Heart Attack and How to Find it?

Heart Attack and How to Find it?



What is a Heart Attack?

A heart attack, or myocardial infarction (MI), occurs when coronary arteries are completely blocked, leading to insufficient blood flow to the heart muscle. When tissues do not get enough blood flow and oxygen for an extended period of time, they necrose (die) and cannot perform their function.

There are many etiologies for a blocked artery, but the most common cause is atherosclerosis, which can be due to a
buildup of cholesterol, fat, proteins, calcium, and white blood cells (WBCs) called plaque. Other causes are hypotension, certain infections (anything that damages the heart muscle), and spontaneous coronary artery dissection (SCAD).

There are two types of MI: NSTEMI (non-ST segment elevation myocardial infarction) and STEMI (ST-segment elevation myocardial infarction). An NSTEMI can progress to a STEMI if necrosis occurs long enough without being treated.

Heart attack, sign, and symptom of the disease. A concept hospital for wallpaper and web.

Symptoms?

Myocardial cell death can occur within 20-40 minutes of a completely blocked artery, so it is imperative to be able to
recognize symptoms of an MI to limit the severity of necrosis.
Common symptoms

  • Severe chest pain/pressure (like an elephant sitting on your chest), which may radiate to the left arm or jaw.
    o This is gradual in onset and usually provoked by exercise or exertion.
    o Usually described more as discomfort rather than pain and is not easily localized to one spot.
    o Does not change with position or respiration.
  • Diaphoresis (sweating)
  • Fatigue
  • Nausea and/or vomiting
  • Dyspnea (difficulty breathing)
    Other symptoms
  • In females, dyspnea is the predominant feature.
  • In diabetics and the elderly, dyspnea without chest pain is common.
  • Belching, or indigestion
  • Dizziness, lightheadedness
  • Clamminess
  • Weakness
  • Palpitations
  • Syncope (fainting)
    Risk Factors
  • Older age
  • Male sex
  • Family history or previous MI
  • Hypertension (high blood pressure)
  • Diabetes
  • Dyslipidemia (increased cholesterol, triglycerides)
  • Obesity
  • Sedentary lifestyle
  • Certain autoimmune diseases (eg. Lupus, rheumatoid arthritis)
  • Cigarette smoking or cocaine use

Diagnostic Signs

  • On ECG: 1)ST segment depression (if necrosis is limited to inner third of the endocardium) 2)ST segment elevation
    (if necrosis extends the entire endocardium wall thickness).
  • On labs:

1) ↑ troponins seen within 2-4 hours of infarction and peaking ~48 hours 2) ↑ CK-MB seen within 2-4
hours of infarction and peaking around 24 hrs

Summary:

  • Heart attack: Blocked coronary arteries cut off blood flow, damaging heart muscle.
  • Cause: Atherosclerosis (plaque buildup) most common, other causes include infections, spontaneous artery damage.
  • Types: NSTEMI (gradual) and STEMI (severe).
  • Symptoms: Severe chest pain (radiates), sweating, fatigue, nausea, shortness of breath. May vary in women, diabetics, elderly.
  • Risk factors: Age, male sex, family history, high blood pressure, diabetes, cholesterol issues, obesity, inactivity, smoking/cocaine.
  • Diagnosis: ECG (ST segment changes), blood tests (elevated troponins, CK-MB).
  • Act fast: Immediate medical attention crucial to limit damage. Manage risk factors to prevent future episodes.

This article reviewed by Dr. Jim Liu, MD and Ms. Deb Dooley, APRN.

There’s nothing more important than our good health – that’s our principal capital asset.

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