Myocardial infarction

Overview

Myocardial infarction, also known as a heart attack, occurs when the blood supply to the heart is significantly decreased or blocked. The accumulation of fat, cholesterol, and other chemicals in the heart’s (coronary) arteries is what causes the obstruction.

Plaques are the name given to the fatty, cholesterol-containing deposits. Atherosclerosis is the name for the process of plaque accumulation. A plaque may occasionally burst and generate a clot that restricts blood flow. Part of the heart muscle can be harmed or destroyed by a lack of blood flow.

To avoid mortality, a heart attack requires prompt treatment. If you believe you could be having a heart attack, call for emergency help right away.

Symptoms

Heart attack symptoms can vary, from none, to mild and serious. Typical heart attack signs include:

• Pain in the chest that may feel like pressure, tightness, discomfort, squeezing or hurting
• Dizziness that suddenly occurs
• Lightheadedness
• Nausea
• Shortness of breath
• Cold sweat
• Fatigue
• Heartburn or indigestion
• Discomfort or pain that radiates to the shoulder, arm, back, neck, jaw, teeth, or even the upper abdomen.

Atypical symptoms in women can include back, arm, or neck discomfort that is sudden. Sudden cardiac arrest can occasionally be the initial indication of a heart attack.

Heart attacks can happen suddenly. However, many people have warning symptoms and signals hours, days, or even weeks in advance. A brief reduction in the amount of blood flowing to the heart is what causes angina. An early warning sign of angina is persistent chest pressure or pain that does not go away with rest.

Consult a doctor if you think you are experiencing a heart attack, get immediate medical attention. Do the following:

• Request immediate medical assistance. Call for emergency help as soon as you suspect a heart attack. Have someone transport you to the closest hospital if you do not have access to emergency medical care.
• Take nitroglycerin if a doctor has advised it for you. While awaiting assistance, take it as directed.
• If aspirin is advised, take it. By inhibiting blood clotting, aspirin use during a heart attack may lessen cardiac damage.

Aspirin and other medications can interact. If neither your healthcare physician nor emergency medical personnel advise it, do not take an aspirin. Call for emergency help immediately after taking an aspirin. Make an urgent call for assistance.

What to do if you spot a potential heart attack victim
Call your emergency number first if you believe someone is experiencing a heart attack while they are unconscious. Next, make sure the individual is breathing and has a pulse. Only then should you start performing CPR if the victim is not breathing or you cannot feel their pulse.

• If you do not have any CPR training, perform hands-only CPR. This implies quick and forceful compressions to the person’s chest at a rate of 100 to 120 compressions per minute.
• If you have had CPR training and feel competent in this area, begin with 30 chest compressions before administering two rescue breaths.

Causes

Most heart attacks are brought on by coronary artery disease. One or more of the heart’s (coronary) arteries are clogged in coronary artery disease. Plaques, which are cholesterol-containing deposits, are typically the cause for this. Plaques can cause artery narrowing, which reduce heart blood flow and may rupture resulting in a cardiac blood clot.

A cardiac (coronary) artery blockage may be fully or partially responsible for a heart attack. If an electrocardiogram (ECG or EKG) reveals any specific changes (ST elevation) which need urgent invasive treatment, that electrocardiogram can be used to identify heart attacks. ECG readings may be used by your doctor to describe these kinds of heart attacks.

• Complete blockage. An ST elevation myocardial infarction (STEMI) is typically indicated by an immediate full blockage of a medium or large heart artery.
• Partial blockage. A partial blockage frequently indicates that you have experienced a Non-ST Elevation Myocardial Infarction (NSTEMI). However, a complete blockage can occur in some NSTEMI patients.

Blocked arteries are not the only reason for heart attacks. Additional factors include:

• Coronary artery spasm. This is a condition where coronary artery severely constricted but not blocked and has cholesterol plaques or has early vascular hardening from smoking or other risk factors. Prinzmetal’s angina, vasospastic angina, or variant angina are other names for coronary artery spasms.
• Some infections. Viral infections like COVID-19 and others can harm the heart muscle.
• Spontaneous coronary artery dissection (SCAD). This potentially fatal illness is brought on by a tear inside a cardiac artery.

Risk factors

These are the risk factors that may lead to heart attack:

• Age: Elderly men and women are more likely to get a heart attack.
• Using tobacco: This covers both smoking and prolonged passive smoking exposure.
• High blood pressure: The arteries leading to the heart might become damaged over time by excessive blood pressure. The risk is much higher when high blood pressure coexists with other diseases such as diabetes, high cholesterol, or obesity.
• High cholesterol or triglycerides: Such as a high level of Low-Density Lipoprotein (LDL) cholesterol, also known as “bad” cholesterol. The risk of heart attack is also increased by excessive triglyceride levels in the blood. If your High-Density Lipoprotein (HDL) cholesterol, or “good” cholesterol, levels are within the normal range, your chance of having a heart attack may decrease.
• Obesity. Diabetes, high triglyceride and bad cholesterol levels, and low good cholesterol levels are all associated with obesity.
• Diabetes. When the body cannot properly use the hormone insulin or does not produce enough of it, blood sugar levels increase. Heart attacks are more likely to occur when blood sugar levels are high.
• Metabolic syndrome. Having central obesity, high blood pressure, low good cholesterol, high triglycerides, and high blood sugar are all contributing factors.
• Family history of heart attacks. You may be at higher risk if a sibling, parent, grandparent, or parent had a heart attack before age 55 for men and 65 for women.
• Less exercise. More likely to occur in people who lead sedentary lifestyles and lack of physical activity. Heart health is improved by regular exercise.
• Unhealthy diet. Heart attacks are more likely to occur in people who consume a diet rich in sweets, animal fats, processed foods, trans fats, and salt. Physician usually advise to consume lots of fruits, veggies, fiber, and good fats.
• Stress. Extreme emotional stress, including rage, can raise your risk of having a heart attack.
• Using illegal drugs. Stimulants include cocaine and amphetamines may result in a heart attack by causing a coronary artery spasm.
• Preeclampsia history. During pregnancy, this syndrome raises blood pressure which causes a long-term risk of heart disease.
• Autoimmune disease. A heart attack risk increase as you have lupus or rheumatoid arthritis.