ACUTE MYOCARDIAL INFARCTION (HEART ATTACK)

CORONARY DISEASE.

This disease is also known as heart attack and it consists in the obstruction of large epicardial coronary arteries that supply blood and oxygen to the heart. The World Health Organization (WHO) estimated in 2012 that out of the 17.5 million people who died from cardiovascular disease, 7. 4 million suffered a heart attack.

An acute myocardial infarction occurs when the flow of oxygen-rich blood is interrupted and blood can’t reach a portion of the heart’s muscle; without any blood flow, the heart becomes damaged. Regularly, heart attacks are caused by a clot located on top of a cholesterol plaque called atherosclerosis, which leads to an interruption of blood flow to the coronary arteries which transport oxygen and blood.


Causes


Several heart attacks are caused by a total obstruction of the heart’s blood vessels (coronary arteries). When oxygen-rich blood does not reach the heart’s muscle, after 40 minutes without any blood flow, cells start to die, which leads to Myocardial Necrosis. Heart attacks can be caused by:

  • Fat or atheroma accumulation (plaque). A fat plaque accumulates in the coronary artery, which prevents blood flow from reaching the heart, thus causing a heart attack.
  • Blood clot. It obstructs an arrow that has become narrow because of plaque. It can form in a different part of the body and travel towards the narrow artery. This process is called atherothrombosis.
  • Coronary artery spasms. When the narrow coronary artery momentarily contracts, it interrupts or prevents blood flow from reaching certain parts of the muscle. This can occur in arteries affected by plaque or those that aren’t.

Heart attacks can be associated with serious health problems such as heart failure or arrhythmia which can be deadly. What causes heart attacks is not always clear since a heart attack can occur in diverse ways:

  • When the person is resting or sleeping
  • After a sudden increase in physical activity
  • When performing physical activity in cold weather
  • After emotional stress or sudden and intense physical stress such as a disease

Symptoms


General symptoms are:

  • Pressure, burning, tension, chest tightness that last more than 20 minutes
  • Constant discomfort similar to indigestion
  • An intense and uncomfortable sense of tightness in the chest that travels all the way to your shoulders, arms, jaw and back
  • Dizziness and ‘cold’ sweat, which always indicate something serious is happening, or diffuse stomach discomfort
  • Anxiety, weakness, nausea and sudden tiredness
  • Abnormal heart beat, accompanied by excessive sweating and paleness

Women in particular present symptoms such as:

  • Pain or discomfort in half the chest.
  • Discomfort in other areas in the upper body, arms, back, neck, jaw or stomach
  • Shortness of breath, cold sweat—known as diaphoresis—and nausea or dizziness

When you experience one of the symptoms above, it is important to seek help immediately as you could be saving your life and prevent further damage to your heart. There isn’t a rule that guarantees you experience the same symptoms everyone else does; there might be people who experience different sensations like burning similar to indigestion or acid reflux, or the pain might focus on a very small part of your chest. Sometimes symptoms do not originate in the thorax but in the abdomen, which can cause confusion and lead to mistake them with other causes such as gastric causes, etc. This is particularly frequent among people with diabetes, women and elderly people.


Treatment


The treatment after an episode like this has the purpose of reestablishing blood flow to the heart muscle, stabilizing heart rate and providing the heart with enough time to heal. The immediate treatment is essential to prevent further and greater damage to the heart, which is why it is imperative to get medical help as soon as possible for proper medical assessment.

Specific treatment for an acute myocardial infarction are reperfusion therapy (clearing the obstructed artery)—there are two types: Primary angioplasty (clearing the artery using catheters, balloon pumps and a metal mesh coil called Stent)—and thrombolysis (administering intravenous drugs that dissolve the clot.)


Primary angioplasty is the most successful type of treatment to open the affected artery, which makes it the treatment of choice; however, it is high in cost and not available in all 100% of the cases.


Thrombolysis therapy is the second method of choice since it is available in most cases, it is much more economical and it does not require highly specialized staff to perform the procedure.



Drugs capable to dissolve clots such as tenecteplase and tissue plasminogen activators are the most available treatment option in the world for ST-segment elevation myocardial infarction (STEMI) which have proven to dramatically reduce morbi-mortality caused by heart attack.

Other Therapeutic Measures



A cardiac monitor to which the patient is connected so that the medical staff can observe how often the patient’s heart beats and detect any changes in the patient’s heart rate.


Oxygen to prevent extra strain on the heart provided there is documentation that indicates the patient presents hypoxemia.


Intravenous medication prescribed by the doctor


Possible administration of nitroglycerin and morphine to alleviate chest pain


Provided the patient is not allergic, acetylsalicylic acid might be administered to avoid further platelet aggregations or clot formation.


Abnormal rhythm and arrhythmia might be treated with specific medication and electrical-shock therapy. They are reserved for patients experiencing tachycardia or ventricular fibrillation.



Resting is also a key part of the treatment over the days following the event; however, it is important that the patient be able to stand on their own, walk and exercise moderately as moderate exercise will help them recover.


Preventive Measures


  • Quit smoking. Smoking increases heart attack risk. By quitting, risk decreases by 50%.
  • Monitor cholesterol levels and the intake of foods that tend to elevate them.
  • Avoid foods high in saturated fats, sugars and refined grains.
  • Monitor your high blood pressure and stick to the treatment; this will ensure your blood pressure does not present peaks and valleys. Stick to a balanced diet plan—foods low in sodium, no sugars and low alcohol intake—and preform low-impact exercises.
  • Follow the treatment prescribed by your doctor.
  • Reduce stress levels. Chronic stress, anxiety or worry damage the heart over time. Performing relaxing activities such as yoga, meditation or therapy will help you reduce these levels.

It is crucial that the patient, along with health experts and professionals, develop a better lifestyle to prevent any future heart disease.

It is important that all patients are under medical supervision and that they only take the medication exclusively prescribed by their doctor, following any dosage or other instructions provided; that they attend medical appointments or medical test appointments; and that they choose a healthier lifestyle including a balanced diet and regular exercising.


Welcome

Register Now | Forgot Password?

Forgot Password

Please enter your username or email address. You will receive a link to create a new password via email.

Subscribe to Newsletter