Myocardial Infarction Infarction (MI) (heart attack)
Abedin Mehmedovic MVCC SN
What is MI? A heart attack is when blood vessels that supply blood to the heart are blocked, preventing enough oxygen from getting to the heart. This causes the muscle to die.
Causes •
Smoking
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High LDL Cholesterol Levels
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High Blood Pressur Pressure e
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Diabetes
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Chronic Kidney Disease
Symptoms Chest pain is a major sympt symptom om of heart attack. You may feel the pain in only one part of your body, or it may move from your chest to your arms, shoulder, neck, teeth, jaw, belly area, or back. The pain can be severe or mild. • •
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A tight band around the chest Something heavy sitting on your chest Squeezing or heavy pressure
Symptoms Continued Chest pain is due to ischemia (a lack of blood and hence oxygen supply) to the heart muscle. Approximately one fourth of all myocardial infarctions are silent, without chest pain or other symptoms. These cases can be discovered later on electrocardiograms. This is called “silent heart attack”.
Symptoms Continued • • • • • •
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Anxiety Cough Fainting Light-headedness, dizziness Nausea or vomiting Palpitations (feeling like your heart is beating too fast or irregularly) Shortness of breath Sweating, which may be extreme.
If you experience any of these symptoms call 9-1-1. DO NOT attempt to drive to ER by your self as this may be unsafe for others.
Risk Factors Tobacco Use
Certain components of tobacco and tobacco combustion gases are known to damage blood vessel walls. The body's response to this type of injury elicits the formation of atherosclerosis atheroscler osis and its progression, thereby increasing the risk of MI.
Risk Factors Continued Hypertension High blood pressur p ressure e has consistently been associated with an increased risk of MI. This risk is associat associated ed with systolic and diastolic hypertension. The control of hypertension hypert ension with appropriat appropriate e medication has been shown to reduce the risk of MI significantly.
Risk Factors Continued Diabetes Mellitus Patients with diabetes have a substantially greater risk of atherosclerotic atherosc lerotic vascular disease in the heart as well as in other vascular beds. Diabetes increases the risk of MI because it increases the rate of atherosclerotic progression and adversely affects the lipid profile. This accelerated form of atherosclerosis occurs regardless of whether a patient has insulindependent or non –insulindependent diabetes.
Risk Factors Continued Hyperlipidemia
Elevated levels of total cholesterol, LDL, or triglycerides are associated with an increased risk of coronary atherosclerosis and MI. Levels of HDL less than 40 mg/dl also show an increased risk.
Risk Factors Continued Family History
A family history of premature coronary disease increases an individual's risk of atherosclerosis atheroscler osis and MI.
Diagnosis for MI Electrocardiogram (ECG)
An electrocardiogram is a recording of the electrical activity of the heart. Abnormalities in the electrical activity usually occur with heart attacks and can identify the areas of heart muscle that are deprived of oxygen and/or areas of muscle that have died.
Diagnosis of MI Continued Blood Tests
Cardiac enzymes are proteins that are released into the blood by dying heart muscles. These cardiac enzymes are creatine phosphokinase (CPK), and troponin, and their levels can be measured in blood. These cardiac enzymes typically are elevated in the blood several hours after the onset of a heart attack.
MI Medication Treatment Beta Blockers These medicines decrease the workload on your heart. Beta blockers also are used to relieve chest pain or discomfort and to help prevent additional heart attacks. Beta blockers also are used to correct irregular heartbeats.
MI Medication Treatment Continued ACE Inhibitors
These medicines lower blood pressure pressur e and reduce the strain on your heart. They also help slow down further weakening weak ening of the th e heart muscle.
MI Medication Treatment Continued Anticoagulants
These medicines thin the blood and preve prevent nt clots from forming forming in your arteries.
MI Medical Procedures Treatment Angioplasty During angioplasty, a thin, flexible tube with a balloon on the end is threaded through through a blood bloo d vessel to the blocked coronary artery. Then, the balloon is inflated to push the plaque against the wall of the artery. This widens the inside of the artery, restoring blood flow. Also a small mesh tube called a sten stentt may be put in the artery to help keep it open. Some stents are coated with medicines that help prev prevent ent the artery from becoming blocked again.
MI Medical Procedures Treatment Continued Coronary Artery Bypass Grafting (CABG) Coronary artery bypass grafting also known as “cabbage” is a surgery in which arteries or veins are taken from other areas of your body and sewn in place to go around the blocked coronary arteries. This provides a new route for blood flow to the heart muscle.
MI Prevention •
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Keep your blood pressure, blood sugar,, and sugar a nd cholesterol under un der control. Don't smoke. Consider drinking 1 to 2 glasses of wine each e ach day. day. Moderate Mod erate amounts of alcohol may reduce your risk of cardiovascular problems. However However,, drinking larger amounts does more harm than good. Eat a low-fat diet rich in fruits and vegetables and low in animal fat.
MI Prevention Continued •
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Eat fish twice a week. Baked or grilled fish is better than fried fish. Frying can destroy destro y some of the health benefits. Exercise daily or several times a week. Walking is a good form of exercise. Talk to your doctor before starting an exercise routine. Lose weight if you are overweight. If you have one or more risk factors for heart disease, talk to your doctor about possibly taking aspirin to help prevent a heart attack. It’s been shown that aspirin lowers a chance of MI for about 30%.
