Patients suffering from acute myocardial infarction (AMI) usually present with severe chest pain, anxiety and variable degrees of breathlessness. The pain is due to an imbalance between demand and supply of oxygen to the myocardium; demand is increased when the heart works harder and supply is reduced by occlusion of the coronary arteries (see image).
Simple measures that increase supply and reduce demand should be instituted without delay. They should be considered alongside specific reperfusion therapies and will include delivery of supplemental oxygen (if oxygen saturations are reduced), Glyceryl Trinitrate (GTN), relief of pain and anxiety and the reduction of sympathetic over-activity.