Diyaabout 1 year ago

MYOCARDIAL INFARCTION

What is a heart attack? A myocardial infarction (commonly called a heart attack) is an extremely dangerous condition that happens because of a lack of blood flow to your heart muscle. The lack of blood flow can occur because of many different factors but is usually related to a blockage in one or more of your heart’s arteries. Without blood flow, the affected heart muscle will begin to die. If blood flow isn’t restored quickly, a heart attack can cause permanent heart damage and death. A heart attack is a life-threatening emergency. If you suspect you or someone you’re with is having a heart attack, call 911 (or your local emergency services phone number). Time is critical in treating a heart attack, and a delay of even a few minutes can result in permanent heart damage or death. What does a heart attack feel like? When a heart attack happens, blood flow to a part of your heart stops or is far below normal, which causes injury or death to that part of your heart muscle. When a part of your heart can’t pump because it’s dying from lack of blood flow, it can disrupt the pumping sequence for your entire heart. That reduces or even stops blood flow to the rest of your body, which can be deadly if it isn’t corrected quickly. What are the symptoms of a heart attack? Heart attacks can have a number of symptoms, some of which are more common than others. Men and people assigned male at birth (AMAB) are likely to have different heart attack symptoms than women and people assigned female at birth (AFAB). Symptoms of a heart attack that people describe most often include: Chest pain (angina). This can be mild and feel like discomfort or heaviness, or it can be severe and feel like crushing pain. It may start in your chest and spread (or radiate) to other areas like your left arm (or both arms), shoulder, neck, jaw, back or down toward your waist. Shortness of breath or trouble breathing. Fatigue. Trouble sleeping (insomnia). Nausea or stomach discomfort. Heart attacks can often be mistaken for indigestion or heartburn. Heart palpitations. Anxiety or a feeling of “impending doom.” Sweating. Feeling lightheaded, dizzy or passing out. Heart attack symptoms in women and people AFAB Medical research in recent years has shown that women and people AFAB are less likely to have chest pain or discomfort that feels like indigestion. They’re more likely to have shortness of breath, fatigue and insomnia that started before the heart attack. They also have nausea and vomiting or pain in the back, shoulders, neck, arms or abdomen. What causes a heart attack? The vast majority of heart attacks occur because of a blockage in one of the blood vessels that supplies your heart. This most often happens because of plaque, a sticky substance that can build up on the insides of your arteries (similar to how pouring grease down your kitchen sink can clog your home plumbing). That buildup is called atherosclerosis. Sometimes, plaque deposits inside the coronary (heart) arteries can break open or rupture, and a blood clot can get stuck where the rupture happened. If the clot blocks the artery, this can deprive the heart muscle of blood and cause a heart attack. Heart attacks are possible without a blockage, but this is rare and only accounts for about 5% of all heart attacks. This kind of heart attack can occur for the following reasons: Coronary artery spasm. Rare medical conditions: An example of this would be any disease that causes unusual narrowing of blood vessels. Trauma: This includes tears or ruptures in the coronary arteries. Obstruction that came from somewhere else in your body: A blood clot or air bubble (embolism) that gets trapped in a coronary artery. Electrolyte imbalance. Eating disorders: Over time, these can damage your heart and ultimately result in a heart attack. Takotsubo or stress cardiomyopathy. Anomalous coronary arteries (a congenital heart defect you’re born with where the coronary arteries are in different positions than normal in your body. Compression of these causes a heart attack). How are heart attacks diagnosed? Healthcare providers usually diagnose heart attacks in an emergency room setting. Anyone with heart attack symptoms should undergo a physical examination, including checking pulse, blood oxygen levels and blood pressure and listening to heart and lung sounds. A healthcare provider will diagnose a heart attack using the following: History and symptoms: The provider will ask you about the symptoms you experienced. They might also ask someone who was with you to describe what happened. Blood tests: During a heart attack, the damage to heart muscle cells almost always causes a chemical marker, a cardiac troponin, to appear in your bloodstream. Blood tests that look for that marker are among the most reliable methods to diagnose a heart attack. Electrocardiogram (EKG or ECG): This is one of the first tests you get when you come to an ER with heart attack symptoms. Echocardiogram: Using ultrasound (high-frequency sound waves), an echocardiogram generates a picture of the inside and outside of your heart. Angiogram: This test shows areas with little or no blood flow. Heart computed tomography (CT) scan: This creates a highly detailed scan of your heart. Heart MRI: This test uses a powerful magnetic field and computer processing to create an image of your heart. Nuclear heart scans: Similar to angiography, these scans use a radioactive dye injected into your blood. What sets them apart from an angiogram is that they use computer-enhanced methods like computed tomography (CT) or positron emission tomography (PET) scans. MANAGEMENT AND TREATMENT How are heart attacks treated? Treating a heart attack means restoring blood flow to the affected heart muscle as soon as possible. This can happen in a variety of ways, ranging from medication to surgery. It’s extremely likely that treatment will use several of the following methods. Supplementary oxygen People having trouble breathing or with low blood oxygen levels often receive supplementary oxygen along with other heart attack treatments. You can breathe the oxygen either through a tube that sits just below your nose or a mask that fits over your nose and mouth. This increases the amount of oxygen circulating in the blood and reduces the strain on your heart. Medications Anti-clotting medications: This includes aspirin and other blood-thinning medicines. Nitroglycerin: This medicine relieves chest pain and causes blood vessels to widen so blood can pass through more easily. Thrombolytic (clot-busting) medications: Providers use these only within the first 12 hours after a heart attack. Anti-arrhythmia medications: Heart attacks can often cause malfunctions in your heart’s normal beating rhythm called arrhythmias, which can be life-threatening. Anti-arrhythmia medications can stop or prevent these malfunctions. Pain medications: The most common pain medication given during heart attack care is morphine. This can help alleviate chest pain. Percutaneous coronary intervention Providers restore circulation to your affected heart muscle with a procedure called percutaneous coronary intervention (PCI). This uses a catheter-based device inserted into a major blood vessel (usually one near your upper thigh or your wrist). PCI is a critical tool in restoring blood flow, and the sooner that happens, the better the chance of a good outcome. Hospitals use a metric called “door-to-balloon time” to measure their ability to treat a heart attack. This is the average time it takes for people to undergo PCI after they first come into the Emergency Room. PCI often includes the placement of a stent at the site of the blockage to help hold the artery open so another blockage doesn’t happen in the same spot. Coronary artery bypass grafting People who have severe blockages of their coronary arteries may undergo coronary artery bypass grafting. This surgery is often called open-heart surgery, bypass surgery or CABG (the acronym is pronounced the same as “cabbage”). CABG involves using a blood vessel from elsewhere in your body (usually your chest, arm or leg) to construct a detour for blood. This reroutes blood around one or more blocked artery sections and brings blood to your heart muscle.