Myocardial Infarction

Myocardial infarction, commonly known as a heart attack, is a serious condition where a coronary artery (a blood vessel of the heart) is blocked and can not supply the heart muscle with blood and oxygen.

This causes damage to the heart muscle. The typical symptoms are chest and arm pain, shortness of breath, nausea and a cold sweat. A heart attack requires immediate medical assistance.

Important risk factors:

• diabetes
• high blood pressure
• high cholesterol
• drinking alcohol
• smoking
• being overweight and having a family member who has had a heart attack.

People who have had one heart attack are more likely to have another. Heart attacks are slightly more common in men than women, and are most common in middle-aged and older adults.

The most common symptom is the feeling of pressure, tightness or pain in the chest, which may spread to the left arm or the jaw or the back.

Not all people who are having a heart attack have chest pain. Other common symptoms are shortness of breath, cold sweats, dizziness, fainting and nausea.

Diagnosis is made by a physician based on the symptoms, the physical examination, a troponin test (troponin is a protein found in the blood after a heart attack) and an electrocardiogram (an ECG or EKG). The most conclusive test to check for blockages in the heart arteries is coronary angiography, where dye is injected into the heart blood vessels and X-rays are taken.

Treatment during a heart attack:

• Aims to widen the blocked blood vessel
• remove the blockage in the heart artery and help the person having the heart attack with pain relief
• supplying extra oxygen

To widen the artery, the paramedics or doctors will give a tablet or spray immediately, called nitroglycerine. To remove the blockage, the person having the heart attack will have medications to thin the blood. Sometimes urgent cardiac catheterization (a tube through the leg blood vessels into the heart blood vessels) is done to find and remove the blockage. If the blockage or narrowing is severe, the doctor may put a stent (a small wire cage) into the blood vessel to widen the vessel.

It is important to have urgent treatment in order to prevent heart muscle damage. After a heart attack, cardiac rehabilitation (physical therapy) is important to help the heart regain strength.

Preventing heart attacks involves:

• life-style and diet changes
• being physically active
• maintaining a healthy weight
• quitting smoking
• reducing alcohol intake

Good management of other medical conditions, such as high blood pressure, diabetes and high cholesterol levels, also helps.

• Heart attack
• Acute myocardial infarction