Acute Myocardial Infarction : Causes, Symptoms, and Treatment

Acute myocardial infarction is the medical name for a heart attack. A heart attack is a life-threatening condition that occurs when blood flow to the heart muscle is abruptly cut off, causing tissue damage. This is usually the result of a blockage in one or more of the coronary arteries. A blockage can develop due to a buildup of plaque, a substance mostly made of fat, cholesterol, and cellular waste products.

While the classic symptoms of a heart attack are chest pain and shortness of breath, the symptoms can be quite varied. The most common symptoms of a heart attack include:
  • pressure or tightness in the chest
  • pain in the chest, back, jaw, and other areas of the upper body that lasts more than a few minutes or that goes away and comes back
  • shortness of breath
  • sweating
  • nausea
  • vomiting
  • anxiety
  • a cough
  • dizziness
  • a fast heart rate
It’s important to note that not all people who have heart attacks experience the same symptoms or the same severity of symptoms. Chest pain is the most commonly reported symptom among both women and men. However, women are more likely than men to have:
  • shortness of breath
  • jaw pain
  • upper back pain
  • lightheadedness
  • nausea
  • vomiting
In fact, some women who have had a heart attack report that their symptoms felt like the symptoms of the flu.

Your heart is the main organ in your cardiovascular system, which also includes different types of blood vessels. Some of the most important vessels are the arteries. They take oxygen-rich blood to your body and all of your organs. The coronary arteries take oxygen rich blood specifically to your heart muscle. When these arteries become blocked or narrowed due to a buildup of plaque, the blood flow to your heart can decrease significantly or stop completely. This can cause a heart attack. Several factors may lead to a blockage in the coronary arteries.

Bad cholesterol

Bad cholesterol, also called low-density lipoprotein (LDL), is one of the leading causes of a blockage in the arteries. Cholesterol is a colorless substance that’s found in the food you eat. Your body also makes it naturally. Not all cholesterol is bad, but LDL cholesterol can stick to the walls of your arteries and produce plaque. Plaque is a hard substance that blocks blood flow in the arteries. Blood platelets, which help the blood to clot, may stick to the plaque and build up over time.

Saturated fats

Saturated fats may also contribute to the buildup of plaque in the coronary arteries. Saturated fats are found mostly in meat and dairy products, including beef, butter, and cheese. These fats may lead to an arterial blockage by increasing the amount of bad cholesterol in your blood system and reducing the amount of good cholesterol.

Trans fat

Another type of fat that contributes to clogged arteries is trans fat, or hydrogenated fat. Trans fat is usually artificially produced and can be found in a variety of processed foods. Trans fat is typically listed on food labels as hydrogenated oil or partially hydrogenated oil.

Certain factors may increase your risk of having a heart attack.

High blood pressure

You’re at greater risk for heart attack if you have high blood pressure. Normal blood pressure is below 120/80 mm Hg (millimeters of mercury) depending on your age. As the numbers increase, so does your risk of developing heart problems. Having high blood pressure damages your arteries and accelerates the buildup of plaque.

High cholesterol levels

Having high levels of cholesterol in your blood puts you at risk for acute myocardial infarction. You may be able to lower your cholesterol by making changes to your diet or by taking certain medications called statins.

High triglyceride levels

High triglyceride levels also increase your risk for having a heart attack. Triglycerides are a type of fat that clog up your arteries. Triglycerides from the food you eat travel through your blood until they’re stored in your body, typically in your fat cells. However, some triglycerides may remain in your arteries and contribute to the buildup of plaque.

Diabetes and high blood sugar levels

Diabetes is a condition that causes blood sugar, or glucose, levels to rise. High blood sugar levels can damage blood vessels and eventually lead to coronary artery disease. This is a serious health condition that can trigger heart attacks in some people.

Obesity

Your chances of having a heart attack are higher if you’re very overweight. Obesity is associated with various conditions that increase the risk of heart attack, including:
  • diabetes
  • high blood pressure
  • high cholesterol levels
  • high triglyceride levels

Smoking

Smoking tobacco products increases your risk for heart attack. It may also lead to other cardiovascular conditions and diseases.

Age

The risk of having a heart attack increases with age. Men are at a higher risk of a heart attack after age 45, and women are at a higher risk of a heart attack after age 55.

Family history

You’re more likely to have a heart attack if you have a family history of early heart disease. Your risk is especially high if you have male family members who developed heart disease before age 55 or if you have female family members who developed heart disease before age 65.
Other factors that can increase your risk for heart attack include:
  • stress
  • lack of exercise
  • the use of certain illegal drugs, including cocaine and amphetamines
  • a history of preeclampsia, or high blood pressure during pregnancy

To determine whether you’ve had a heart attack, your doctor will listen to your heart to check for irregularities in your heartbeat. They may measure your blood pressure as well. Your doctor will also run a number of different tests if they suspect that you’ve had a heart attack. An electrocardiogram (EKG) may be done to measure your heart’s electrical activity. Blood tests can also be used to check for proteins that are associated with heart damage, such as troponin.
Other diagnostic tests include:
  • a stress test to see how your heart responds to certain situations, such as exercise
  • an angiogram with coronary catheterization to look for areas of blockage in your arteries
  • an echocardiogram to help identify areas of your heart that aren’t working properly

Heart attacks require immediate treatment, so most treatments begin in the emergency room. A minimally invasive procedure called angioplasty may be used to unblock the arteries that supply blood to the heart. During an angioplasty, your surgeon will insert a long, thin tube called a catheter through your artery to reach the blockage. They will then inflate a small balloon attached to the catheter in order to reopen the artery, allowing blood flow to resume. Your surgeon may also place a small, mesh tube called a stent at the site of the blockage. The stent can prevent the artery from closing again.
Your doctor may also want to perform a coronary artery bypass graft (CABG) in some cases. In this procedure, your surgeon will reroute your veins and arteries so the blood can flow around the blockage. A CABG is sometimes done immediately after a heart attack. In most cases, however, it’s performed several days after the incident so your heart has time to heal.
A number of different medications can also be used to treat a heart attack:
  • Blood thinners, such as aspirin, are often used to break up blood clots and improve blood flow through narrowed arteries.
  • Thrombolytics are often used to dissolve clots.
  • Antiplatelet drugs, such as clopidogrel, can be used to prevent new clots from forming and existing clots from growing.
  • Nitroglycerin can be used to widen your blood vessels.
  • Beta-blockers lower your blood pressure and relax your heart muscle. This can help limit the severity of damage to your heart.
  • ACE inhibitors can also be used to lower blood pressure and decrease stress on the heart.
  • Pain relievers may be used to reduce any discomfort you may feel.

There are many steps you can take to prevent a heart attack, even if you’ve had one before.
One way to lower your risk is to eat a heart-healthy diet. This diet should largely consist of:
  • whole grains
  • vegetables
  • fruits
  • lean protein
You should also reduce the amount of the following in your diet:
  • sugar
  • saturated fat
  • trans fat
  • cholesterol
This is especially important for people with diabetes, high blood pressure, and high cholesterol.
Exercising several times a week will also improve your cardiovascular health. If you’ve had a heart attack recently, you should speak with your doctor before starting a new exercise plan.
It’s also important to stop smoking if you smoke. Quitting smoking will significantly lower your risk of a heart attack and improve both your heart and lung health. You should also avoid being around secondhand smoke.

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