Myocardial infarction: Difference between revisions
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A '''myocardial infarction''', also and commonly called a '''heart attack''', happens when a [[blood vessel]] in the [[heart]] suddenly becomes blocked. Blood vessels carry [[blood]] and [[oxygen]]. When a blood vessel in the heart gets blocked, blood cannot get to part of the [[heart]]. This part of the heart does not get enough oxygen. This is called [[Ischaemia|ischemia]]. When the heart muscle becomes ischemic (does not get enough blood and oxygen), the ischemia often causes chest pain. This is called [[angina pectoris|Angina Pectoris]]. If the ischemia lasts long enough, the heart muscle that is not getting enough oxygen dies. This is called an [[infarction]]. "[[Myocardium|Myocardial]] infarction" means "infarction (muscle death) in the heart muscle."
A heart attack is a [[medical emergency]]. The first few minutes are very important for keeping the person alive. Some of the damage from the heart attack can be repaired if the person gets treatment
== Causes ==
Most heart attacks are caused by [[coronary heart disease|Coronary Artery Disease]] (CAD). In coronary artery disease, a [[wax]]-like material called [[atheroma|plaque]] builds up on the inside walls of arteries in the heart. This is called [[atherosclerosis]]. Plaque is made of [[cholesterol]] and other [[cell]]s. The amount of plaque increases slowly. As more plaque builds up, the insides of the heart's blood vessels get narrower. This means that less blood can flow through the blood vessels. This can cause [[platelet]]s (which make the [[Clot|blood clot]]) to build up in front of the plaque. This causes a blood clot in the blood vessel. If the clot breaks free and gets stuck in part of the blood vessel made narrower by the plaque, the plaque and the clot together block the blood vessel completely. This makes it impossible for blood to get to part of the heart, and causes a heart attack.
A person can lower their chances of getting coronary artery disease by eating [[Healthy diet|healthy]] foods, [[Physical exercise|exercising]], not smoking cigarettes, and not drinking too much [[alcohol]].<ref>{{Cite journal|last1=McNeal|first1=Catherine J.|last2=Dajani|first2=Tala|last3=Wilson|first3=Don|last4=Cassidy-Bushrow|first4=Andrea E.|last5=Dickerson|first5=Justin B.|last6=Ory|first6=Marcia|date=2010-01-01|title=Hypercholesterolemia in Youth: Opportunities and Obstacles to Prevent Premature Atherosclerotic Cardiovascular Disease|url=https://doi.org/10.1007/s11883-009-0072-0|journal=Current Atherosclerosis Reports|language=en|volume=12|issue=1|pages=20–28|doi=10.1007/s11883-009-0072-0|pmid=20425267 |s2cid=37833889 |issn=1534-6242}}</ref><ref>{{Cite journal|last1=McGill|first1=Henry C.|last2=McMahan|first2=C. Alex|last3=Gidding|first3=Samuel S.|date=2008-03-04|title=Preventing Heart Disease in the 21st Century|url=https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.107.717033|journal=Circulation|volume=117|issue=9|pages=1216–1227|doi=10.1161/CIRCULATIONAHA.107.717033|pmid=18316498 |s2cid=13115938 }}</ref>
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[[File:Heart attack warning signs-women.PNG|thumb|left|<center>''Heart attack<br>(''myocardial infarction'')<br> Warning signs in women.''</center>]]
[[File:Coronary heart disease.PNG|thumb|'''Coronary heart disease''': Plaque builds up in blood vessels in the heart making them narrow, '''Heart attack:''' here, a blood clot suddenly gets stuck in one of the narrow blood vessels.]]
Signs that a person is having a heart attack show over several minutes, and [[wikt:rare|rare]]ly come immediately. Most people having a heart attack have chest pain. Sometimes, people also have pain in the left [[arm]], the lower [[jaw]], the [[neck]], the right arm, the back, or in parts of the [[abdomen]]. Heart attacks cause increased [[troponin]].
Many women have different symptoms than men. The most common symptoms include
Sometimes, people have "silent heart attacks." These are heart attacks that do not cause any pain. They are more common in [[Old age|elderly]] people, women, and people with [[Diabetes mellitus|diabetes]]. In these people, suddenly feeling very tired, or [[Syncope|fainting]], may be the only sign of a heart attack.
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Doctors or [[paramedic]]s usually start certain treatments as soon as a heart attack is suspected. These treatments include:<ref name=HeartLung>[http://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/treatment How is a heart attack treated?]. National Heart, Lung, and Blood Association. Retrieved November 26, 2015.</ref>
* ''[[Aspirin]].'' Aspirin is an early and important treatment for a heart attack. Aspirin keeps platelets from sticking together, and can help prevent more blood clots from forming inside the blood vessels and the heart. Chewing an asprin tablet in the early sages of a heart attack may be helpeful
* ''[[Nitroglycerin]]'' ''(nitro).'' Nitro [[Vasodilation|widens the blood vessels]] in the heart. This makes it easier for blood to flow through those vessels to the heart.
* ''Oxygen (if needed).'' If the patient is having trouble breathing, oxygen can be given.
* ''Pain medicine for chest pain (if needed).''
Once doctors are sure that a person is having a heart attack, there are two main treatments: "clot-busting medicines" ([[Thrombolytic|thrombolytics]]) and percutaneous coronary intervention.<ref name=HeartLung/>
Prevention methods also include no smoking, increase in physical activity, a healthy, low saturated and low cholesterol diet, and minimal to no alcohol beverage intake. Secondary prevention may include additional rehabilitation and physical activity participation. Regularly and actively participating in physical activity can reduce the risk of a heart attack recurring by 34% and increase overall health, when comparing the highest activity group to the lowest. <ref>{{Cite web|title=More physical activity before a heart attack may reduce risk for a second one|url=https://www.heart.org/en/news/2022/11/08/more-physical-activity-before-a-heart-attack-may-reduce-risk-for-a-second-one#:~:text=After%20a%20median%20follow-up,in%20the%20lowest%20activity%20group.|access-date=2024-11-23|website=www.heart.org|language=en}}</ref>
=== Clot busters ===
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If a person is having trouble breathing, sitting straight up can help. The person should follow any instructions they get from the emergency operator or their doctor.
== Related pages ==
*[[Aspirin|Asprin]]
*[[Obesity]]
*[[Troponin]]
== References ==
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