Myocardial Infarction

Heart Attack | Myocardial Infarction

Myocardial Infarction literally means the total stoppage of the blood supply to a part of the heart resulting in the death of heart muscles. Theses dead muscles are then replaced by a scar tissue. When any muscle of the heart dies, it causes chest pain and may also cause the instability of the heart muscle tissue which results in rapid and disorganized heartbeat. In such condition, heart cannot pump oxygenated blood to the brain. As a result of which permanent damage occurs leading to death unless oxygenated blood flow is quickly revived. Causes:

  1. Trauma such as cardiac wound or any chest trauma.
  2. Electromagnetic causes like heat stroke.
  3. Self induced disorders such as coronary angiography.
  4. Previous surgeries like angioplasty or coronary artery bypass grafting.
  5. Infections like bacterial endocarditis.
  6. Abscess formation in any organ like infective endocarditis.
  7. Inflammatory disorders like Wegner’s granulomatosis.
  8. Neoplastic disorders such as thrombocytopenia.
  9. Autoimmune disorders like rheumatoid arthritis.
  10. Metabolic disorders e.g. Diabetes Mellitus or Obesity
  11. Congenital Abnormalities such as Sticky Platelet Syndrome.
  12. Genetic disorders e.g. Hypertrophic Obstructive cardiomyopathy
  13. Arteriosclerosis, Spasmodic Angina or Coronary embolism may also cause MI
  14. Endocrine Disorders like hypertensive heart disease.
  15. Certain drugs like ergot or any bronchodilator drug administration can cause toxicity.

Symptoms:

  1. Chest pain and pressure on chest i.e. feeling of fullness and squeezing sensation in chest is usually there.
  2. Pain in jaw or tooth.
  3. Shortness of Breath.
  4. Nausea, vomiting and general gastric discomfort.
  5. Sweating can also be there.
  6. Heartburn or indigestion.
  7. Either arm pain which is more common in left arm.
  8. Upper back pain may also present.
  9. Vague feeling of illness.

Almost 1/4th of all the attacks are silent i.e. without any kind of chest pain. Silent attacks are commonly seen in diabetics and can be serious.   Complications:  

  1. Heart Failure: It occurs when large amount of heart muscle dies and oxygen supply to the whole body is diminished.
  2. Ventricular Fibrillation: It occurs when the normal and regular activation of the heart muscle contraction is replaced by arrhythmic electrical activity that causes heart to stop pumping blood to brain.

Managing the Ventricular Fibrillation:

  1. Cardiopulmonary Resuscitation: It should be started within five minutes by applying external chest compression to squeeze the heart and to force it to pump the blood.
  2. Electrical Shock: It can be administered to convert ventricular fibrillation to normal heart rhythm which allows the heart to pump blood normally.

Risk Factors:

  1. High blood cholesterol levels
  2. Hypertension
  3. Smoking or excessive tobacco use.
  4. Diabetes Mellitus
  5. Male Gender
  6. Family History of Heart Disease

Diagnosis: Whenever severe chest pain is there, MI is usually suspected and tests are performed             quickly which confirm the heart attack.

  1. Electrocardiogram (ECG)
  2. Blood Tests: A series of blood tests is performed to detect the elevated levels of cardiac enzymes (CPK) which are typically elevated in blood several hours after the onset of attack.

Treatment: Rapid Evaluation allows early treatment of heart attack. The more rapidly the blood flow is re-established, more heart muscles that are saved.

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