Disorders of Cardiac Function

Martha had just finished dinner with her husband, and they had just sat down to watch television. She is 72 years old and has had a history of angina. Shortly after they sat down, Martha said she had indigestion and went to take some antacid tablets. An hour later, she began to feel warm, restless, and anxious. Her husband noticed she was looking pale and said he would take her to a nearby walk-in clinic. By the time they arrived, Martha said her left arm and shoulder were sore. Suspecting Martha was having a heart attack, her husband turned the car around and rushed her to the hospital. Three hours after the onset of her symptoms, Martha was receiving oxygen, fibrinolytic therapy, and nitroglycerin in the emergency ward. Afterward, she was moved to the cardiac unit for STEMI.

1. An ECG of Martha's heart demonstrated an elevated ST segment. What are the physiological effects of myocardial ischemia that produce this finding? What variables affect the ECG tracing of a patient with ACS?

2. What are the benefits of administering fibrinolytic therapy, nitroglycerin, and oxygen in the early management of STEMI?

3. What is the inflammatory response in the postinfarction recovery period? Why will Martha's heart function be compromised after her STEMI?