Inpatient progress

Mental health issues:

Normal psychological reactions to a new heart diagnosis/MI include anger, panic, disbelief, Shock, low mood, guilt, re assessment of priorities and should all be considered normal for the patient and family.

Recognising when patients require additional interventions are important. Supporting the patient and family after they have experienced this trauma should include signposting them to patient information.

• Chest Heart & Stroke Scotland
• British Heart Foundation

Referring patients to cardiac rehabilitation can ensure that this area of recovery is followed up and recognised if continuing. This will discussed in more detail in Module 5.

Ongoing monitoring:

Documenting Pulse, Heart Rhythm, Blood Pressure, Oxygen saturations, and further episodes of chest Pain will continually monitor Joan for signs of deterioration. Joan will be encouraged to mobilise in order reduce complications and increase her confidence to get back to normal.

Cardiac rehab assessment:

Cardiac Rehab will provide Joan with advice regarding lifestyle changes in accordance with her Risk Factor Profile. The team will provide support psychologically to allow her to come to terms with her heart attack and encourage her to address any anxieties she is experiencing. Cardiac rehab will discuss and explain the medication Joan will have to take and the purpose of optimising the medication. Joans partner Mark will be included in all aspects of Joans care and discharge planning and his concerns will be addressed as appropriately.

Medication optimisation:

Joan will require optimisation of her cardiac medications in order to reduce the risk of further heart attack in the future. The optimisation of medication will be titrated whilst Joan is in hospital in accordance with her blood pressure and pulse, On discharge this will be monitored and titrated by her GP.

Discharge planning:

Joan may stay in hospital for up to 5 days post heart attack and coronary angioplasty, this allows for further monitoring and titration of medication. However, as Joan lives in Glasgow she may be discharged from the interventional centre earlier, therefore discharge planning should include early follow up by GP and local Cardiac Rehabilitation team.