Nursing care for patients with acute myocardial infarction who have been referred : Two case studies

Abstract

     A comparative case study of two patients aimed to compare the disease progression, treatment, and nursing care of two transferred patients with acute myocardial infarction who received services at the Emergency Department of Janghan Hospital. This case study compares two transferred patients with acute myocardial infarction. Case 1 presented to the Emergency Department of Janghan Hospital on July 14, 2026, and Case 2 presented on April 29, 2026. Data were collected through interviews, observation, and medical record reviews. Patient health status was assessed using Gordon’s 11 Functional Health Patterns, and nursing diagnoses were formulated and applied alongside the nursing process framework to guide patient care.

     Main findings : Case 1 was a 68-year-old Thai male. Twenty minutes prior to hospital admission, he experienced a squeezing sensation in the left chest radiating to the left scapula, accompanied by sweating, palpitations, shortness of breath, and dyspnea; his symptoms did not improve upon standing. The patient was treated via the STEMI Fast Track, the physician diagnosed STEMI anterior wall . Treatment involved the administration of a thrombolytic agent (Streptokinase) without complications. Key metrics included a Door-to-EKG time of 5 minutes, Onset-to-Door time of 20 minutes, and Door-to-Needle time of 27 minutes; care was provided according to the established nursing care plan. The second case study involved an 88-year-old Thai male. Four hours prior to hospital arrival, he experienced a sensation of tightness in the throat radiating to the chest, shortness of breath, and fatigue following the consumption of ripe mangoes. He had a history of hypertension and asthma. He was treated via the STEMI Fast Track, the physician diagnosed STEMI inferior wall. Treatment involved the administration of a thrombolytic agent (Streptokinase); a complication of hypotension occurred. Key metrics included a Door-to-EKG time of 5 minutes, Onset-to-Door time of 4 hours, and Door-to-Needle time of 32 minutes; care was provided according to the established nursing care plan. Both patients received care in accordance with clinical guidelines and were transferred for coronary angiography (CAG) via the fast track system to Roi Et Hospital.