Heart Attack



Heart Attack

(Myocardial Infarction)

by Rosalyn Carson-DeWitt, MD

Definition

A heart attack occurs when blood flow to the heart muscle is interrupted. This deprives the heart muscle of oxygen, causing tissue damage or tissue death.

Heart Attack

[pic]

Copyright © 2005 Nucleus Communications, Inc. All rights reserved.

Causes

A heart attack may be caused by:

• Thickening of the walls of the arteries feeding the heart muscle (coronary arteries)

• Accumulation of fatty plaques in the coronary arteries

• Narrowing of the coronary arteries

• Spasm of the coronary arteries

• Development of a blood clot in the coronary arteries

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Sex: Male

• Increased age

• Obesity

• Smoking

• High blood pressure

• Sedentary lifestyle

• High blood cholesterol (specifically, high LDL cholesterol, and low HDL cholesterol)

• High blood triglycerides

• Diabetes

• Stress

• Family members with heart disease

Symptoms

Symptoms include:

• Squeezing, heavy chest pain, especially with:

o Exercise or exertion

o Emotional stress

o Cold weather

o A large meal

• Pain in the left shoulder, left arm, or jaw

• Shortness of breath

• Sweating, clammy skin

• Nausea

• Weakness

• Loss of consciousness

Unusual symptoms of heart attack (may occur more frequently in women):

• Stomach pain

• Back pain

• Confusion

• Fainting

Diagnosis

If you think you are having a heart attack, call 911 immediately. You need emergency medical care.

Tests may include:

Blood Tests – to look for certain substances found in the blood within hours or days after a heart attack. Blood tests will be repeated every 6-8 hours to track the progressive elevation of certain enzymes that indicate heart muscle damage.

Urine Tests – to look for certain substances found in the urine within hours or days after a heart attack

Electrocardiogram (EKG) – records the heart's activity by measuring electrical currents through the heart muscle. Certain abnormalities in the EKG occur when there is significant blockage of the coronary arteries and/or damage to the heart muscle. The EKG will be repeated to track the progression of these changes.

Echocardiogram – uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart

Stress Test – records the heart's electrical activity under increased physical demand

Thallium Stress Test – thallium is used to scan the myocardium, the middle layer of the heart

Nuclear Scanning – radioactive material is injected into a vein and observed as it is absorbed by the heart muscle

Electron-beam CT scan – a type of x-ray that uses a computer to make pictures of the heart and surrounding structures

Coronary Angiography – x-rays taken after a dye is injected into the arteries; to look for abnormalities in the arteries

Treatment

Treatment may include:

• Oxygen

• Pain-killing medications (such as morphine)

• Nitrate medications

• Atropine

• Beta-blocking and/or ACE inhibitor medications

• Anti-anxiety medications

• Clot-busting agents: within the first six hours after a heart attack, you may be given medications to break up blood clots in the coronary arteries. These include:

o Tissue plasminogen activator (tPA)

o Streptokinase

o APSAC

Surgery

Surgeries for people with severe blockages in their coronary arteries may include:

• Coronary bypass graft

• Atherectomy

• Balloon angioplasty with or without stenting

Physical or Rehabilitative Therapy

During recovery from a heart attack, you may need physical or rehabilitative therapy to help you regain your strength.

Psychotherapy or Antidepressant Medication

Some people have depression after suffering a heart attack. If you do, psychotherapy and/or antidepressant medications may help relieve depression.

Prevention

Preventing or treating coronary artery disease may help prevent a heart attack.

• Maintain a healthy weight.

• Begin a safe exercise program with the advice of your doctor.

• If you smoke, quit.

• Eat a healthful diet, one that is low in saturated fat and rich in whole grains, fruits, and vegetables.

• Appropriately treat high blood pressure and/or diabetes.

• Ask your doctor about taking a small, daily dose of aspirin. It has been shown to decrease the risk of heart attack.

• Ask your doctor about taking cholesterol-lowering medications.

• Ask your doctor about taking nitrate medications if you have angina due to coronary artery disease.

• Ask your doctor about taking medication to improve heart function or prevent future ehart attacks, such as:

o Beta-blockers

o ACE-inhibitors

o Platelet inhibiting drugs

o Digitalis-type drugs

RESOURCES:

American Academy of Family Physicians



American Heart Association



American Medical Association



References:

American Medical Association website. Available at: . Accessed October 7, 2005.

Meier MA, Al-Badr WH, Cooper JV, et al. The new definition of myocardial infarction: diagnostic and prognostic implications in patients with acute coronary syndromes. Arch Intern Med. 2002 Jul 22;162(14):1585-9.

Rakel RE and Bope ET. Conn's Current Therapy 2001, 53rd ed. Philadelphia, PA: W.B. Saunders Company; 2001.

What is a Heart Attack? American Heart Association website. Available at: . Accessed October 7, 2005.

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download