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Myocardial 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 High LDL Cholesterol Levels High Blood Pressure Diabetes Chronic Kidney Disease

Symptoms
Chest pain is a major symptom 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.
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
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 and its progression, thereby increasing the risk of MI.

Risk Factors Continued


Hypertension High blood pressure has consistently been associated with an increased risk of MI. This risk is associated with systolic and diastolic hypertension. The control of hypertension with appropriate 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 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 noninsulindependent 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 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 and reduce the strain on your heart. They also help slow down further weakening of the heart muscle.

MI Medication Treatment Continued


Anticoagulants These medicines thin the blood and prevent clots from forming in your arteries.

MI Medical Procedures Treatment


Angioplasty During angioplasty, a thin, flexible tube with a balloon on the end is threaded through a blood 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 stent may be put in the artery to help keep it open. Some stents are coated with medicines that help prevent 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
Keep your blood pressure, blood sugar, and cholesterol under control. Don't smoke. Consider drinking 1 to 2 glasses of wine each day. Moderate amounts of alcohol may reduce your risk of cardiovascular problems. 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
Eat fish twice a week. Baked or grilled fish is better than fried fish. Frying can destroy 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. Its been shown that aspirin lowers a chance of MI for about 30%.