pain: Ischemia and Infarction (Nursing)

00:00 Hi! Welcome to our video serie.

00:03 In this one we're going to look at acute coronary syndrome.

00:06 What happens from ischemia to infarct.

00:09 So for those of you that are interested in ER you're going to love this topic.

00:14 Let's talk about what everyone needs to know about what causes cardiac chest pain.

00:19 The cause is inadequate oxygen to the heart muscle.

00:22 It's kind of heart muscles way of communicating to you.

00:25 Hello.

00:26 I'm not getting what I need.

00:28 So I'm going to make sure you're aware of it by causing chest pain.

00:32 Now Ischemia, the whole goal of ischemia is to try to prevent it from becoming myocardial infarction.

00:39 So we define ischemia as chest pain or discomfort that's caused by the cardiac muscle not getting enough oxygen.

00:46 Now that can be caused by a vasospasm by a thrombus, that's a clot that would break off and travel where it blocked off the blood supply or coronary atherosclerosis.

00:57 Now, it's an early sign the point of recognizing ischemia is ischemia is to prevent it from becoming infarction.

01:05 So the tissue still viable if we can get perfusion restored, then we can still rescue that tissue.

01:12 And I want to go back and explain a little bit about chest pain and what's really going on in a cellular level because less oxygen, Now I know you already know that's a problem, but I want to break it down a little bit for you because less oxygen and glucose for the anaerobic metabolism and the body switches over to anaerobic metabolism.

01:33 So if you cut off that oxygen supply to the heart, which is what's going on got less oxygen and glucose available you go from aerobic metabolism, oxygen-based to anaerobic metabolism.

01:46 Now, you've got metabolic and lactic acidosis at all accumulates that's what we've got going on.

01:52 So not enough oxygen, you know, I've not have oxygen and not enough glucose because you don't have blood supply you end up switching from a Aerobic metabolism to anaerobic metabolism and you're building up this lactic acid.

02:06 That's what accumulates and that's why you feel that pain because that myocardial fibers they get all irritated.

02:13 And that's where the pain comes from.

02:15 So back it up a little bit and walk through that with me.

02:18 Why do you have pain? Because those myocardial fibers are irritated.

02:23 Why are they irritated? Because you have a buildup of lactic acid.

02:28 Why do we have the lactic acid? Because without oxygen and glucose to the cells because the blood supply has been cut off you switch from aerobic metabolism to anaerobic.

02:41 There you go.

02:42 Now, you've got it down on a cellular level why it hurts to not have enough oxygen or good blood supply to the muscle.

02:48 I know ischemia is warning sign for us.

02:51 That's a call to action we need to do something to resolve that.

02:55 So our goal is to stop ischemia from becoming infarcted tissue because infarcted tissue is dead tissue dead tissue, stiff tissue, that means the heart is not going to be as efficient as it was before the myocardial infarction.

03:11 So that's our goal educate our patients educate ourselves.

03:15 So we recognize ischemia when it happens and we know what to do.

03:20 Now myocardial infarction is because that oxygenated blood supply that was inadequate it's been cut off long enough that the tissue is dead from less oxygen.

03:31 All right, you've got it.

03:32 So if we ask you to pause for a minute, can you answer the question? What's the difference between ischemia and myocardial infarction?