Q. Nutrition Support for myocardial infarction patient?

The nutrient requirements of a MI patient vary from time of getting hospitalized in an emergency to the time of getting discharged. Patients when admitted to the intensive cardiac unit are critically ill and could be on life-support system.

They are initially kept on intravenous fluids to maintain a desirable blood volume and also to supply some amount of calories. As the condition improves; the patients may either be put on enteral tube feeding (intubated with ventilator lo supply oxygen) or introduced small sips of full-fluids after every 1 to 2 hours. The diets gradually progressed to a semi-soft and then a soft one. The patients are closely observed when on a soft to normal diet, a few days before discharge. Thus, great care must be taken regarding the consistency and quantity of food being served to the patient,

The patient should be advised to cat slowly and adhere to a small frequent meal pattern even after discharge. Rest after meals should be advocated and the patient should avoid all forms of activity after meals. If the palient is overweight/ obese and needs to be operated, a low calorie diet to aid in weight reduction is a must. As a dietician you must be vigilant if the patient is also a diabetic as his insulin requirements may fluctuate drastically during the post MI period. Proper dietary counseling must be provided, particularly if congestive cardiac failure is present.We shall learn about the causes, symptoms, treatment and management of congestive cardiac failure-a decompensate heart disease that frequently develops among patients of MI after several years of rehabilitation.