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Heart Attack- Myocardial Infarction

by | Jul 20, 2023 | Info | 0 comments

 Heart Attack or Myocardial Infarction Overview

Heart attacks, also called myocardial infarction, are very common in the United States. In fact, one happens every 40 seconds, according to the Centers for Disease Control and Prevention (CDC).

A heart attack happens when there is a loss of blood supply to part of the heart muscle, often due to a blockage in a nearby artery. Symptoms include pain in the chest. It is a medical emergency that needs hospital treatment.

A person who is experiencing a heart attack or myocardial infarction, will feel pain in their chest and other parts of their body, as well as other symptoms.

Spotting the early signs of a heart attack and getting prompt treatment is crucial and can save a person’s life.

A heart attack is different from cardiac arrest, in which the heart stops working completely. Both are medical emergencies, and without treatment, a heart attack can lead to cardiac arrest.

Signs and Symptoms of a Heart Attack

As heart attacks can be fatal, it is crucial to recognize the warnings as soon as possible and contact emergency services.

Symptoms include the following:

  • A feeling of pressure, tightness, pain, squeezing, or aching in the chest
  • Pain that spreads to the arms, neck, jaw, or back
  • A feeling similar to heartburn or indigestion
  • Nausea and sometimes vomiting
  • A feeling of crushing or heaviness in the chest
  • Feeling clammy and sweaty
  • Shortness of breath
  • Feeling lightheaded or dizziness
  • in some cases, anxiety that can feel similar to a panic attack
  • Coughing or wheezing, if fluid builds up in the lungs

The symptoms can vary in their order and duration, they may last several days or come and go suddenly.

The following may also develop:

  • Hypoxemia: This involves low levels of oxygen in the blood.
  • Pulmonary edema: This involves fluid accumulating in and around the lungs.
  • Cardiogenic shock: This involves blood pressure dropping suddenly because the heart cannot supply enough blood for the rest of the body to work adequately.

Research suggests that women patients experience symptoms for several weeks before a heart attack.

A study published in 2003 of 515 women who had experienced a heart attack, reports 80 percent of women had at least 1 symptom at least 4 weeks before their heart attack.

Symptoms may be constant or come and go, and they may also disrupt sleep.

It is vital for a woman who experiences any of these symptoms to seek help immediately, as heart attacks can be fatal, regardless of whether symptoms are mild or severe.

Causes of a Heart Attack

The leading cause of heart attacks is coronary heart disease. This is where plaque builds up in the arteries that supply blood to the heart. The general buildup of plaque in the arteries is also known as atherosclerosis.

Following are the two main types of heart attack:

Type I heart attacks are where plaque on the inner wall of the artery ruptures and releases cholesterol and other substances into the bloodstream. This can then form a blood clot and block the artery.

In type II heart attacks the heart does not receive as much oxygen-rich blood as it needs, but there is not a complete blockage of an artery.

Other causes of heart attacks include:

  • Blood vessel spasms
  • Drug misuse
  • Hypoxia, lack of oxygen in the blood 
  • Torn blood vessels


Risk Factors of a Heart Attack

According to the AHA following factors can increase the risk of a heart attack:

Often, a heart attack results from a combination of factors.

In addition, the AHA report that Black Americans, Latinx Americans, Native Americans, Native Hawaiians, and some Asian Americans have increased risks of high blood pressure and dying of heart disease, compared with their white counterparts.

Patients with high blood pressure or a history of heart disease heart disease or cardiovascular disease also have an increased risk of a heart attack.

Diagnosis of a Heart Attack

Doctors typically diagnose a heart attack after they perform a physical exam and review your medical history. Your doctor will likely conduct an electrocardiogram (ECG) to check your heart’s electrical activity.

An echocardiogram, which uses sound waves to create an image of the heart’s chambers and valves, can reveal how blood is flowing through the heart and what parts of the heart, if any, have been damaged.

Your doctor may also order a cardiac catheterization. This is a probe inserted into the blood vessels through a flexible tube called a catheter. It allows your doctor to view areas in and around your heart where plaque may have built up. They can also inject dye into your arteries, order an X-ray to see how the blood flows, and view any blockages.

Your healthcare team will likely also take a sample of your blood or perform other tests to see if there’s evidence of heart muscle damage.

A commonly used blood test checks for levels of troponin T, a protein found in the heart muscle. Elevated levels of troponin T in the bloodstream is associated with a heart attack.

In the hospital, a doctor will ask about symptoms. When making a diagnosis and drawing up a treatment strategy, they will take into account the person’s:

  • Age
  • Daily history
  • Medical history
  • Overall health

They will also need to carry out tests, which include:

  • Blood tests, which can confirm that a heart attack has occurred
  • Cardiac catheterization, which enables a doctor to examine the inside of the heart 
  • Electrocardiography, to measure electrical activity in the heart 
  • Imaging tests, such as X-rays, CT scans, and echocardiograms


Treatment of a Heart Attack

If you’ve had a heart attack, your doctor may recommend a procedure (surgery or nonsurgical). These procedures can relieve pain and help prevent another heart attack from occurring.

Common procedures include:

  • Angioplasty: An angioplasty opens the blocked artery by using a balloon or by removing the plaque buildup. It’s important to note that healthcare professionals rarely use angioplasty alone anymore.
  • Heart bypass surgery: In a bypass surgery, a doctor reroutes the blood around the blockage.
  • Stent: A stent is a wire mesh tube surgeons insert into the artery to keep it open after angioplasty.
  • Heart valve surgery. In a valve repair replacement surgery, surgeons repair or replace leaky valves to help the heart pump.
  • Pacemaker: A pacemaker is a device implanted beneath the skin. It can help your heart maintain a normal rhythm.
  • Heart transplant. Surgeons may recommend a heart transplant in cases where a heart attack causes permanent tissue death to most of the heart.

Your doctor may also prescribe medications to treat your heart attack, including:

  • Aspirin
  • Beta-blockers
  • Blood-pressure medication
  • Anti-platelet and anticogulants, also known as blood thinners
  • Nitroglycerin
  • Other drugs to break up clots
  • Pain relievers

The timing of getting treatment is crucial with a heart attack. The sooner you get treatment after having a heart attack, the more quickly blood flow can be restored to the affected part of your heart, and the more successful the outcome is likely to be.

Heart Attack Emergency

A heart attack is life threatening and needs emergency attention. Nowadays, many people survive heart attacks, due to effective treatment. Delaying treatment, however, dramatically reduce the chances of survival.

Call 911 immediately

  • Be ready to explain what has happened and where you are.
  • Stay calm and follow all instructions from the emergency team.

While waiting for the team to arrive, talk to the person, and reassure them that help is on the way.

CPR

If the person stops breathing, take the following steps:

Do manual chest compressions:

  • Lock your fingers together and place the base of your hands in the center of the chest.
  • Position your shoulders over your hands, lock your elbows, and press hard and fast, at a rate of 100–120 compressions per minute. Press to a depth of 2 inches.
  • Continue these movements until the person starts to breathe or move, until someone else can take over, or until you are exhausted.
  • If possible, take turns without pausing the compressions.

Use an automatic external defibrillator (AED)

  • AEDs are available in shopping malls and many other public places.
  • An AED provides a shock that may restart the heart.
  • Remain calm and follow the instructions. Most newer AEDs talk you through the steps.

Medical Treatment

When the emergency team arrives, they will take over the person’s care.

Give the team as much detail as possible about the person’s health and what was happening before the event.

The team will try to stabilize the person’s condition, including providing oxygen.

In the hospital, a medical team will perform tests and provide appropriate treatment.

Many approaches can help, but three common options are:

  • Medications, including those to dissolve blood clots
  • Percutaneous coronary intervention, a mechanical method of restoring blood flow to any damaged tissue
  • Coronary artery bypass grafting, commonly called a heart bypass, diverts blood around damaged areas of the arteries to improve blood flow

The healthcare team will also work with the individual to develop a treatment plan designed to prevent future attacks.

Recovery

A heart attack can damage your heart muscles and impact their function. This can include changing your heart’s rhythm and reducing its ability to pump blood effectively to all the organs and tissues in your body.

Following a heart attack, it’s important to work with your healthcare team to design a recovery plan. This plan may include the following lifestyle changes:

  • Avoiding strenuous activities, especially shortly after the heart attack
  • Eating a nutrient-dense, balanced diet low in saturated and trans fats
  • Losing weight if you’re carrying extra weight
  • Monitoring your blood sugar levels closely if you have diabetes
  • Participating in light or moderate exercise, according to what your doctor approves
  • Taking steps to keep your blood pressure and cholesterol within a healthy range
  • Quitting smoking
  • Undergoing cardiac rehabilitation


Prevention of a Heart Attack

There are various ways to lower the risk of a heart attack. The American Heart Association advise people to make heart health a priority.

Ways to do this include:

  • Avoiding or quitting smoking
  • Getting regular exercise
  • Having a balanced, healthful diet
  • Managing diabetes, high cholesterol levels, high blood pressure, and other conditions
  • Limiting alcohol intake
  • Maintaining a healthy body weight
  • Whenever possible, avoiding stress or practicing ways to reduce it

Knowing the symptoms of a heart attack can help a person get prompt treatment, and this increases the chances of a positive outcome.

Complications of a Heart Attack

Heart attacks can result in various complications. When a heart attack occurs, it can disrupt your heart’s normal rhythm, potentially stopping it altogether. These abnormal rhythms are known as arrhythmias.

When your heart stops getting a supply of blood during a heart attack, some of the heart tissue can die. This can weaken your heart and cause serious complications such as heart failure.

Heart attacks can also affect your heart valves and cause leaks.

The long-term effects on your heart will be determined by how much time it takes to receive medical treatment and how much of your heart has been damaged from the heart attack.

Depending on how severe the event was, complications may include the following:

  • Arrhythmia: The heart beats irregularly, either too fast or too slowly.
  • Angina: Insufficient oxygen reaches the heart, causing chest pain.
    Aneurysm: Scar tissue builds up on the damaged heart wall, which causes thinning and stretching of the heart muscle, eventually forming a sac. This can also lead to blood clots.
  • Depression: This is common after a heart attack, and engaging with loved ones and support groups can help.
  • Edema: Fluid accumulates and causes swelling in the ankles and legs.
  •  Heart failure: The heart can no longer pump effectively, leading to fatigue, difficulty breathing, and edema.
  • Myocardial rupture: This is a tear in a part of the heart, due to damage caused by a heart attack.

Ongoing treatment and monitoring can help reduce the risk of these complications.

Outlook

A heart attack can be life threatening and needs immediate medical attention.

Key warnings include pain and tightness in the chest, pain in other parts of the body, and difficulty breathing.

If anyone has symptoms of a heart attack, someone should call 911 at once. With prompt treatment, there is often a good chance of a positive outcome.

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