MYOCARDIAL INFARCTION

Myocardial Infarction General Information

Myocardial Infarction or MI has a more common name, heart attack, and it is caused when a part of the heart does not receive a blood supply. This interruption is due to a vulnerable plaque that has been broken. The myocardium is the heart muscle and the infarction is the death of the tissue because the shortage of oxygen reaching it. The result is the death of the heart tissue or sometimes a simply damaged caused by the diminution of the oxygen quantity and ischemia, which is one of the diseases that usually lead to death (13% of deaths on the globe, especially in the developed countries, are because of this presentation of ischemic heart illness) and represents a medical emergency, requiring immediate hospitalization and close surveillance. The risk factors (the same for atherosclerosis) are usually vascular disease, including angina, atherosclerotic coronary heart disease, a stroke, abnormal heart rhythms (especially among women over 45 years old and men over 50 years old, depending so very much of the age), the lifestyle (living in a permanent high stress, the consumption of alcohol in excess, smoking and the abuse of drugs), diabetes, obesity (a body mass index of more than 20 Kg/m3), high blood pressure, a low high density lipoprotein (HDL) and a high low density lipoprotein (LDL). The heart attack is sometimes seen as a sudden cardiac death. The acute type of this heart disease is the type of a serious coronary syndrome (a manifestation of coronary artery disease).

Myocardial Infarction Symptoms

One of three patients does not present any of the symptoms, having a silent Myocardial Infarction. They discover the disease at an autopsy or after a regular check on electrocardiograms without any suspicions. This type of Myocardial Infarction is more specific among patients who had a heart transplant (may be because the heart is not well connected to the nerves of the body-host), with diabetes mellitus and in elder patients. The psychological factors, the autonomic neuropathy and the pain threshold are possibilities why the diabetics do not have the regular symptoms for this heart disease. The symptoms appear suddenly, giving you no time to call for help if you are alone somewhere. The general manifestations consist in difficulty and shortness in breathing, palpitations, pain in the chest that usually are also felt in the left arm, nausea, sweating, anxiety and vomiting. They appear over a couple of minutes, but more intense and painful. In women, the symptoms may vary from those of the men and this illness can cause more sleep irregularities, tiredness, weakness and dyspnea. The chest pain is not that strong or obvious. In their case, the signs may appear at least one month before the actual disease. The dyspnea leads to a failure of the left ventricle and can cause some other effects such as loss of consciousness, palpitations, an excessive form of sweating (diaphoresis) and light-headedness.

Myocardial Infarction Treatment

Any heart attacks demand special and immediate attention and an emergency medical treatment because the primary target of a specialist is to prevent further complications of this disease and save the heart muscles. Every second counts; after a second the risk of a major damage to the myocardium could get bigger. Before arriving to the hospital, nitroglycerin (glyceryl trinitrate), analgesia, for example, morphine, oxygen and aspirin should be administrated as soon as possible to the patient. Morphine is used drug because it dilates the blood vessels ensuring the normal circulation to the heart and relieves the pain. From all these, only the aspirin apparently minimizes the risk dying. After the cardiologist or an emergency room physician confirms the Myocardial Infarction, some pharmacologic agents, used independent from the reperfusion (heparin, anticoagulation, clopidogrel, an additional antiplatelet and beta blockers) are prescribed to the patient. These agents minimize the risk of death, preventing an acute Myocardial Infection, but at the same time, if they are not used properly, because of them the patient can develop some complications that can also lead to death. A central modern treatment for the Myocardial Infarction is the reperfusion. Those people who are suspected of a new fascicle branch block on the 10 lead ECG or of an acute Myocardial Infarction may have an occlusive in the epicardial coronary artery. They need a pressing reperfusion accompanied by PCI (percutaneous coronary intervention) or by thrombolytic therapy and if these do not end successfully, a bypass surgery is the last solution, even if it is not that common as the rest. After a Myocardial Infarction, one could develop cardiogenic shock. This form of rehabilitation has benefic effects on the mood, stress, weight, blood pressure and cholesterol levels. Some consider making physical exercises a real risk because another infarct might appear. But it is better if the amount of activity it is dosed to each patient depending on his possibilities by a specialist. The treatments may have a negative aspect because they can also produce other problems to the patient. Instead of amelioration, trying to restore the blood flow after a short critical period, a reperfusion injury could get installed. Other complications could appear after using antithrombotics, causing serious bleeding. Even if the Myocardial Infarction is cured, the risk to reappearance is still big depending on the style of life each person has.