Introduction
The acute myocardial infarction occurs when the flow of blood to the heart is blocked, most often by a build-up of fat, cholesterol and other substances, which form a plaque in the arteries that feed the heart (coronary arteries). The interrupted blood flow (oxygen supply) can damage or destroy part of the heart muscle. a portion of the heart is starved of oxygen, a condition called "cardiac ischemia." If cardiac ischemia lasts too long, the starved heart tissue dies. This is called as heart attack also known as a myocardial infarction.
The acute myocardial infarction occurs when the flow of blood to the heart is blocked, most often by a build-up of fat, cholesterol and other substances, which form a plaque in the arteries that feed the heart (coronary arteries). The interrupted blood flow (oxygen supply) can damage or destroy part of the heart muscle. a portion of the heart is starved of oxygen, a condition called "cardiac ischemia." If cardiac ischemia lasts too long, the starved heart tissue dies. This is called as heart attack also known as a myocardial infarction.
Presentation
Signs & symptoms
Signs & symptoms
·
Pressure, tightness,
pain, or a squeezing or aching sensation in the chest or arms that may spread
to the neck, jaw or back
·
Nausea, indigestion,
heartburn or abdominal pain
·
Shortness of breath
·
Cold sweat
·
Fatigue
·
Lightheadedness or
sudden dizziness
Causes
coronary artery diseases, coronary artery can narrow from the buildup of various substances, including cholesterol (atherosclerosis)
During a heart attack, one of these plaques can rupture and spill cholesterol and other substances into the bloodstream. A blood clot forms at the site of the rupture. If large enough, the clot can completely block the flow of blood through the coronary artery.
During a heart attack, one of these plaques can rupture and spill cholesterol and other substances into the bloodstream. A blood clot forms at the site of the rupture. If large enough, the clot can completely block the flow of blood through the coronary artery.
A spasm of
a coronary artery that shuts down blood flow to part of the heart muscle.
Risk factors
·
Age. Men age 45 or older
and women age 55 or older are more likely to have a heart attack than are
younger men and women.
·
Tobacco. Smoking
·
High blood pressure
·
High blood cholesterol or triglyceride levels. A high level of low-density lipo protein
(LDL) and high level of triglycerides.
·
Diabetes
·
Family history of heart attack.
·
Lack of physical activity.
·
Obesity
·
Stress
A history of pre clampsia.
This condition causes high blood pressure during pregnancy and increases the
lifetime risk of heart disease.
·
A history of an autoimmune condition (Colin 2012).
Test and diagnosis
·
Electrocardiogram (ECG)
·
Blood tests. Certain heart
enzymes slowly leak out into the blood stream while heart has been damaged by a
heart attack.
Additional tests
·
Chest X-ray. (To check the size of heart and its blood
vessels and to look for fluid in lungs)
·
Echocardiogram
·
Coronary catheterization (angiogram)
·
Exercise stress test.
Stress tests measure how your heart and blood vessels respond to exertion.
·
Cardiac computerized tomography (CT) or magnetic resonance imaging (MRI)
Management
*Aspirin, it reduces blood clotting, thus helping maintain blood
flow through a narrowed artery.
*Thrombolytic, help dissolve a blood clot that's blocking blood
flow to heart.
*Antiplatelet agents. These include medications, such as
clopidogrel (Plavix) and others, called platelet aggregation inhibitors.
*Other blood-thinning medications, such as heparin
*Pain reliever, such as morphine
* Nitroglycerin. This medication, used to treat chest pain (angina),
can help improve blood flow to the heart by widening (dilating) the blood
vessels. (Uptodate 2015).
*Beta blockers. These medications help relax heart muscle, slow heart
rate and decrease blood pressure and also can limit the amount of heart muscle
damage and prevent future heart attacks.
* ACE inhibitors. These drugs lower blood pressure and reduce stress
on the heart.
And cholesterol lowering medications.
And cholesterol lowering medications.
Surgical and other
procedures
*Coronary angioplasty and stenting
*Coronary artery bypass surgery
*Life style modifications such as, avoid smoke, avoid
alcohol, control blood pressure and cholesterol levels, get regular
medical checkups, exercise regularly, maintain a healthy weight, eat
a heart-healthy diet, manage diabetes and control stress.
(NICE 2015).
(NICE 2015).
References
Reeder S,Harold L K (2015). Criteria for the diagnosis of acute myocardial infarction. [ONLINE] Available at: http://www.uptodate.com/contents/criteria-for-the-diagnosis-of-acute-myocardial-infarction. [Last Accessed 20 april 2015
Reeder S,Harold L K (2015). Criteria for the diagnosis of acute myocardial infarction. [ONLINE] Available at: http://www.uptodate.com/contents/criteria-for-the-diagnosis-of-acute-myocardial-infarction. [Last Accessed 20 april 2015
Colin, T 2012, 'Acute Myocardial Infarction', retrieved 16th of March 2015, <http://www.patient.co.uk/doctor/acute-myocardial-infarction>
2015. Mayoclinicorg. [Online]. [6 May 2015]. Available from: http://www.mayoclinic.org/diseases-conditions/heart-attack/basics/definition/con-20019520
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