Alternate Names : Acute MI, MI, Myocardial Infarction
Definition
A heart attack (myocardial infarction) occurs when an area of heart muscle dies or is permanently damaged because of an inadequate supply of oxygen to that area
Heart Attack Symptoms & Signs
Chest pain behind the sternum (breastbone) is a major symptom of heart attack, but in many cases the pain may be subtle or even completely absent (called a "silent heart attack"), especially in the elderly and diabetics. Often, the pain radiates from your chest to your arms or shoulder; neck, teeth, or jaw; abdomen or back. Sometimes, the pain is only felt in one these other locations
The pain typically lasts longer than 20 minutes and is generally not fully relieved by rest or nitrioglycerine, both of which can clear pain from angina
The pain can be intense and severe or quite subtle and confusing. It can feel like
Squeezing or heavy pressure
A tight band on the chest
Bad indigestion
Other symptoms you may have either alone or along with chest pain include
Shortness of breath
Cough
Lightheadedness - dizziness
Fainting
Nausea or vomiting
Sweating, which may be profuse
Feeling of - impending doom
Anxiety
Heart Attack Diagnosis & Tests
During a physical examination, the doctor will usually note a rapid pulse. Blood pressure may be normal, high, or low. While listening to the chest with a stethoscope, the doctor may hear crackles in the lungs, a heart murmur, or other abnormal sounds.
The following tests may reveal a heart attack and the extent of heart damage
Electrocardiogram (ECG) -- single or repeated over several hours
Echocardiography
Coronary angiography
Nuclear ventriculography - MUGA or RNV
The following tests may show the by-products of heart damage and factors indicating you have a high risk for heart attack
Troponin I and troponin T
CK and CK-MB
Serum myoglobin
Heart Attack Treatment
A heart attack is a medical emergency! Hospitalization is required and, possibly, intensive care. Continuous ECG monitoring is started immediately, because life-threatening arrhythmias are the leading cause of death in the first few hours of a heart attack.
The goals of treatment are to stop the progression of the heart attack, to reduce the demands on the heart so that it can heal, and to prevent complications.
An intravenous line will be inserted to administer medications and fluids. Various monitoring devices may be necessary. A urinary catheter may be inserted to closely monitor fluid status.
Oxygen is usually given, even if blood oxygen levels are normal. This makes oxygen readily available to the tissues of the body and reduces the workload of the heart.
PAIN CONTROL MEDICATIONS
Sublingual (under the tongue) or intravenous (IV) nitrates such as nitroglycerin are given to reduce the oxygen requirements of the heart. Morphine or morphine derivatives are potent pain killers that may also be given for a heart attack.
OTHER MEDICATIONS
Beta-blockers (like metoprolol, atenolol, and propranolol) are used to reduce the workload of the heart
ACE Inhibitors (like ramipril, lisinopril, enalapril, or captopril) to prevent heart failure
Heart Attack Prevention
Control your blood pressure
Control total cholesterol levels. To help with cholesterol control, your doctor may prescribe a medication of the statins group - atorvastatin, simvastati
Stop smoking if you smoke
Eat a low fat diet rich in fruits and vegetables and low in animal fat
Control diabetes
Lose weight if you are overweight
Exercise daily or several times a week by walking and other exercises to improve heart fitness
Heart Attack Complications
Arrhythmias such as ventricular tachycardia, ventricular fibrillation, heart blocks
Congestive heart failure
Cardiogenic shock
Infarct extension: extension of the amount of affected heart tissue
Pericarditis - infection around the lining of the heart
Pulmonary embolism - blood clot in the lungs
Complications of treatment - For example, thrombolytic agents increases the risk of bleeding
الخميس 18 سبتمبر - 21:12