Myocardial infarction

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Case Study




Sharon Thomas

Waitakere Hospital

Abstract Of This Case Study

Have you ever wanted to know what a Myocardial Infarction is and what its all about.  Read on and find out through my eyes, about a patient I was caring for - what happened to him in both his body and mind.

The following will show what a Myocardial Infarction ( MI ) is, what happens in the patients body and what care is involved by the medical and nursing teams. All of this to ensure my patient would walk out of hospital and again feel like productive member of society that he most certainly was before his cardiac event.

Also within the body of this case study will be evidence based articles to support statements made.  Congruent to this, will be reflection on how all that transpired with this man affected me and how my nursing practice has developed because of it.  

This patients health related journey and the anonymous intimacy that took place, came to a happy conclusion for both nurse and patient.  Judith Christiansen’s Nursing Partnership Model was published in 1990 and was developed in response to the knowledge gaps in the nursing system in New Zealand ( Taylor, 1995 ).

This partnership model is a theoretical framework for nursing practice.  It has 3 major concepts – these being nursing partnership, the passage and the context. Anonymous Intimacy is one of 3 elements of the contextual facet of the partnership model – the other 2 being episodic continuity and mutual benevolence.  According to Watson ( 1992 ) she perceives nursing as being continuous when in reality it is a series of episodes.  Separate nurses in separate episodes contribute to a single patients health related journey ( Christensen, 1990, p.33 ).  And to me each nurse has “ anonymous intimacy” with there patient.  Each time I interacted with Mr T it was a privelege – he sanctioned personal closeness by a person he had not long met .


Sixteen New Zealanders die each day, or one person every 90 .

minutes, as a result of Coronary Artery Disease ( Hay, 2004 ).

Acute Coronary Syndrome accounts for approximately 7 million deaths annually in the world.

“In New Zealand, Cardiovascular Disease ( heart, stroke and blood vessel disease ) was the leading cause of death, accounting for 40% of all deaths in 2000 ”.  22% of those deaths were from coronary heart disease ( CHD ) with admissions to public hospitals totalling 29,456 in 2000 – 2001 ( 59% men and 41% women ). The death rate from CHD is more than twice as high for men than women – also across the age groups in New Zealand, deaths are highest for Maori, closely followed by Pacific people ( Hay, 2004 ).

Life means many things to many people but the common denominator for all appears to be that life is for living and enjoying.  As heart disease is largely preventable, we can uptake the many resources available to ensure we can live a long and healthy life ( National Heart Foundation ).

Informed Consent

Informed consent is a legal contract. It is when a patient gives consent for any nursing and/or medical treatment once full explanation, appreciation and understanding of his/her condition and the implications of any actions has been discussed between themselves and the medical/nursing team. Congruent to this the patient must be in possession of all of his/her faculties, and his/her judgment must not be impaired at the time of consenting (by sleepiness, intoxication by alcohol or drugs, other health problems, etc).

Mr T was consented for treatment, nursing care and his interventional procedure. This was done once all treatments, procedures, implications, complications and alternatives were comprehensively discussed with him.

Patient Demographics:

Mr T

  • 61 year old Ice-Cream Factory Worker
  • Works night shift so he can manage his son’s soccer team
  • Married – lives in own home with wife, youngest son and 2 cats

Mr T has excellent family support once he returns home

  • Non-Smoker/Social Alcohol
  • Weight 110kgs – Body Mass Index is 34
  • Height 178cms

Past Medical History

  • Prostatism         – details unknown
  • Viral pneumonia one year ago requiring hospital admission
  • Arthritis        – details unknown
  • No previous history of cardiac problems but has a strong family history of heart disease
  • Father died @ 60 – had a Myocardial Infarction ( MI ) @40 years. Acute myocardial infarction is the rapid development of myocardial necrosis. This is caused by a crucial imbalance between the oxygen supply and demand of the myocardium. It usually results from plaque rupture with thrombus formation in a coronary vessel, resulting in an acute reduction of blood supply to a portion of the myocardium (Stahmer, 2005 )
  • Sister had a Coronary Artery Bypass Graft x4grafts ( CABG ) Brother has heart problems but details unknown
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Presenting Complaint

  • History of Chest Pain on minimal exertion for 3 – 4 days - relieved by rest. No shortness of breath ( SOB ), no nausea, no palpitations, no radiating pain.
  • Visited local Accident and Emergency Clinic – was told ECG was “good“ and sent home.  I was unable to determine what “ good “ meant as this information was unavailable. The following day went to GP with same history as above who then referred him to hospital( GP referral stated Crescendo Angina.  Hx of chest pain with ...

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This is an extremely well researched case study. 1. The referencing is good and the inclusion of information from primary sources excellent. 2. The report is well structured though its subheadings. 3. The use of key terms is outstanding. 4. Avoid the use of running commentaries. *****