Heart Attack (Myocardial Infarction)

Heart Attack (Myocardial Infarction)

Aheart attack, medically known as amyocardial infarction (MI), occurs when blood flow to a part of the heart is blocked for a long enough time that part of the heart muscle is damaged or dies. This is most commonly due to a blockage in one or more of the coronary arteries.

Pathophysiology

A myocardial infarction typically occurs when a coronary artery becomes blocked by a blood clot, a process known as thrombosis. This blockage is often the result of a rupture of an atherosclerotic plaque, which is a buildup of cholesterol and fatty deposits on the inner walls of the arteries. When a plaque ruptures, it can trigger the formation of a blood clot that can obstruct blood flow.

The lack of blood flow deprives the heart muscle of oxygen, leading to ischemia and, if not resolved quickly, infarction, or tissue death. The extent of the damage depends on the size of the area supplied by the blocked artery and the duration of the blockage.

Symptoms

Common symptoms of a heart attack include:

• Chest pain or discomfort, often described as a feeling of pressure, squeezing, or fullness in the center or left side of the chest.
• Pain or discomfort that radiates to the shoulders, neck, arms, back, teeth, or jaw.
• Shortness of breath.
• Nausea, vomiting, or lightheadedness.
• Cold sweat.

It is important to note that symptoms can vary, and some individuals, particularly women, may experience atypical symptoms such as fatigue, indigestion, or anxiety.

Diagnosis

The diagnosis of a myocardial infarction is based on a combination of clinical symptoms, electrocardiogram (ECG) changes, and elevated cardiac biomarkers in the blood, such as troponin. An ECG can show changes indicative of ischemia or infarction, such as ST-segment elevation or depression, T-wave inversion, or the development of Q waves.

Treatment

Immediate treatment for a heart attack aims to restore blood flow to the affected area of the heart. This can be achieved through:

• Thrombolytic therapy: Medications that dissolve blood clots.
• Percutaneous coronary intervention (PCI): A procedure that involves the insertion of a catheter with a balloon to open up the blocked artery, often followed by the placement of a stent.
• Coronary artery bypass grafting (CABG): A surgical procedure that creates a new route for blood to flow around the blocked artery.

Long-term treatment includes lifestyle changes, medications to manage risk factors, and cardiac rehabilitation.

Prevention

Preventive measures for myocardial infarction include:

• Maintaining a healthy diet low in saturated fats, cholesterol, and sodium.
• Regular physical activity.
• Smoking cessation.
• Managing stress.
• Controlling risk factors such as hypertension, diabetes, and hyperlipidemia through medication and lifestyle changes.

Prognosis

The prognosis after a myocardial infarction depends on the extent of the heart muscle damage, the timeliness of treatment, and the presence of other health conditions. Early intervention and adherence to treatment plans can significantly improve outcomes.

Also see

• Coronary artery disease
• Atherosclerosis
• Cardiac arrest
• Angina pectoris
• Heart failure

Cardiovascular disease A-Z

Most common cardiac diseases

• Cardiac arrhythmia‎
• Cardiogenetic disorders‎
• Cardiomegaly‎
• Cardiomyopathy‎
• Cardiopulmonary resuscitation‎
• Chronic rheumatic heart diseases‎
• Congenital heart defects‎
• Heart neoplasia‎
• Ischemic heart diseases‎
• Pericardial disorders
• Syndromes affecting the heart‎
• Valvular heart disease‎

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

A

• Accelerated idioventricular rhythm
• Acute decompensated heart failure
• Arteriosclerotic heart disease
• Athletic heart syndrome
• Atrial flutter
• Atrioventricular fistula
• Cardiovascular disease in Australia
• Autoimmune heart disease

B

• Brown atrophy of the heart

C

• Ebb Cade
• Cardiac allograft vasculopathy
• Cardiac amyloidosis
• Cardiac asthma
• Cardiac tamponade
• Cardiogenic shock
• Cardiogeriatrics
• Cardiorenal syndrome
• Cardiotoxicity
• Carditis
• Coronary artery aneurysm
• Coronary artery anomaly
• Coronary artery disease
• Spontaneous coronary artery dissection
• Coronary artery ectasia
• Coronary occlusion
• Coronary steal
• Coronary thrombosis
• Coronary vasospasm
• Cœur en sabot
• Coxsackievirus-induced cardiomyopathy

D

• Duke Treadmill Score
• Duroziez's disease

E

• Eisenmenger's syndrome
• Embryocardia
• Endocardial fibroelastosis
• Eosinophilic myocarditis

H

• Heart attack
• Heart failure
• Heart failure with preserved ejection fraction
• Heart to Heart (1949 film)
• High-output heart failure
• Hyperdynamic precordium

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

I

• Idiopathic giant-cell myocarditis
• Interventricular dyssynchrony
• Intraventricular dyssynchrony
• Isolated atrial amyloidosis

K

• Keshan disease

L

• Loeffler endocarditis

M

• Mydicar
• Myocardial bridge
• Myocardial disarray
• Myocardial rupture
• Myocardial scarring
• Myocardial stunning
• Myocarditis

N

• Nonbacterial thrombotic endocarditis

O

• OLR1
• Ostial disease

P

• Papillary fibroelastoma
• Pathophysiology of heart failure
• Postpericardiotomy syndrome
• Pulmonary vein stenosis

R

• Right axis deviation
• Roemheld syndrome

S

• Saturated fat and cardiovascular disease
• SCAR-Fc
• Shone's syndrome
• Strain pattern
• Subacute bacterial endocarditis
• Sudden cardiac death of athletes

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

T

• Traumatic cardiac arrest

V

• Ventricular aneurysm
• Vibroacoustic disease
• Viral cardiomyopathy

W

• Waon therapy