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Myocardial infarction (heart attack): Treatment, symptoms, advice and help

About myocardial infarction (heart attack)

Myocardial infarction, often referred to as a heart attack, is the death of heart muscle caused by a sudden blockage (by a blood clot) of the main artery (coronary) of the heart. Blockage of a coronary artery deprives the heart muscle of blood and oxygen leading to injury to the heart muscles.

Myocardial infarction (heart attack): Incidence, age and sex

Myocardial infarction is a common occurrence, especially in individuals of advanced and developed nations. It mainly affects individuals more than 65 years of age and men are more affected than women.

Signs and symptoms of myocardial infarction (heart attack): Diagnosis

Chest pain is a major symptom of a heart attack. This chest pain may radiate to the arms, the shoulders, the neck, the lower face, or the back. It may be mild or severe. The individual feels as if a tight band has been tied around the chest or something heavy has put upon on his/her chest. The pain usually lasts longer than 20 minutes. The pain does not get relieved by rest.

Other symptoms of a heart attack include anxiety, fainting, light-headedness, dizziness, nausea or vomiting, palpitations (feeling that the heart is beating too fast or irregularly), shortness of breath, and sweating. Some people (usually the elderly, diabetics and women) may have little or no chest pain. This is called as a silent heart attack.

While heart attacks may occur at any time, most of them occur in the early morning hours because of higher blood levels of adrenaline that are released from the adrenal glands during the morning hours. Increased adrenaline contributes to the rupture of cholesterol plaques. Approximately 50% of patients who develop heart attacks have warning symptoms such as chest pain at rest prior to their heart attacks, but these symptoms may be mild.

The above stated symptoms need immediate examination by a doctor, who may conduct an (ECG) Electrocardiography test to confirm the diagnosis.

Causes and prevention of myocardial infarction (heart attack)

The most important cause of heart attack is atherosclerosis which is a gradual process wherein cholesterol is deposited in the walls of arteries of heart which harden the arterial walls and narrow the inner channel (lumen) of the artery. Once the arteries are narrowed, they cannot deliver enough blood to maintain normal function of the parts of the body they supply.

In many people, atherosclerosis causes no symptoms for years or decades though it can begin as early as the teenage years, but start showing symptoms only later in adulthood when the arterial narrowing becomes severe. Smoking, high blood pressure, high cholesterol levels, and diabetes can accelerate atherosclerosis and lead to the earlier onset of symptoms and complications, particularly in those people who have a family history of early atherosclerosis.

Occasionally, sudden, significant emotional or physical stress, including an illness, can trigger a heart attack. Risk factors for heart attack include patient’s age over 65 years, male gender, family history of coronary artery disease, diabetes, high blood pressure, smoking, consuming fatty foods, high bad cholesterol and low good cholesterol and chronic kidney disease.

Myocardial infarction (heart attack): Complications

Possible complications of a heart attack are shock, heart failure, damage of the heart valves, swelling around the lining of the heart (pericarditis), irregular heartbeats, blood clot in the lungs (pulmonary embolism), and blood clot to the brain (stroke).

Myocardial infarction (heart attack): Treatment

A heart attack is a medical emergency which needs immediate medical attention and possibly a hospital stay too. Life-threatening irregular heartbeats, known as arrhythmia, usually develop which becomes the main cause of death in the first few hours, following a heart attack. These arrythmias may be treated either with appropriate medications or certain procedures. Such procedures include electrical cardioversion or defibrillation. Oxygen needs to be given, even if the blood oxygen levels are normal. Medicines and fluids need to be administered, through an intravenous line placed in one of the veins.

Angioplasty is the preferred emergency procedure for opening the clogged arteries for some types of heart attacks, but if coronary angiography reveals severe coronary artery disease in many vessels or a narrowing of the left main coronary artery, then the cardiologist may recommend emergency coronary artery bypass surgery (CABG). This procedure is also called "open heart surgery."

Depending on the results of the Electrocardiography, certain patients may be given drugs to break up the clot. This is called thrombolytic therapy. Many different medicines are used to treat and prevent heart attacks. Antiplatelet medicines are also prescribed which help in prevention of blood clot formation.