Myocardial Infarction

Myocardial infarction (MI) or heart attack is one of the leading causes of death in both men and women. MI occurs when the coronary arteries (blood vessels that supply blood to the heart) get narrowed or blocked. This blockage deprives the heart of blood and oxygen causing damage to the heart muscle.

Causes and risks

Atherosclerosis is the most common cause for the narrowing of the arteries. It is a condition in which fatty material called plaque builds up in the walls of your coronary arteries. The plaque can rupture exposing the fatty material within the plaque. This process promotes accumulation of platelets (clotting component of blood) at the site which can form blood clots that may further narrow the arteries and block the flow of blood.

Risk factors for heart attack that can be controlled include high blood pressure, high blood cholesterol, smoking, obesity, high blood sugar, physically inactivity, and stress. Uncontrollable risk factors are not under your control and include older age, family history of early heart disease, pre-existing heart disease and post-menopausal symptoms.

Symptoms

The most common symptom of a heart attack is chest pain, which usually lasts for more than 20 minutes and can be:

• Severe or mild
• In only one part of your body

• Fullness or squeezing sensation in the middle of the chest
• Tightness around the chest
• Feeling of a heavy weight over your chest
• Pain may radiate from your chest to your arms, shoulder, neck, teeth, jaw, belly area, or back

• Like severe indigestion

Other symptoms include anxiety, fainting, coughing, nausea, vomiting, shortness of breath, light-headedness, dizziness, and heavy sweating. Heart attack needs immediate medical care, so identifying the symptoms is of utmost importance.

Diagnosis

Heart attack is diagnosed based on your signs and symptoms, medical and family histories, and other diagnostic tests such as:

• Electrocardiogram (EKG or ECG): measures electrical activity of the heart
• Blood Tests: assesses for presence of certain proteins released upon death of heart muscle
• Coronary angiography: used to check for blockage of blood flow by inserting a thin flexible tube called a catheter into the coronary arteries and injecting a dye into the bloodstream, which is captured by X-ray images

First aid

Heart attack is a medical emergency which requires immediate first aid to increase the chances of recovery and lessen damage to the heart muscle. First aid treatment includes the following:

• Call your local emergency number immediately if you suspect a heart attack and follow the dispatchers' instructions.
• Stay with the person and have them lie down, rest, and remain calm.
• Loosen any tight clothing.
• Have the person chew an aspirin unless they are under 18 or they have been told by their physician to never take aspirin.
• If the person has emergency chest pain medications such as nitro-glycerine help them place the medicine under their tongue.
• If the person becomes unconscious, make sure they are lying on their back. Maintain a clear airway and check for breathing and a pulse.
• If the person has stopped breathing and there is no pulse, begin cardiopulmonary resuscitation (CPR)

Treatment

Once a heart attack is confirmed by medical personnel, treatments to restore blood flow to the heart are started immediately. Medicines may be given to dissolve blood clots, decrease the workload on the heart and thin the blood to prevent formation of blood clots in the arteries. Other medical procedures may be conducted:

• Coronary angioplasty (percutaneous coronary intervention or PCI) is a non-surgical procedure performed to open narrowed or blocked coronary blood vessels. A thin, flexible tube with a balloon on the end is guided to the blockage, which is inflated to compress the blockage against the inside wall of your artery. This opens the artery and restores blood flow to the heart muscle.

• Coronary artery bypass grafting (CABG) a surgical procedure in which a healthy artery or vein taken from another part of the body is used to bypass the blocked coronary arteries.

Prevention

Certain life style modifications can help you to lower your risk for developing heart disease and heart attack:

• Healthy diet choices: Eat a low fat, low salt, low cholesterol diet
• Do not smoke
• Exercise regularly
• Lose weight because being overweight puts excess strain on your heart
• Treat related conditions such as high cholesterol, high blood pressure, and diabetes
• Have regular health screening and follow your doctor's advice