help need some info

[hotlooks]

Hi everyone, it as been a long time since i last posted. Have been very busy. Can anyone give me any info on why people who have heart disease and diabetes and who suffer an MI might not get chest pain but only shortness of breath would be grateful of any feed back

Thanks:confused:

[hoolahan, ASN, RN]

Well, one reason may be b/c as the area of heart muscle goes w/o oxygen, that decreases the hearts ability to meet the body's needs for oxygen, so the lungs are stimulated to increase rate and depth of respiration to compensate, in attempt to get more oxygen to the damaged area. This is probably stimulated by the release of lactic acid from the injured mycardial tissue ???

Or, could be that they are in congestive heart failure as well??

[BadBird, BSN, RN]

Depending upon how long a diabetic, some patients suffer from neuropathy and decreased sensations. Others have compensated due to long time illness, does this patient have a history of CHF? or CAD? What medications are this patient on?

[NSDRN]

I have taken care of many diabetic patients who have had MI's w/o CP. Many of these pt.'s diabetes has been uncontrolled for some time. They have high HbgA1C values. This is often due to the neuropathy caused by their diabetes which leads to decreased sensation. Hope this helps.

[DelGR]

I'd be inclined to agree with NSDRN and BadBird. It's amazing how diabetic patients have so many diverse symptoms that aren't the "classic" symptoms you'd expect for most diseases.

[RNConnieF]

We just had this in a Critical Care inservice today. The RN giving the program said that in IDDM chest pais in unusual. The predominate sign of MI is jaw/neck/shoulder pain. She wasn't sure why but just presented it as a useful piece of information for the clinical area.

[hotlooks]

Thank you to all who have replied have found the information helpful.