field_of_work frank matthews 
The verb license or grant license means to give permission . The noun licence ( British , Indian , Canadian , Australian , New Zealand , Irish , or South African ___MASK13___ ) or license ( American ___MASK13___ ) refers to that permission as well as to the document recording that permission . The blood  brain barrier ( BBB ) is a highly selective semipermeable membrane barrier that separates the circulating blood from the brain extracellular fluid in the central nervous system ( CNS ). The blood  brain barrier is formed by brain endothelial cells , which are connected by tight junctions . The blood  brain barrier allows the passage of water , some gases , and lipid - soluble molecules by passive diffusion , as well as the selective ___MASK84___ of molecules such as glucose and amino acids that are crucial to neural function . Furthermore , it prevents the entry of lipophilic potential neurotoxins by way of an active ___MASK84___ mechanism mediated by P - glycoprotein . Astrocytes have been claimed to be necessary to create the blood  brain barrier . A few regions in the brain , including the circumventricular organs , do not have a blood  brain barrier . The Single Convention on Narcotic Drugs of 1961 is an international treaty to prohibit ___MASK91___ and supply of specific ( nominally narcotic ) drugs and of drugs with similar effects except under licence for specific purposes , such as medical treatment and research . As noted below , its major effects included updating the Paris Convention of 13 July 1931 to include the vast number of synthetic opioids invented in the intervening thirty years and a mechanism for more easily including new ones . From 1931 to 1961 , most of the families of synthetic opioids had been developed , including drugs in whatever way related to methadone , pethidine , morphinans and dextromoramide and related drugs ; research on fentanyls and piritramide was also nearing fruition at that point . Frank `` Black Caesar '' Matthews ( born February 13 , 1944 ) is a major heroin and cocaine trafficker who operated throughout the eastern seaboard during the late 1960s and early 1970s . At the peak of his career he operated in 21 states and supplied major dealers throughout every region of the country . Although there is more attention paid to other drug kingpins of the era , Frank Matthews is said by the DEA to be one of the most significant traffickers of the time . He led a flamboyant lifestyle , with large sable mink coats , prime seats at major sporting events , luxury vehicles , and regular trips to Las Vegas where he was treated like a king . Matthews would also become known for hosting a major African - American drug dealers `` summit '' in Atlanta in 1971 . The attendee list , gathered by DEA surveillance , was a who ' s who of most major African - American and Hispanic dealers throughout the country ; they were all there to discuss how to break the Italian Mafia ' s control of heroin importation so that blacks would not have to rely on them for survival in the future . ___MASK17___ ( Pashto / Dari : , " Afnistn "), officially the Islamic Republic of ___MASK17___ , is a landlocked country located within South ___MASK31___ and Central ___MASK31___ . It has a population of approximately 32 million , making it the 42nd most populous country in the world . It is bordered by Pakistan in the south and east ; Iran in the west ; Turkmenistan , Uzbekistan , and Tajikistan in the north ; and China in the far northeast . Its territory covers , making it the 41st largest country in the world . Opiates are alkaloid compounds naturally found in the opium poppy ___MASK88___ " Papaver somniferum ". The psychoactive compounds found in the opium ___MASK88___ include morphine , codeine , and thebaine . The term " opiate " should be differentiated from the broader term " opioid ," which includes all drugs with morphine - like effects , including opiates , semi - synthetic opioids derived from opiates ( such as heroin , hydrocodone , hydromorphone , oxycodone , and oxymorphone ), and synthetic opioids which are not derived from opiates ( such as fentanyl , buprenorphine , and methadone ). All opioids , including the opiates , are considered drugs of high abuse potential and are listed on various " Substance - Control Schedules " under the Uniform Controlled Substances Act of the United States . Epinephrine , also known as adrenalin or adrenaline , is a hormone , neurotransmitter and medication . Epinephrine is normally produced by both the adrenal glands and certain neurons . It plays an important role in the fight - or - flight response by increasing blood flow to muscles , output of the heart , pupil dilation , and blood sugar . Epinephrine does this by its effects on alpha and beta receptors . It is found in many animals and some one cell organisms . Jokichi Takamine first isolated epinephrine in 1901 . As a medication it is used to treat a number of conditions , including anaphylaxis , cardiac arrest , and superficial bleeding . Inhaled epinephrine may be used to improve the symptoms of croup . It may also be used for asthma when other treatments are not effective . It is given intravenously , by injection into a muscle , by inhalation , or by injection just under the skin . Common side effects include shakiness , anxiety , and sweating . A fast heart rate and high blood pressure may occur . Occasionally it may result in an abnormal heart rhythm . While the ___MASK89___ of its use during pregnancy and breastfeeding is unclear , the benefits to the mother must be taken into account . Stroke is when poor blood flow to the brain results in cell death . There are two main types of stroke : ischemic , due to lack of blood flow , and hemorrhagic , due to bleeding . They result in part of the brain not functioning properly . Signs and symptoms of a stroke may include an inability to move or feel on one side of the body , problems understanding or speaking , feeling like the world is spinning , or loss of vision to one side . Signs and symptoms often appear soon after the stroke has occurred . If symptoms last less than one or two hours it is known as a transient ischemic attack ( TIA ) or mini - stroke . A hemorrhagic stroke may also be associated with a severe headache . The symptoms of a stroke can be permanent . Long - term complications may include pneumonia or loss of bladder control . The main risk factor for stroke is high blood pressure . Other risk factors include tobacco smoking , ___MASK65___ , high blood cholesterol , ___MASK66___ mellitus , previous TIA , and atrial fibrillation . An ischemic stroke is typically caused by blockage of a blood vessel , though there are also less common causes . A hemorrhagic stroke is caused by either bleeding directly into the brain or into the space between the brain ' s membranes . Bleeding may occur due to a ruptured brain aneurysm . Diagnosis is typically with medical imaging such as a CT scan or magnetic resonance imaging ( MRI ) scan along with a physical exam . Other tests such as an electrocardiogram ( ECG ) and blood tests are done to determine risk factors and rule out other possible causes . Low blood sugar may cause similar symptoms . Prevention includes decreasing risk factors , as well as possibly aspirin , statins , surgery to open up the arteries to the brain in those with problematic narrowing , and warfarin in those with atrial fibrillation . A stroke or TIA often requires emergency care . An ischemic stroke , if detected within three to four and half hours , may be treatable with a medication that can break down the clot . Aspirin should be used . Some hemorrhagic strokes benefit from surgery . Treatment to try recover lost function is called stroke ___MASK59___ and ideally takes place in a stroke unit ; however , these are not available in much of the world . In 2013 approximately 6 . 9 million people had an ischemic stroke and 3 . 4 million people had a hemorrhagic stroke . In 2010 there were about 33 million people who had previously had a stroke and were still alive . Between 1990 and 2010 the number of strokes which occurred each year decreased by approximately 10 % in the developed world and increased by 10 % in the developing world . In 2013 , stroke was the second most frequent cause of death after coronary artery disease , accounting for 6 . 4 million deaths ( 12 % of the total ). About 3 . 3 million deaths resulted from ischemic stroke while 3 . 2 million deaths resulted from hemorrhagic stroke . About half of people who have had a stroke live less than one year . Overall , two thirds of strokes occurred in those over 65 years old . Pneumonia is an inflammatory condition of the lung affecting primarily the microscopic air sacs known as alveoli . Typical signs and symptoms include a varying severity and combination of productive or dry cough , chest pain , fever , and trouble breathing , depending on the underlying cause . Pneumonia is usually caused by ___MASK23___ with viruses or bacteria and less commonly by other microorganisms , certain medications and conditions such as autoimmune diseases . Risk factors include other lung diseases such as cystic fibrosis , COPD , and asthma , ___MASK66___ , heart failure , a history of smoking , a poor ability to cough such as following a stroke , or a weak immune system . Diagnosis is often based on the symptoms and ___MASK54___ . Chest X - ray , blood tests , and culture of the sputum may help confirm the diagnosis . The disease may be classified by where it was acquired with community , hospital , or health care associated pneumonia . Vaccines to prevent certain types of pneumonia are available . Other methods of prevention include handwashing and not smoking . Treatment depends on the underlying cause . Pneumonia believed to be due to bacteria is treated with antibiotics . If the pneumonia is severe , the affected person is generally hospitalized . Oxygen therapy may be used if oxygen levels are low . Pneumonia affects approximately 450 million people globally ( 7 % of the population ) and results in about 4 million deaths per year . Pneumonia was regarded by William Osler in the 19th century as " the captain of the men of death ". With the introduction of antibiotics and vaccines in the 20th century , survival improved . Nevertheless , in developing countries , and among the very old , the very young , and the chronically ill , pneumonia remains a leading cause of death . Pneumonia often shortens suffering among those already close to death and has thus been called " the old man ' s friend ". A genus ( genera ) is a taxonomic rank used in the biological ___MASK49___ of living and fossil organisms in biology . In the hierarchy of biological ___MASK49___ , genus comes above species and below family . In binomial nomenclature , the genus name forms the first part of the binomial species name for each species within the genus . Mammals are any vertebrates within the ___MASK2___ Mammalia ( from Latin " mamma " " breast "), a clade of endothermic amniotes distinguished from reptiles and birds by the possession of a neocortex ( a region of the brain ), hair , three middle ear bones and mammary glands . The sister group of mammals may be the extinct " Haldanodon ." The mammals represent the only living Synapsida , which together with the Sauropsida form the Amniota clade . The mammals consist of the Yinotheria including monotrema and the Theriiformes including the theria . Opium ( poppy tears , with the scientific name : " Lachryma papaveris ") is the dried latex obtained from the opium poppy ( scientific name : " Papaver somniferum "). Opium latex contains approximately 12 percent of the analgesic alkaloid morphine , which is processed chemically to produce heroin and other synthetic opioids for medicinal use and for the ___MASK57___ . The latex also contains the closely related opiates codeine and thebaine , and non - analgesic alkaloids such as papaverine and noscapine . The traditional , labor - intensive method of obtaining the latex is to scratch (" score ") the immature seed pods ( fruits ) by hand ; the latex leaks out and dries to a sticky yellowish residue that is later scraped off and dehydrated . The word " meconium " ( derived from the Greek for " opium - like ", but now used to refer to infant stools ) historically referred to related , weaker preparations made from other parts of the opium poppy or different species of poppies . South America is a continent located in the western hemisphere , mostly in the southern hemisphere , with a relatively small portion in the northern hemisphere . It is also considered a subcontinent of the Americas , which is the model used in nations that speak ___MASK28___ . The reference to South America instead of other regions ( like Latin America or the Southern Cone ) has increased in the last decades due to changing geopolitical dynamics ( in particular , the rise of Brazil ). Pain is a distressing feeling often caused by intense or damaging stimuli , such as stubbing a toe , burning a finger , putting alcohol on a cut , or bumping the " funny bone ". Because it is a complex , subjective phenomenon , defining pain has been a challenge . The International Association for the Study of Pain ' s widely used definition states : " Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage , or described in terms of such damage ." In ___MASK24___ , pain is regarded as a symptom of an underlying condition . Mink are dark - colored , semiaquatic , carnivorous mammals of the family Mustelidae , which also includes weasels , otters and ferrets . There are two extant species referred to as " mink ": the American mink and the European mink . The extinct sea mink is related to the American mink , but was much larger . The American mink is larger and more adaptable than the European mink . Due to variations in size , an individual mink usually cannot be determined as European or American with certainty without looking at the skeleton . There is one exception to this rule : all European minks have a large white patch on their upper lip , while only some American minks do . Thus , any mink with no such patch is certainly of the American variety . Taxonomically , both American and European minks used to be placed in the same genus " Mustela " (" weasels "), but most recently the American mink has been reclassified as belonging to its own genus " Neovison ". Naltrexone is a medication that reverses the effects of opioids and is used primarily in the ___MASK51___ of alcohol dependence and opioid dependence . The European mink (" Mustela lutreola "), also known as the ___MASK40___ mink , is a semiaquatic species of mustelid native to Europe . In ordinary ___MASK11___ , a crime is an unlawful act punishable by a state or other authority . The term " crime " does not , in modern criminal ___MASK46___ , have any simple and universally accepted definition , though statutory definitions have been provided for certain purposes . The most popular view is that crime is a category created by ___MASK46___ ; in other words , something is a crime if declared as such by the relevant and applicable ___MASK46___ . One proposed definition is that a crime or offence ( or criminal offence ) is an act harmful not only to some individual or individuals but also to a community , society or the state (" a public wrong "). Such acts are forbidden and punishable by ___MASK46___ . Opioids are substances that act on opioid receptors to produce morphine - like effects . Opioids are most often used medically to relieve pain , and by people addicted to opioids . Opioids include , an older term that refers to such drugs derived from , including morphine itself . Other opioids are semi - synthetic and synthetic drugs such as hydrocodone , oxycodone and fentanyl ; antagonist drugs such as naloxone and endogenous peptides such as the endorphins . The terms and are sometimes encountered as synonyms for opioid . is properly limited to the natural alkaloids found in the resin of the opium poppy although some include semi - synthetic derivatives . , derived from words meaning or , as an American legal term , refers to cocaine and opioids , and their source materials ; it is also loosely applied to any illegal or controlled psychoactive drug . In other jurisdictions all controlled drugs are legally classified as " narcotics ". The term can have pejorative connotations and its use is generally discouraged where that is the case . Primarily used for pain relief , including anesthesia they are also used to suppress cough , suppress diarrhea , treat addiction , reverse opioid overdose , and suppress opioid induced constipation . Extremely strong opioids are approved only for veterinary use such as immobilizing large mammals . Opioids act by binding to opioid receptors , which are found principally in the central and peripheral nervous system and the gastrointestinal tract . These receptors mediate both the psychoactive and the somatic effects of opioids . Opioid drugs include partial agonists and antagonists , which produce moderate or no effect ( respectively ) but displace other opioids from binding in those receptors . The side effects of opioids may include itchiness , sedation , nausea , respiratory depression , constipation , and euphoria . Tolerance and dependence will develop with continuous use , requiring increasing doses and leading to a withdrawal syndrome upon abrupt discontinuation . The euphoria attracts recreational use , and frequent , escalating recreational use of opioids typically results in addiction . Accidental overdose or concurrent use with other depressant drugs commonly results in death from respiratory depression . Because of opioid drugs ' reputation for addiction and fatal overdose , most are controlled substances . Illicit ___MASK91___ , smuggling , and addiction to opioids prompted treaties , laws and policing which have realized limited success . In 2013 between 28 and 38 million people used opioids illicitly ( 0 . 6 % to 0 . 8 % of the global population between the ages of 15 and 65 ). In 2011 an estimated 4 million people in the United States used opioids recreationally or were dependent on them . Current increased rates of recreational use and addiction are attributed to over - prescription of opioid medications and inexpensive illicit heroin . Conversely , fears about over - prescribing , exaggerated side effects and addiction from opioids are similarly blamed for under - treatment of pain . The Mustelidae ( from Latin " mustela ", weasel ) are a family of carnivorous mammals , including the weasel , badger , otter , marten , ferret , mink , stoat , and wolverine . Mustelids are diverse and the largest family in the order Carnivora . The internal ___MASK49___ is still disputed , with rival proposals containing between two and eight subfamilies . One study , published in 2008 , questions the long - accepted Mustelinae subfamily , and suggests that the Mustelidae consist of four major clades and three much smaller lineages . Constipation refers to bowel movements that are infrequent or hard to pass . Constipation is a common cause of painful defecation . Severe constipation includes obstipation ( failure to pass stools or ___MASK64___ ) and fecal impaction , which can progress to bowel obstruction and become life - threatening . Cannabis is a genus of flowering ___MASK88___ that includes three species ( and seven taxa ) or subspecies , " sativa ", " indica ", and " ruderalis ". The ___MASK88___ is indigenous to central ___MASK31___ and the Indian subcontinent . In ___MASK6___ and telecommunications a transmitter or ___MASK15___ transmitter is an electronic device which generates a ___MASK15___ frequency alternating current . When a connected antenna is excited by this alternating current , the antenna emits ___MASK15___ waves . Cocaine , also known as coke , is a strong stimulant mostly used as a recreational drug . It is commonly snorted , inhaled , or injected into the veins . Mental effects may include loss of contact with reality , an intense feeling of happiness , or agitation . Physical symptoms may include a fast heart rate , sweating , and large pupils . High doses can result in very high blood pressure or body temperature . Effects begin within seconds to minutes of use and last between five and ninety minutes . Cocaine has a small number of accepted medical uses such as numbing and decreasing bleeding during nasal ___MASK55___ . Cocaine is addictive due to its effect on the reward pathway in the brain . After a short period of use , there is a high risk that dependence will occur . Its use also increases the risk of stroke , myocardial infarction , lung problems in those who smoke it , blood infections , and sudden cardiac death . Cocaine sold on the street is commonly mixed with local anesthetics , cornstarch , quinine , or sugar which can result in additional toxicity . Following repeated doses a person may have decreased ability to feel pleasure and be very physically tired . Cocaine acts by inhibiting the reuptake of serotonin , norepinephrine , and dopamine . This results in greater concentrations of these three neurotransmitters in the brain . It can easily cross the blood  brain barrier and may lead to the breakdown of the barrier . Cocaine is made from the leaves of the " coca " plant which are mostly grown in South America . In 2013 , 419 kilograms were produced legally . It is estimated that the illegal market for cocaine is 100 to 500 billion USD each year . With further processing crack cocaine can be produced from cocaine . After cannabis , cocaine is the most frequently used illegal drug globally . Between 14 and 21 million people use the drug each year . Use is highest in North America followed by Europe and South America . Between one and three percent of people in the developed world have used cocaine at some point in their life . In 2013 cocaine use directly resulted in 4 , 300 deaths , up from 2 , 400 in 1990 . The leaves of the " coca " plant have been used by Peruvians since ancient times . Cocaine was first isolated from the leaves in 1860 . Since 1961 the international Single Convention on Narcotic Drugs has required countries to make recreational use of cocaine a crime . Heroin , also known as diamorphine among other names , is an opiate typically used as a recreational drug for its euphoric effects . Medically it is occasionally used to relieve pain and as a form of opioid replacement therapy alongside counseling . Heroin is typically injected , usually into a vein ; however , it can also be smoked , snorted or inhaled . Onset of effects is usually rapid and lasts for a few hours . Common side effects include respiratory depression ( decreased breathing ) and about a quarter of those who use heroin become physically dependent . Other side effects can include abscesses , infected heart valves , blood borne infections , constipation , and pneumonia . After a ___MASK22___ of long - term use , withdrawal symptoms can begin within hours of last use . When given by injection into a vein , heroin has two to three times the effect as a similar dose of morphine . It typically comes as a white or brown powder . Treatment of heroin addiction often includes behavioral therapy and medications . Medications used may include methadone or naltrexone . A heroin overdose may be treated with naloxone . An estimated 17 million people as of 2015 use opiates such as heroin , which together with opioids resulted in 122 , 000 deaths . The total number of opiate users has increased from 1998 to 2007 after which it has remained more or less stable . In the United States about 1 . 6 percent of people have used heroin at some point in time . When people die from overdosing on a drug , the drug is usually an opioid . Heroin was first made by C . R . Alder Wright in 1874 from morphine , a natural product of the opium poppy . Internationally , heroin is controlled under Schedules I and IV of the Single Convention on Narcotic Drugs . It is generally illegal to make , possess , or sell heroin without a license . In 2015 Afghanistan produced about 66 % of the world ' s opium . Often heroin , which is illegally sold , is mixed with other substances such as sugar or strychnine . Peruvians are the citizens of the Republic of Peru or their descendants abroad . Peru is a multiethnic country formed by the combination of different groups over five centuries , so people in Peru usually treat their nationality as a citizenship rather than an ethnicity . Amerindians inhabited Peruvian territory for several millennia before ___MASK33___ Conquest in the 16th century ; according to ___MASK67___ David N . Cook their population decreased from an estimated 5  9 million in the 1520s to around 600 , 000 in 1620 mainly because of infectious diseases . Spaniards and Africans arrived in large numbers under colonial rule , mixing widely with each other and with indigenous peoples . During the Republic , there has been a gradual immigration of European people ( specially from Spain and Italy , and in a less extent from France , the Balkans , Great Britain and Germany ). Japanese and Chinese arrived in large numbers at the end of nineteenth century . A pen ( Latin : " penna ", feather ) is a ___MASK85___ implement used to apply ink to a surface , such as paper , for ___MASK85___ or drawing . Historically , reed pens , quill pens , and dip pens were used , with a nib dipped in ink . Ruling pens allow precise adjustment of line width , and still find a few specialized uses , but technical pens such as the Rapidograph are more commonly used . Modern types also include ballpoint , rollerball , fountain , and felt or ceramic tip pens . Peru , officially the Republic of Peru , is a country in western South America . It is bordered in the north by Ecuador and Colombia , in the east by Brazil , in the southeast by Bolivia , in the south by Chile , and in the west by the Pacific Ocean . Peru is an extremely biodiverse country with habitats ranging from the arid plains of the Pacific coastal region in the west to the peaks of the Andes mountains vertically extending from the north to the southeast of the country to the tropical Amazon Basin rainforest in the east with the Amazon ___MASK14___ . Stimulants ( also referred to as psychostimulants ) is an overarching term that covers many drugs including those that increase activity of the body , drugs that are pleasurable and invigorating , or drugs that have sympathomimetic effects . Due to their rendering a characteristic " up " feeling , stimulants are also occasionally referred to as " uppers ". Depressants or " downers ", which decrease mental and / or physical function , are in stark contrast to stimulants and are considered to be the functionally opposite drug ___MASK2___ . Stimulants are widely used throughout the world as prescription medicines as well as without a prescription ( either legally or illicitly ) as performance - enhancing or recreational drugs . The most frequently prescribed stimulants as of 2013 were lisdexamfetamine , methylphenidate , and amphetamine . It is estimated that the percent of the population that has abused amphetamines , cocaine and MDMA combined is between . 8 % and 2 . 1 %. Europe is a continent that comprises the westernmost part of Eurasia . Europe is bordered by the Arctic Ocean to the north , the Atlantic Ocean to the west , and the Mediterranean Sea to the south . To the east and southeast , Europe is generally considered as separated from ___MASK31___ by the watershed divides of the Ural and Caucasus Mountains , the Ural River , the Caspian and Black Seas , and the waterways of the Turkish Straits . Yet the non - oceanic borders of Europe  a concept dating back to classical antiquity  are arbitrary . The primarily physiographic term " continent " as applied to Europe also incorporates cultural and political elements whose discontinuities are not always reflected by the continent ' s current overland boundaries . The American mink (" Neovison vison ") is a semiaquatic species of mustelid native to North America , though human intervention has expanded its range to many parts of Europe and South America . Because of range expansion , the American mink is classed as a least - concern species by the IUCN . Since the extinction of the sea mink , the American mink is the only extant member of the genus " Neovison ". The American mink is a carnivore which feeds on rodents , fish , crustaceans , frogs , and birds . In its introduced range in Europe it has been classified as an invasive species linked to declines in European mink , Pyrenean desman , and water vole populations . It is the most frequently farmed ___MASK86___ for its fur , exceeding the silver fox , sable , marten , and skunk in economic importance . Myocardial infarction ( MI ) or acute myocardial infarction ( AMI ), commonly known as a heart attack , occurs when blood flow stops to a part of the heart causing damage to the heart muscle . The most common symptom is chest pain or discomfort which may ___MASK18___ into the shoulder , arm , back , neck , or jaw . Often it is in the center or left side of the chest and lasts for more than a few minutes . The discomfort may occasionally feel like heartburn . Other symptoms may include shortness of breath , nausea , feeling faint , a cold sweat , or feeling tired . About 30 % of people have atypical symptoms , with women more likely than men to present atypically . Among those over 75 years old , about 5 % have had an MI with little or no ___MASK22___ of symptoms . An MI may cause heart failure , an irregular heartbeat ( including serious types ), cardiogenic shock , or cardiac arrest . Most MIs occur due to coronary artery disease . Risk factors include high blood pressure , smoking , ___MASK66___ , lack of exercise , obesity , high blood cholesterol , poor diet , and excessive alcohol intake , among others . The mechanism of an MI often involves the complete blockage of a coronary artery caused by a rupture of an atherosclerotic plaque . MIs are less commonly caused by coronary artery spasms , which may be due to cocaine , significant emotional stress , and extreme cold , among others . A number of tests are useful to help with diagnosis , including electrocardiograms ( ECGs ), blood tests , and coronary angiography . An ECG may confirm an ST elevation MI if ST elevation is present . Commonly used blood tests include troponin and less often creatine kinase MB . Aspirin is an appropriate immediate treatment for a suspected MI . Nitroglycerin or opioids may be used to help with chest pain ; however , they do not improve overall outcomes . Supplemental oxygen should be used in those with low oxygen levels or shortness of breath . In ST elevation MIs treatments which attempt to restore blood flow to the heart are typically recommended and include angioplasty , where the arteries are pushed open , or thrombolysis , where the blockage is removed using medications . People who have a non - ST elevation myocardial infarction ( NSTEMI ) are often managed with the blood thinner heparin , with the additional use of angioplasty in those at high risk . In people with blockages of multiple coronary arteries and ___MASK66___ , bypass surgery ( CABG ) may be recommended rather than angioplasty . After an MI , lifestyle modifications , along with long term treatment with aspirin , beta blockers , and statins , are typically recommended . Worldwide , about 8 . 6 million myocardial infarctions occurred in 2013 . More than 3 million people had an ST elevation MI and more than 4 million had an NSTEMI . STEMIs occur about twice as often in men as women . About one million people have an MI each year in the United States . In the developed world the risk of death in those who have had an STEMI is about 10 %. Rates of MI for a given age have decreased globally between 1990 and 2010 .