Myocardial Infarction (MI)(heart attack)

Abedin MehmedovicMVCC 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 FactorsTobacco 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 ContinuedHypertension

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 ContinuedDiabetes 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 insulin-dependent or non–insulin-

dependent diabetes.

Risk Factors ContinuedHyperlipidemia

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 HistoryA family history of

premature coronary disease increases an

individual's risk of atherosclerosis and MI.

Diagnosis for MIElectrocardiogram (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 ContinuedBlood 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 TreatmentBeta 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 InhibitorsThese 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

AnticoagulantsThese medicines thin the blood and prevent clots

from forming in your arteries.

MI Medical Procedures Treatment

AngioplastyDuring 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.

• It’s been shown that aspirin lowers a chance of MI for about 30%.