One of Australia’s biggest health problems today is cardiovascular disease. One of the common manifestations of this disease is known clinically as heart attack (myocardial infarction) and angina. In Australia there were more than 160,000 people hospitalised in 2006 and approximately 23,000 people died from this disease (AIHW, 2010). These deaths are largely preventable and contributed to one of the biggest burdens for the Australian economy (Heart Foundation, 2010).
The number of Australians suffering from this disease is increasing especially for those people aged between 55 to 65 years old, and more significantly for those aged 75 years and over (AIHW, 2010). In the case of Mathew, who was diagnosed with acute myocardial infarction, will be the subject of this essay. I will highlight and explore the pathophysiology of the disease and other underlying diseases that contribute to his illness. It will also present some collaborative management, risks factors and potential complications. This will all be reviewed and discussed in this assessment.
Pathophysiology of coronary heart disease: Coronary heart disease is a condition in the body where there is an obstruction of circulating blood flow in the coronary arteries that produces various negative pathological responses (Martini, 2006). Atherosclerosis, one of the defining factors in obstructing coronary artery walls; is defined as the thickening of the artery walls as a result of the build up of fatty materials (plaque/cholesterols) that narrows the lumen of the arteries eventually causing blockage to blood flow (MERK, 2010).
Because of this blockage, the smooth muscle in the heart can go into spasm and further limit or totally stop blood flow altogether in the heart (Martini, 2006). As a consequence of this, the delivery of nutrients and oxygen that the body needs, especially the heart muscle is reduced, thus leading to a heart attack (myocardial infarction), angina, irreversible damage to the heart and other coronary heart disease (Medline Plus, 2010). According to Huether, McCance, Brashers, & Rote (2008), there are two major types of myocardial infarction; subendocardial infarction and transmural infarction.
Subendocardial infarction results when the blood clot (thrombus) dislodged before “complete distal necrosis” takes place; the infarction only affects the endocardium layer of the heart (Huether et al, 2008, p. 631). Transmural infarction on the other hand, results when the thrombus loges permanently in the lumen of the blood vessels; the infarction involves necrosis to all three layers of the heart ( endocardium, myocardium, epicardium) (Huether et al, 2008). Intervention is necessary at this point for people suffering from transmural infarction as this is a life threatening condition.