Heart attack

Description

Myocardial infarction or heart attack. Damage or death of the cells of heart muscle caused by the blockage of the artery (coronary artery) which provides the heart muscle with oxygen and nutrients. Symptoms may vary greatly and be atypical in older persons, diabetics and women. The most common cause of the blockage is accumulation of the fat deposits, called plaque, in the artery (atherosclerosis). High blood pressure, high cholesterol, smoking, family anamnesis of the heart attack and diabetes increase the risk for heart attack. If not being treated may lead to the heart failure and, sometimes very soon, to death.

Symptoms

Chest pain (usually described as tightness, squeezing, pressing, burning, etc.); some people may feel little or even no chest pain (older persons, diabetics and women). Other symptoms include: jaw pain, pain in the arm, pain in the back, abdominal pain, difficult breathing, sweating, nausea, vomiting, tightness, dizziness, vertigo.

Overview

Medical history will be taken and physical examination . Initial examination should include an electrocardiogram ( EKG) and blood test for troponin ( cardiac muscle protein that is released into the blood during a heart attack ) . Coronary angiogram can determine the spot where the coronary artery occlusion . CT scan of the chest - high resolution also can show blockages. CT - scanner can rule out other diseases that mimic a clinical heart attack . An echocardiogram is used to see how the heart pumps .

Tests

Complete blood count (CBC), biochemical blood analysis, electrocardiogram (ECG/EKG), coronary angiogram, troponim and X-rays.

Additional analyses

Coronary angiography, echocardiogram (ultrasound of the heart).

Specialists

Cardiology

Therapy

Treatment is directed at improving the blood flow in the heart muscle, treating life-threatening arrhythmias, and maximizing the heart function. Anti-platelet medicines, such as aspirin and clopidogrel/Plavix, are given immediately. Blockage of the coronary artery is reduced by the following: clot busting medication (alteplase/t-PA), angioplasty (balloon catheterization), stent, bypass, and/or blood thinners (anticoagulants). Other medicines that are also given usually include a high dose statin to lower cholesterol, beta blocker to slow heart rate and angiotensin enzyme inhibitor (ACE) that helps the heart reconstruct appropriately.