Health Management

Myocardial infarction (MI) : Heart Attack, Symptoms & Treatment

Myocardial infarction

Death of prolonged oxygen deprived heart muscles is myocardial infarction. Otherwise called heart attack, is a serious medical emergency. It is the condition in which the oxygen supply of heart through blood is greatly compromised hence called ischemic injury. The organ greatly effected in episode of MI is heart. Heart is a crucial organ of human body that serves to circulate blood throughout the body. This human pump help nourish body organs and provide a medium for cellular respiration and its waste metabolites to excreted. Along with its crucial function heart is sensitive to numerous insults. Only a slight disturbing stimulus can affect its function greatly. The specialised doctor, who treat MI are cardiologists.

Causes

Following are the causes of myocardial infraction,

  • Atherosclerosis

Build-up of substances (plaque: due to any hemodynamic insult, cholesterol, clot or endothelial injury) in arteries that result in compromised blood supply.

  • Coronary artery disease

Arteriosclerosis of artery, partial or complete blockage of coronary arteries result in insufficient blood supply to heart that in return result in development of infarct (area of dead cells).

  • Mental stress

Mental stress or generalise restlessness result in disturbed body hemodynamic and hypertension which result in myocardial infarction.

  • Hypertension

Increased blood pressure result in disturbance in hemodynamic that result in endothelial injury that causes atheroma formation in artery that causes insufficient blood supply that ultimately leads to myocardial infarction.

  • Genetic basis

Studies have showed that the cause of myocardial infarction can be familial (runs in family)

Myocardial infarction

Pathogenesis

As we all know that myocardial infarction take place due to ischemic insult to heart muscles (myocardium). How ischemia happens? well the answer is simple, when there is any sort of hemodynamic disturbance to flow of blood this causes injury in endothelium (single cell inner most layer of artery which is exposed internally to blood) this injury to endothelium causes development of plaque that distort the flow of blood in artery by narrowing the arterial (coronary artery) lumen. This narrowing lead to ischemia of heart, ischemia (low oxygen supply) when prolonged result in death of heart muscle i.e., myocardial infarction.

Symptoms

symptoms of heart attack are usually confused with heartburn, gas trouble, muscular pain, etc. symptoms include severe chest pain which radiates towards the left arm (sometimes in both arms) and left lower jaw. This pain sometimes maybe felt in the neck and the back of shoulder. Other generalised symptoms commonly observed in MI patient are dyspnoea (shortness of breath), Nausea, vomiting, sweating, tachycardia or bradycardia, Discomfort, fatigue, anxiety, stress, depression, muscular weakness, Sleeplessness, yellowing of skin, etc.

complications

myocardial infarction when treated, leaves its negative impacts behind which appear in the form of following conditions,

  • arrythmia

disturbed rhythm of heart which involves incoordination between contraction of heart muscles and abnormal cardiac cycle.

  • VSD

Ventral Septal Defects can be innate (by birth) or acquired due to MI. such defects further cause numerous complications (such as mixing of oxygenated and deoxygenated blood)

  • Papillary muscle rupture

Another rare but potentially fatal complication of myocardial infarction is papillary muscle rupture. Any rupture in papillary muscles of heart result in serious outcomes such as cardiogenic shock or pulmonary oedema.

  • Ventricular aneurysm

Ventricular aneurysm means dilatation of ventricle that can be. Due to disturbed blood floe in heart. It is also the complication of MI.

  • RV failure

Right ventricular failure leads to right heart failure (cor pulmonale). This is followed by acute episode of myocardial infarction.

  • Outflow tract obstruction

It has been observed in myocardial infarction patient that the MI caused the obstruction in outflow path of blood that caused pooling of blood in heart weakening the musculature of heart.

  • Mitral regurgitation and prolapse,

Bicuspid valve or mitral valve is a valve present at the junction between left atrium and left ventricle. usually It is seen, after an episode of MI this valve loses its elasticity due to which blood backflows (regurgitate) to atrium. The other possibility is this valve fails to open completely (stenosis) that again causes incomplete filling of ventricle hence hinder normal blood flow path.

diagnostic tests

cardiologists diagnose MI with the following tests,

  • ECG

Electrocardiographs are widely being used to diagnosed acute Mi in patient presented with chest pain. It uses leads and cardiograph that shows changes in ST segment (elevated), p-wave (poor) and T wave (inverted) of electrocardiogram.

  • Blood test

Blood test shows markers (namely, Ck-MB, Troponin, Creatinine kinase, Myoglobin, Lactate dehydrogenase) of acute myocardial infarction that remain elevated in blood for certain period after episode of MI.

  • Chest x ray

Radiographic findings are non-specific. But usually after an acute myocardial infarction episode there appears the congestion in heart ad left side of heart appear bigger than its normal size.

  • Echocardiography

It the ultrasound of heart. It is more accurate for detecting the myocardial infarction. It shows clear picture of heart.

  • Angiography

Angiography is the invasive method used to detect the position of obstruction in coronary artery that hinders the blood supply of heart. This is also use for placing the stents in coronary arteries(angioplasty).

  • Cardiac CT

Cardiac computed tomography is non-invasive method for detecting numerous heart complications.

Myocardial infarction

Prevention

As its said prevention is better then cure, to prevent oneself from suffering with any disease should be one of the goals of human life. the following preventions can help person to remain safe from life threatening health condition,
Quit smoking as it causes hypertension, exercise daily to improve the quality of life, take balance diet and avoid high cholesterol content diet, avoid getting obese maintain balance weight, regular health examination to catch a disease at its early acute stages before advancing, follow basic sleeping roles as sleep help to take rest, avoid and manage stresses as these causes’ mental disturbances etc.

Treatment

MI, being one of the common and fatal heart condition, had been worked on a lot that shows the availability of vast variety of medicines, which are as follow.

  • Therapy

Certain physical therapy treatment are practiced now a days that can help restoration of maximum pre-attack physical activity, such treatment technique in physical therapy is caller cardiopulmonary endurance training.

Medication

  • Thrombolysis (to lyse the clot present in blood vessels.
  • Anti-thrombotic (to stop the formation of thrombus)
  • Analgesics (to reduce pain)
  • Blood thinners (e.g., aspirin)
  • Bp meds (vasodilators)
  • Anti-arrhythmic (in case of arrythmia)
  • Cardiac depressant (to reduce the activity of heart to cope with insufficient blood supply)

surgery

the invasive method for the treatment of MI includes,

  • angioplasty (stents)

it is the method of opening the closed coronary artery by passing a catheter through blood vessel in arm that travel throughout artery and reach coronary artery the balloon present on the end help open the arterial lumen. Other method is passing a stent (metallic mesh) through catheter to open the narrowed or blocked coronary artery.

  • bypass grafting

the major open-heart procedure for the treatment or MI, this procedure includes taking a graft from other artery of body and grafting it on coronary artery bypassing the point of obstruction, thus giving the collateral passage for the flow of blood.

Epidemiology

Epidemiologists calculated the prevalence of myocardial infarction to be 3 million people around the globe. The age associated death rate of MI is 239.8 per 100,000 people. Developed countries are equally rather more effected with myocardial infarction.

Myocardial infarction

Research

Due to high prevalence and death rate of myocardial infarction, researchers are trying to find the best suitable treatment with least diverse effect and a method to restore the maximum myocardium and clean the infarct that require 100% regeneration of heart muscle without any impact in its function. The work is still in progress.

Conclusion

MI is the leading cause of deaths in people worldwide. Diabetic, smokers, hypertensive people are at the high risks for fatal MI episode in their life. Myocardial infarction can be the causes of DVT (deep vein thrombosis) and stroke. The thrombus embolise to coronary arteries that hinder blood flow to heart. Hence any pain or chest discomfort should be considered seriously to prevent MI from happening. Preventive measures should be seriously followed by people who are at the highest risk of developing MI in their future.

Related Articles

One Comment

Leave a Reply

Your email address will not be published. Required fields are marked *

Back to top button