This is caused by a blockage so long that blood fails to reach the heart, leading to death or significant heart muscle damage. Your doctor is referring to this condition by the name myocardial infarction.
Description Terms
Myocardial infarction; MI; Acute MI; ST elevation myocardial infarction; Non-staved myocardial infarction
Causes
In most heart attacks, there is a blockage, usually by a clot of blood, in one of the coronary arteries. Coronary arteries transfer oxygen and blood to the heart. With the blocked flow of blood, heart cells will die because they won't be able to get enough oxygen for survival.
There is a hardened substance called plaque that accumulates in the walls of your coronary arteries. Plaque is cholesterol and other cell aggregates. Plaque buildup can lead to a heart attack.
• Plaque can rupture and tear. Then, blood platelets adhere at those tears. This clumping eventually forms a blood clot. Under circumstances that cause it to block flow to the heart because there is no oxygen flowing to it, this can lead to a heart attack and is likely a significant reason why this disease attacks a person's heart.
• Gradually, plaque builds up and almost completely blocks one of your coronary arteries. If the flow of oxygenated blood through this blockage is not adequate, a heart attack will occur. This is more likely to happen when your body is under stress for example through a serious illness.
Unknown. A heart attack can occur: • While resting or sleeping • After a sudden increase in physical activity • While at work or otherwise outdoors in cold weather • After sudden, severe emotional or physical stress, such as due to an illness
See Coronary Artery Disease Risk Factors: to learn about risk factors. Cardiogenic shock is a condition in which the heart becomes damaged and cannot pump enough blood to the body's organs. This is an emergency.
Symptoms
A heart attack is a medical emergency. Call 911 or your local emergency number immediately if you suspect you are having a heart attack. • Do not drive yourself to the hospital. • Do not wait for the symptoms to go away. You will probably die fairly quickly in the early stages of an attack.
The most common symptom associated with a heart attack is chest pain, but many times it radiates to only one part of the body and also radiates to the arms, shoulder, neck, teeth, jaw, stomach area, or back.
The pain can be severe or mild. It can sometimes be compared to: • Wearing a tight band around your chest • Having something heavy lying on your chest • Experiencing a heavy pressure Having bad indigestion or experiencing pain that is usually continuous for more than 20 minutes. When an attack occurs, rest and a medicine known as nitroglycerin may not completely relieve the pain. Your symptoms may remit and then recur.
Other heart attack symptoms include the following: • Anxiety • Coughing • Dizziness or lightheadedness • Fainting • Heart palpitations. It can sometimes feel as if the heart beats too quickly or irregularly. Nausea or vomiting occurs • Shortness of breath. Sweating may also occur in most patients, especially among the elderly, diabetics, and women who rarely have chest pain, or rarely come with some strange symptoms such as drowsiness and weakness. It was a silent heart attack because symptoms had not yet developed.
Physical examination and diagnostic tests
A doctor or nurse will check the physical findings. He/she will auscultate the chest area using a stethoscope. • Tachycardia is present. • The BP may be normal, increased or decreased. He may listen for lung crackles or even your heart murmur. There may be anomalies that he may pick up. He will draw some blood to be sent for troponin. When that result is returned, it means that you do in fact have some damage to the heart tissue. This will confirm that you are having an attack. The procedure can be done straight away or when the patient has been mostly stabilized. There are electrocardiogram tests that you will also be subjected to. The test will involve special dye and X-ray images showing how your blood will pass through your heart. This will make it easier for your doctor to know what kind of treatment you should have once you leave the hospital. Other tests of your heart, which may be done in a hospital, are: • Echocardiogram • Exercise stress test • Nuclear stress test
Treatment
You will be treated first in the emergency room. • You will be connected to a heart monitor, so the medical team can see how your heart is beating. • The medical team will put you on oxygen so your heart doesn't have to work as hard. • You will be put on an IV, which is a needle inserted into one of your veins. This IV provides you with fluids and medications. • You will be put on nitroglycerin and morphine, which help ease chest pain. The main cause of death within the first hours after having a stroke is from having an abnormal heart rhythm, called an arrhythmia. Some of these can be reversed with medication, but others can also be treated by cardioversion
Emergency Treatment
Angioplasty—surgery to open or dilate narrowed or blocked arteries that supply the heart.
• Typically, along with this, a stent—a relatively thin, tubular structure made from mesh-wire—is usually implanted inside as well. • Generally, angioplasty is usually the first course of treatment. The fact of the matter is that it needs to be done within 90 minutes of arriving at the hospital. Also, you should have it no later than 12 hours after you realize you're having a heart attack. A small mesh-wire tube called a stent is opened up inside a coronary artery by the process of angioplasty. • Often, a stent is placed after angioplasty. This ensures that it doesn't clot again. You'll likely get medications that dissolve clots. These work better when administered within less than 3 hours of when you start experiencing chest pain. This is called thrombolytic therapy. Some patients with this condition must have heart bypass surgery because the heart must be opened through a narrowing or blockage that has occurred in the blood vessels supplying the patient's heart. This is known as open-heart surgery.
After your heart attack
Most patients are usually given most of the medicines listed below after a heart attack. In some patients, these may prevent him or her from having another heart attack. Discuss the following medicines with your doctor or nurse: • • beta-blockers and ACE inhibitor medicines to help protect your heart • statins or other medicines to improve your cholesterol levels • antiplatelet medicines (blood thinners) such as aspirin, clopidogrel (Plavix), or, or warfarin (Coumadin), to help keep your blood from clotting
You may need to be on some of these medicines lifelong
You should see your doctor and get permission to stop the medication or how it is being given to you.
Any change in medication can lead to a fatal dosage. For all patients after experiencing a myocardial infarction, it makes you groan. As you do anything, they become anxious when you become a little more cautious. These are all expected. They just taper off within 2-3 weeks. You may be very tired when you can go home from the hospital. Most heart attack patients are put under a cardiac rehabilitation program. Even then, you will still be a doctor and nurses' patient. While you are there you will: • Gradually progress your exercise level. • You will learn how you can stay healthy.
Living a healthy lifestyle prevents another heart attack by
• Keeping your blood pressure, blood sugar and cholesterol in check.• Not smoking. • Eat a moderate diet that focuses on lots of fruits, vegetables, and whole grains, but is low in animal fats. Stay active. Aim for at least 30 minutes of physical activity, at least 5 days a week. Talk about it with your doctor first. • Get screened and treated for depression. Limit yourself to no more than one drink a day if you are a woman. Limit yourself to no more than two drinks a day if you are a man. Maintain an appropriate weight. 18.5 to 24.9 - BMI.
