Myocardial Infarction – Causes, Risk Factors, Signs And Symptoms
Myocardial infarction or heart attack is a medical emergency in which blood flow to the heart is suddenly blocked, causing heart muscle death due to lack of oxygen. Oxygenated blood flow that is supplyed to the heart by the coronary arteries become blocked by atheromatous plaques, that rupture and form a thrombus (blood clot) around them. Without blood supply, as any living tissue the heart muscle dies. If a large area of myocardium is affected, death is very probable. Emergency myocardial infarction treatment is manditory to restore blood flow to the infarction area.
Myocardial Infarction Protocol
If the person suspected of a heart attack and was prescribed nitroglycerin, it is advisable to administer a nitroglycerin pill. After 5 minutes, if the pain does not respond or it gets worse, call the emergency services. If a heart attack or unstable angina is presumed and nitroglycerin was not prescribed to that patient, the patient must present to the emergency room or imediately call the ambulance. It is important to begin treatment as soon as possible.
Each year about 40% of myocardial infarctions are fatal, of which more than half of deaths occur in the emergency room or before reaching the hospital. After calling the ambulance, chew an aspirin. A recent study showed that those taking aspirin during a heart attack and after another month had a lower risk of dying due to complications like stroke than those not taking aspirin.
Myocardial Infarction Causes
The main cause of both unstable angina and myocardial infarction is coronary artery disease. Coronary heart disease occurs when atheromatous plaques appear along the internal walls of coronary arteries and thus reduces blood flow to the heart. In majority of people coronary heart diseases begins in adolescence and develops over the years. Elevated cholesterol, hypertension and smoking damages your arteries and contributes to plaque formation. The process of forming plaques inside blood vessels is called atherosclerosis.
Coronary atherosclerosis leads in time to angina and worse to myocardial infarction. It is a slow process that can develop for years without any symptoms.
Meanwhile, like limestone deposits on the inside of pipe installations, fat is deposited on the walls of arteries that feed the heart and narrows them. The effect is to reduce blood flow to a portion of the heart muscle. To this process blood clots can be added (thrombus) a process known as atherothrombosis. When there is total cessation of blood flow to an area (usually by a blood clot formation) results in a myocardial infarction. Atherosclerosis can occur in any vascular territory, producing symptoms in that territory, eg the coronary arteries (heart): angina pectoris, myocardial infarction, carotid arteries (supplying the brain): stroke, femoral artery, popliteal (supplying the legs): intermittent claudication (pain in muscles).
Myocardial Infarction Risk Factors
Anyone can reduce risk of heart attack!
Certain factors, called coronary risk factors, increase the risk of atherosclerosis. The process of atherosclerosis can be slowed by reducing these risk factors, thus reducing the risk of death or disability by myocardial infarction. Although not always perfectly predictable, there are some people who have a higher risk than the general population to suffer from a heart attack or angina attacks. These people are carriers of known coronary risk factors. Risk factors fall into two categories: modifiable (those on which we can not have any influence, such as male gender, age or genetic inheritance), and the changeble (important to know because they can be influenced by correcting some unhealthy habits or through drugs). In some families there is a greater tendency of developing myocardial infarction. Its incidence increases with age also, and men are more likely than women to suffer from a heart attack at younger age.
These risk factors – heredity, age and sex – can not be changed but if the patient changes his lifestyle and reduces risk factors , chances of living a longer and healthier life will improve. Prevention of acute myocardial infarction is the best thing and it is never too late to change habits that can harm your heart. This means to do regular health checks and reduce coronary risk factors. Sometime sthe presence of only one risk factor from the set is enaugh to increase the risk of coronary heart disease. Thus, unfortunately, we see increasingly and frequently young patients (between 30-40 years) hospitalized for acute myocardial infarction, where the only measurable coronary risk factor is smoking.
Stress also called the illness of the century, which like smoking is often seen in young people must also be kept under control before irreversible harmful effects on health manifest.
Regular checks and blood tests, especially under the supervision of the family doctor are very important to know your level of blood lipids (cholesterol and triglycerides) and blood sugar.
Myocaridal Infarction Signs and Symptoms
Sometimes a heart attack starts suddenly and intensely. But often, the onset is slow, with mild pain and discomfort. Patients do not understand what is happening and wait too long before getting help. If you notice any of the myocardial infarction symptoms, do not miss a minute! Seek help immediately! When you suffer a heart attack every minute counts! Be sure to recognize clinical signs, as this can save your life.
Symptoms and signs of acute myocardial infarction need to recognize are:
- Previous intense chest pain with pressure, burning, weight, grip sensation
- Pain may radiate to the shoulder, arms, neck, back and upper abdomen
- Pain duration is more than 20 minutes (up to several hours), does not respond to sublingual nitroglycerin tablets (3 tablets taken every 5 minutes)
- Pain may be accompanied by other signs: dizziness, fainting, nausea, vomiting, sweating, choking, anxiety, nervousness, palpitations (not all of these clinical signs occur in every acute myocardial infarction).
- Pain usually begins with a low intensity and increase in intensity over several minutes to a maximum. Discomfort may be intermittent. Chest pain that reaches maximum intensity within seconds can be a sign of another disease, aneurysm of aorta.
If you have one or more of these signs, do not wait any delay could be fatal! Call the ambulance!
What happens if a patient with acute myocardial infarction not present at the hospital? Risks of ignoring the warning symptoms for acute myocardial infarction are multiple:
- Sudden death
- Severe arrhythmias
- Development of new angina pain that further increases patient risk for sudden death
- Appearance of heart failure (fatigue, suffocation, and possibly edema in the legs being the most common symptoms)