| Abstract | Kardiovaskularne bolesti su globalni javnozdravstveni problem od kojeg umiru milijuni ljudi diljem svijeta. Od toga je ishemijska bolest srca na prvom što se tiče uzroka umiranja, a moždani udar na drugome mjestu u zemljama niskog i srednjeg dohotka. U zemljama visokog dohotka je broj umrlih znatno niži zbog većeg obraćanja pažnje na prevenciju i liječenje kardiovaskularnih bolesti. Što se tiče Republike Hrvatske, prvi uzrok smrti je ishemijska bolest srca, druga po redu je hipertenzivna bolest srca, a na trećem mjestu je akutni infarkt miokarda koji je u središtu promatranja ovog rada. On se definira kao nekroza miokarda uslijed opstrukcije koronarne arterije koji najčešće zahvaća lijevu klijetku srca. Akutni infarkt miokarda se može klasificirati na temelju 5 tipova ili prema opsegu infarkta. Najpoznatija podjela infarkta je STEMI i NSTEMI. STEMI označava infarkt miokarda s elevacijom ST segmenta, dok NSTEMI se definira kao infarkt miokarda bez elevacije ST segmenta. Osim promjena na EKG -u, infarkt miokarda se može dijagnosticirati ehokardiogramom, srčanim enzimima te prisutnim simptomima. Neki od simptoma akutnog infarkta miokarda su bol u prsima prisutna više od 30 minuta, bljedoća, znojenje, strah, mučnina, povraćanje, osjećaj nedostatka zraka, gušenje te cijanoza. Ukoliko se infarkt miokarda ne prepozna na vrijeme, postoji visok rizik za razvijanje komplikacija u vidu kardiogenog šoka, aritmija, plućnog edema te srčane dekompenzacije. Kako bi se infarkt miokardna adekvatno liječio, važna je hitna medicinska intervencija. Kod liječenja se primjenjuju farmakološke metode te PCI. Pacijenti su zbrinjavani u jedinici za koronarnu skrb zbog brzog i naglog razvitka promjena zdravstvenog stanja. Pri tome im je potreban kontinuirani nadzor nad vitalnim funkcijama posebnim monitoringom koji alarmira svaku promjenu kod bolesnika. Kada stanje bolesnika dozvoljava, smješta se na odjel za kardiologiju gdje ga se potiče na postupno bavljenje fizičkom aktivnosti kako bi se mogao otpustiti na rehabilitaciju ili kući. Većini bolesnika je ordinirana rehabilitacija čiji je cilj povećati kvalitetu život pacijenti, promijeniti štetne navike koje je provodio te spriječiti komplikacije ili ponovni nastanak infarkta miokarda. Za vrijeme hospitalizacije pacijenti s akutnim infarktom miokarda se suočavaju s određenim problemima za koje je medicinska sestra educirana i sposobna rješavati. Pri tome treba znati procijeniti čimbenike koji su doveli do problema, postaviti si cilj za rješavanje te provoditi intervencije za ostvarivanje tog cilja. |
| Abstract (english) | Cardiovascular diseases are a global public health problem from which millions of people die worldwide. Of these, ischemic heart disease is the leading cause of death, and stroke is the second leading cause of death in low- and middle-income countries. In high-income countries, the number of deaths is significantly lower due to greater attention paid to the prevention and treatment of cardiovascular diseases. As for the Republic of Croatia, the first cause of death is ischemic heart disease, the second in order is hypertensive heart disease, and the third is acute myocardial infarction, which is the focus of this paper. It is defined as necrosis of the myocardium due to obstruction of the coronary artery, which most often affects the left ventricle of the heart. Acute myocardial infarction can be classified based on 5 types or according to the extent of the infarction. The best-known division of infarction is STEMI and NSTEMI. STEMI stands for ST-segment elevation myocardial infarction, while NSTEMI is defined as non-ST-segment elevation myocardial infarction. In addition to changes on the EKG, myocardial infarction can be diagnosed with an echocardiogram, cardiac enzymes and the present symptoms. Some of the symptoms of acute myocardial infarction are chest pain present for more than 30 minutes, pallor, sweating, fear, nausea, vomiting, feeling of lack of air, suffocation and cyanosis. If myocardial infarction is not recognized in time, there is a high risk of developing complications in the form of cardiogenic shock, arrhythmias, pulmonary edema and cardiac decompensation. In order to adequately treat a myocardial infarction, urgent medical intervention is important. Pharmacological methods and PCI are used for treatment. The patients were cared for in the coronary care unit due to the rapid and sudden development of changes in their health status. At the same time, they need continuous monitoring of vital functions with special monitoring that alerts every change in the patient. When the patient's condition allows, he is placed in the cardiology department where he is encouraged to gradually engage in physical activity so that he can be discharged to rehabilitation or home. Most patients are prescribed rehabilitation, the goal of which is to increase the patient's quality of life, to change the harmful habits he was carrying out, and to prevent complications or the recurrence of myocardial infarction. During hospitalization, patients with acute myocardial infarction face certain problems for which the nurse is trained and able to solve. In doing so, one should be able to assess the factors that led to the problem, set a goal for solving it, and implement interventions to achieve that goal. |
