Definition of Myocardial infarction Our Heart Attack Main Article provides a comprehensive look at the who, what, when and how of Heart Attack Definition of Myocardial infarction Take the Heart Disease Quiz! Myocardial infarction: A heart attack . Abbreviated MI. The term "myocardial infarction" focuses on the myocardium (the heart muscle) and the changes that occur in it due to the sudden deprivation of circulating blood. The main change is necrosis (death) of myocardial tissue. The word "infarction" comes from the Latin "infarcire" meaning "to plug up or cram." It refers to the clogging of the artery. Last Editorial Review: 8/28/2013 Myocardial infarction | definition of myocardial infarction by Medical dictionary Myocardial infarction | definition of myocardial infarction by Medical dictionary cardiac infarction myocardial infarction . cerebral infarction an ischemic condition of the brain, causing a persistent focal neurologic deficit in the area affected. myocardial infarction see myocardial infarction .

pulmonary infarction localized necrosis of lung tissue caused by obstruction of the arterial blood supply, most often due to pulmonary embolism. Clinical manifestations range from the subclinical to pleuritic chest pain, dyspnea, hemoptysis, and tachycardia. myocardial [mi″o-kahr´de-al] pertaining to the muscular tissue of the heart (the myocardium). myocardial infarction (MI) death of the cells of an area of the heart muscle ( myocardium ) as a result of oxygen deprivation, which in turn is caused by obstruction of the blood supply; commonly referred to as a “heart attack.” The myocardium receives its blood supply from the two large coronary arteries and their branches. Occlusion of one or more of these blood vessels ( coronary occlusion ) is one of the major causes of myocardial infarction. The occlusion may result from the formation of a clot that develops suddenly when an atheromatous plaque ruptures through the sublayers of a blood vessel, or when the narrow, roughened inner lining of a sclerosed artery leads to complete thrombosis.

Coronary artery disease is the most common type of heart disease in the United States and many other countries. The risk rises rapidly with age, women tending to develop the disease 15 to 20 years later than men. Other causes of MI may be attributed to a sudden increased unmet need for blood supply to the heart, as in shock, hemorrhage, and severe physical exertion, and to restriction of blood flow through the aorta, as in aortic stenosis. Pathology. The most common sites of myocardial infarction are in the left ventricle, that chamber of the heart which has the greatest workload. Tissue changes that occur in the myocardium are related to the extent to which the cells have been deprived of oxygen. Total deprivation results in an area of infarction, in which the cells die and the tissue becomes necrotic. Necrosis in this area is evident within 5 to 6 hours after the occlusion. In response to this necrosis the body increases its production of leukocytes, which aid in removal of the dead cells. As collateral circulation enlarges, it brings fibroblasts, which form a connective tissue scar within the area of infarction.

Usually, the formation of fibrous scar tissue is complete within 2 to 3 months. Immediately surrounding the area of infarction is a less seriously damaged area of injury. It may deteriorate and thus extend the area of infarction or, with adequate collateral circulation, it may regain its function within 2 to 3 weeks. The outermost area of damage is the zone of ischemia, which borders the area of injury. The cells in this area are weakened by decreased oxygen supply, but function can return usually within two to three weeks after the onset of occlusion. All of the pathological changes described above can be identified by electrocardiography. The information thus obtained is used to prescribe the varying degrees of physical activity allowed the patient during convalescence. Risk Factors. Unavoidable traits that increase a person's chances for coronary artery disease include genetic susceptibility, sex, increasing age, and diabetes mellitus. Factors that can be controlled to some extent in order to ameliorate the risk include hypertension, cigarette smoking, and elevated serum lipids. Almost half of the persons who have suffered heart attacks have a history of one or more of these latter three risk factors.

Minimizing or eliminating these avoidable factors can reduce the incidence and severity of ischemic heart disease. Preventive measures are discussed more fully under heart . Symptoms. The most outstanding symptom of acute myocardial infarction is a sudden painful sensation of pressure, often described as a “crushing pain” in the chest, occasionally radiating to the arms, throat, and back, and persisting for hours. Pallor, profuse perspiration, and other signs of shock are present. There may be nausea and vomiting, leading to the mistaken impression that the victim is suffering from acute indigestion. In almost all cases of severe MI the patient is extremely apprehensive and has a sense of impending death. Severity of symptoms may depend on the size of the artery at the point of occlusion and the amount of myocardial tissue served by the artery. In some instances the artery may be small and the symptoms mild. In other cases the extent of damage is quite large and the attack is fatal. Within 24 hours of the initial attack there is an elevated temperature and increased white cell count in response to the inflammatory process arising from necrosis of myocardial tissue. Death of the cells also brings about the release of certain enzymes that enter the general circulation.

The levels of these enzymes in the blood can be determined by clinical laboratory tests. Within 2 to 4 hours after infarction the level of creatine kinase (CK) is increased; it reaches its peak within 24 hours and subsides to normal level within 48 hours. The level of serum aspartate transaminase (AST) increases rapidly in 4 to 6 hours, reaches its peak in 24 to 48 hours, and returns to normal in five days. In contrast to the rapid rise and decline of these two enzyme levels, lactate dehydrogenase (LD) levels begin to increase the first day after attack and persist at high levels for 10 to 20 days. troponin is another enzyme that is a sensitive marker of myocardial infarction. Tests can be made more specific by measuring the LD1 and CK2 isoenzymes, which are found in the heart. Diagnosis of MI is based on the presenting symptoms and evidence of impaired heart function found by physical examination and electrocardiography and on abnormal serum enzyme levels. Treatment and Patient Care.

Immediate care of acute myocardial infarction is concerned with combatting shock , relieving respiratory difficulty, and preventing further circulatory collapse. The victim should be kept lying down, and all tight clothing should be loosened to relieve dyspnea and promote comfort. Supplemental oxygen should be supplied, and oxygen consumption should be reduced by relieving anxiety and pain and supporting respiration. Without delay, but in a calm manner, the patient is transported to a medical care facility. If the victim shows signs of cardiac arrest , efforts at cardiopulmonary resuscitation are begun immediately. Medical treatment includes administration of thrombolytic therapy and an analgesic such as morphine sulfate or meperidine (Demerol). On occasion the physician may order atropine sulfate with morphine to counteract serious bradycardia . In almost all cases oxygen is administered for at least the first 24 hours. Intravenous thrombolytic therapy using tissue plasminogen activator or streptokinase should be considered for all patients presenting within 12 hours of onset of pain. Maximum potential benefit occurs when these drugs are administered within 4 to 6 hours.

Nursing considerations include the early accurate assessment of potential candidates for thrombolytic therapy, prompt administration of medication, and careful monitoring of complications such as arrhythmias, hypotension, allergic reactions, reocclusion, and hemorrhage. Early catheterization and angioplasty with a stent may also be done and may be superior to intravenous thrombolytic therapy. Rest is essential for repair of damaged myocardial cells, but that does not necessarily mean absolute bed rest. Whether the patient is placed on bed rest or allowed up in a chair depends on symptoms and nursing judgments. During the acute stage some physicians may prefer that the patient rest in a chair at the bedside. The patient is permitted to get out of bed with assistance and sit in the chair until he begins to feel fatigued. The amount of time the patient is allowed to sit up and become more physically active is gradually increased. Adequate rest can be achieved more easily if mental anxiety is reduced; a restful environment is thought to enhance the ability to rest.

The amount of rest needed and the degree of physical activity allowed depends on how extensive the area of infarction is thought to be, whether cardiac arrhythmias and other complications develop, and the response of the patient to increased physical activity. Careful monitoring of the pulse rate and blood pressure before and after each activity can provide information with which to evaluate the patient's tolerance for exercise and self-care activities. Most patients with a myocardial infarction are cared for in a coronary care unit during the acute stage. It is important that the patient and family be given a brief explanation of the various kinds of monitoring equipment in use and that they be reassured of each staff member's concern for the patient's welfare. As the patient's status improves he or she is gradually weaned away from intensive care and encouraged to participate more in self-care. For some, this is a traumatic experience and they become very apprehensive about leaving the security of the monitors and the attention of the staff. Cardiac rehabilitation is also an important aspect of care. In some hospitals the transition from coronary care unit to home is made easier by transfer to a “step-down” or intermediate care unit where the patient's response to activities is monitored and instructions are given regarding care for himself or herself after discharge.

Information about local coronary clubs, assistance in patient education, and availability of a Cardiac Work Evaluation Unit to determine the patient's readiness to return to work can be obtained by contacting the local unit of the American Heart Association. Myocardial infarction. From Frazier et al., 2000. my·o·car·di·al in·farc·tion (MI), infarction of a segment of heart muscle, usually due to occlusion of a coronary artery. [mī′ōkär′dē·əl] Etymology: Gk, mys, muscle, kardia, heart; L, infarcire, to stuff necrosis of a portion of cardiac muscle caused by an obstruction in a coronary artery resulting from atherosclerosis, a thrombus, or a spasm. Also called heart attack . See also acute myocardial infarction . observations The onset of MI is characterized by a crushing, viselike chest pain that may radiate to the left arm, neck, jaw, or epigastrium and sometimes stimulates the sensation of acute indigestion or a gallbladder attack.

The patient usually becomes ashen, clammy, short of breath, nauseated, faint, and anxious and often feels that death is imminent. Typical signs are tachycardia, a barely palpable pulse, low blood pressure, mildly elevated temperature, cardiac arrhythmia, and elevation of the S-T segment and Q wave on the electrocardiogram. Laboratory studies usually show an increased sedimentation rate, leukocytosis, and elevated serum levels of creatine kinase and its isoenzyme MB, lactic dehydrogenase and its isoenzymes, and glutamic-oxaloacetic transaminase. Potential complications in MI are pulmonary or systemic embolism, pulmonary edema, acute congestive heart failure, shock, ventricular tachycardia, ventricular fibrillation, and cardiac arrest. interventions Emergency treatment of MI may require cardiopulmonary resuscitation before the patient reaches the hospital emergency department. Early IV administration of thrombolytic drugs and heparin improves left ventricular function, limits damage, and increases survival rates.

Primary percutaneous transvenous coronary angioplasty (PTCA) is being used with increasing frequency and can achieve prompt reperfusion and help prevent the hemorrhagic risks of thrombolysis. Primary PTCA requires a well-staffed, well-equipped cardiac catheterization laboratory that can mobilize within 1 hour and achieve reperfusion within 2 hours. nursing considerations The patient is admitted to an intensive care unit with continual electrocardiographic monitoring at the acute onset. Blood pressure, temperature, respiration, and apical pulse are checked frequently. Parenteral fluids may be administered, and the patient is usually served a low-sodium, low-cholesterol, low-fat diet. Stool softeners and laxatives may be indicated to prevent straining. The nurse's role in helping the patient and family understand the nature and treatment of the disease is extremely important. Before discharge the nurse usually discusses the need to adhere to the prescribed diet and medication, to limit activities, to rest at regular periods, and to avoid caffeine, nicotine, large meals, and emotional stress.

Common locations of myocardial infarction Locations of pain from myocardial infarction Acute myocardial infarction myocardial infarction Acute necrosis of myocardial tissue; in the early post-MI period, there may be a need to rely on 'soft' data, especially if troponin I or CK-MB have yet to ↑, or there is a loss of sensation to the pain characteristic of MI, as occurs in circa 10% Pts with DM; older ♀ may have normal levels of CK after an MI Risk factors for MI ASHD, ↑ cholesterol, HTN, smoking, DM, low selenium, etc Lab Cardiac enzymes, 'flipped' LD, troponins increase to normal size.

Pathology Chronology of myocardial changes Fatal complications of MI Shock, arrhythmias, rupture of ventricular aneurysms or papillary muscle, acute CHF, mural thromboembolism Risks ↑ risk with ↑ TGs, ↑ small LDL particle diameter, ↓ HDL-C my·o·car·di·al in·farc·tion (MI) (mī'ō-kahr'dē-ăl in-fahrk'shŭn) Infarction of an area of the heart muscle, usually as a result of occlusion of a coronary artery. myocardial infarction Abbreviation: MI The loss of living heart muscle as a result of coronary artery occlusion. MI or its related syndromes (acute coronary syndrome or unstable angina) usually occurs when an atheromatous plaque in a coronary artery ruptures, and the resulting clot obstructs the injured blood vessel. Perfusion of the muscular tissue that lies downstream from the blocked artery is lost. If blood flow is not restored within a few hours, the heart muscle dies. Synonym: cardiac infarction Acute MI affects 1.1 million people each year, and approx.

350,000 of them die. The probability of dying from MI is related to the patient's underlying health, whether arrhythmias such as ventricular fibrillation or ventricular tachycardia occur, and how rapidly the patient seeks medical attention and receives appropriate therapies (such as thrombolytic drugs, angioplasty, antiplatelet drugs, beta blockers, and intensive electrocardiographic monitoring). See: illustration; advanced cardiac life support ; atherosclerosis ; cardiac arrest ; sudden death Etiology Proven risk factors for MI are tobacco use, diabetes mellitus, abnormally high cholesterol levels, high blood pressure, gender, advanced age, obesity, physical inactivity, chronic kidney disease, a family history of MI at an early age, and loss of albumin in the urine. Some research suggests that high C reactive protein levels, and other conditions may also lead to increased risk. Symptoms Classic symptoms of MI in men are a gradual onset of pain or pressure, felt most intensely in the center of the chest, radiating into the neck, jaw, shoulders, or arms, and lasting more than a half hour.

Pain typically is dull or heavy rather than sharp or stabbing, and often is associated with difficult breathing, nausea, vomiting, and profuse sweating. Clinical presentations, however, vary considerably, and distinct presentations are seen in woman and the elderly, in whom, e.g., unexplained breathlessness is often the primary symptom. Many patients may mistake their symptoms for indigestion, intestinal gas, or muscular aches. About a third of all MIs are clinically silent, and almost half present with atypical symptoms. Often patients suffering MI have had angina pectoris for several weeks before and simply did not recognize it. Diagnosis A compatible history associated either with segment elevation (on a 12-lead electrocardiogram) or with elevated blood levels of cardiac muscle enzymes such as troponins or creatine kinase can establish the diagnosis. An ST-segment elevation of more than 1 mm above baseline in at least two contiguous precordial leads or two adjacent limb leads suggests myocardial injury. Myocardial infarctions with this presentation are known as ST-segment elevation MI (STEMI).

This finding usually indicates significant muscle damage in the infarct area, a poorer prognosis, and a higher incidence of complications (arrhythmias, cardiogenic shock) than in a non-ST-segment elevation MI (NSTEMI). The differential diagnosis of chest pain must always be carefully considered because other serious illnesses, such as pulmonary embolism, pericarditis, aortic dissection, esophageal rupture, acute cholecystitis, esophagitis, or splenic rupture may mimic MI. Treatment Myocardial infarction is a medical emergency; diagnosis and treatment should not be delayed. People who experience symptoms suggestive of MI should be taught to call 911 immediately and chew and swallow aspirin. Oxygen is administered at 4 L/min as soon as it is available. History is gathered throughout the first few minutes after admission even as a 12-lead ECG is being done and blood taken for biomarkers. Cardiac troponins may not become elevated until 4 or more hr after symptoms begin. If the patient is hypotensive or in cardiogenic shock, right-sided ECG leads are assessed for a right ventricular (RV) infarct.

An intravenous access is established along with continuous cardiac monitoring, and medications (which may include chewed aspirin [162 to 325 mg], heparins, or other medications to inhibit platelet aggregation, nitroglycerin [given SL, sprayed or IV], IV morphine, and beta-blockers) are administered as prescribed. Pain is assessed on a 1 to 10 intensity scale, and morphine 2 to 10 mg administered IV, with incremental doses of 2 to 8 mg every 5 to 15 min until relief is obtained. Beta-blockers (such as metoprolol or atenolol) decrease myocardial oxygen demand, helping to limit the amount of heart muscle damaged. An IV beta-blocker should be given if the patient is hypertensive or has a tachyarrhythmia as long as no contraindications exist. Patients with STEMI who arrive at the hospital within 6 hr of the onset of symptoms are treated with fibrinolytic therapy or percutaneous coronary intervention (PCI).

The goal for administration of fibrinolytic therapy is 30 min postsymptom onset (door-to-needle); for PCI 90 min (door-to-balloon inflation). Absolute contraindications of fibrinolytic therapy include previous intracranial hemorrhage or ischemic stroke within 3 months ( intracranial malignancy), active bleeding, or bleeding disorders (except menses), significant closed head or facial trauma within 3 months (known structural cerebral vascular lesions), and suspected aortic dissection. Reperfusion is the immediate goal, usually best accomplished with balloon angioplasty and endovascular stent placement, although emergency coronary bypass surgery may be needed in cases when PCI fails. An angiotensin-converting enzyme (ACE) inhibitor is administered within 24 hr of a STEMI to suppress the renin-angiotensin-aldosterone system and prevent excess fluid retention. ACE inhibitors also prevent conversion of angiotensin I to angiotensin II (a potent vasoconstrictor), thus reducing afterload to help prevent heart failure. In MI complicated by pulmonary edema, diuretics are administered, and dobutamine infusions may be necessary to increase cardiac output.

Strict glucose control (maintaining blood sugars below 150 mg/dl, and preferably in the normal range) reduces mortality in acute MI. Hypotension and circulatory collapse frequently occur in patients with significant RV infarctions, and fluid challenge is administered to optimize RV preload. If this is unsuccessful, the patient with an RV infarct will require inotropic support, correction of bradycardia, and measures to achieve atrioventricular synchrony (cardioversion for atrial fibrillation, etc). In patients with ventricular arrhythmias, defibrillation, or cardioversion, lidocaine, vasopressin, or amiodarone infusions, or other drugs, may be necessary. Anemic patients (hematocrit less than 30 or those actively bleeding) benefit from blood (packed red cell) transfusions. With contemporary care, about 95% of patients with acute MI who arrive at the hospital in time will survive. These patients are referred to nutrition therapists to learn how to use low-fat, low-cholesterol diets, and to cardiac rehabilitation programs for exercise training, tobacco cessation, and psychosocial support.

Patient care Acute Care: On admission, all diagnostic and treatment procedures are explained briefly to reduce stress and anxiety. Continuous electrocardiographic monitoring is used to identify changes in heart rhythm, rate, and conduction. Location, radiation, quality, severity, and frequency of chest pain are documented and relieved with IV morphine. Bleeding is the most common complication of antiplatelet, anticoagulant, and fibrinolytic therapies. The complete blood count, prothrombin time, and activated partial thromboplastin time are monitored at daily intervals. IV sites are assessed for evidence of bleeding. Fluid balance and pulmonary status are closely monitored for signs of fluid retention and overload. Breath sounds are auscultated for crackles (which may resolve by having the patient cough when caused by atelectasis, or which may indicate pulmonary edema when they do not). Heart sounds are auscultated for S3 or S4 gallops or new heart murmurs. Patient care and other activities should be organized to allow for periods on uninterrupted rest. Stool softeners are prescribed to prevent straining during defecation, which can cause vagal stimulation and slow the heart rate.

Antiembolism stockings help to prevent venostasis and deep vein thrombosis. Emotional support is provided to decrease stress and anxiety. Adjustment disorders and depression are often experienced by MI patients, and the patient and family are assisted to deal with these feelings. Stress tests, coronary angiography, cardiac imaging procedures, reperfusion techniques, and other interventions are explained. The patient receives assistance in coping with changes in health status and self-concept. Ambulatory Care: Cardiac rehabilitation begins as soon as the patient is physiologically stable. The goal of cardiac rehabilitation is to have the patient establish a healthy lifestyle that minimizes the risk of another MI. Ambulation is slowly increased, and a low-level treadmill test may be ordered before discharge to determine exercise tolerance and the risk of future heart attacks. Patients are taught not only to measure their pulse but also to assess their response to exercise in terms of fatigue, ease of breathing, and perceived workload. Following discharge, exercise is slowly increased, first while being monitored closely by supervised cardiac rehabilitation, and then more independently.

The patient also receives information about a low saturated fat, low cholesterol, low calorie diet, such as the DASH eating plan (Dietary Approaches to Stop Hypertension), resumption of sexual activity, work, and other activities. The patient is taught about desired and adverse affects of all medications: aspirin therapy is usually prescribed as ongoing antiplatelet therapy (with or without clopidogrel), but patients should be warned about the risk of bleeding and be advised to avoid products containing ibuprofen, which blocks aspirin’s antiplatelet effects. Smoking cessation is an important preventive for future MIs. High blood pressure, obesity, adverse cholesterol levels, and diabetes mellitus also should be carefully managed to help prevent future MIs. Alcohol intake should be limited to 1 drink daily (women), 2 drinks daily (men). Opportunities are created for patients and families to share feelings and receive realistic reassurance about common fears. illustration See also: infarction myocardial infarction (MI) The death and coagulation of part of the heart muscle deprived of an adequate blood supply by coronary artery blockage in a HEART ATTACK . See also INFARCTION .

Established major risk factors for MI are raised plasma low density lipoprotein cholesterol; decreased high density lipoprotein cholesterol; smoking; and high blood pressure. Risk factors of secondary importance include physical inactivity; obesity; and increased plasma glucose. Currently suspected risk factors include inflammatory markers such as C-reactive protein, interleukins and serum amyloid A; and procoagulant markers such as homocyteine, tissue plasminogen activator, plasminogen activator inhibitor and lipoprotein A. Possible trigger factors include a surge of sympathetic activity and exposure to particulate air pollution. Genetic factors remain uncertain. Myocardial infarction Commonly known as a heart attack, a myocardial infarction is an episode in which some of the heart's blood supply is severely cut off or restricted, causing the heart muscle to suffer and die from lack of oxygen.

Mentioned in: Angina , Antimyocardial Antibody Test , Aspartate Aminotransferase Test , Heart Attack , Troponins Test , Ventricular Aneurysm myocardial infarction ; MI; heart attack life-threatening infarct (loss of function of cone-shaped area of heart muscle) due to coronary artery stenosis or obstruction (e.g. secondary to atherosclerosis and/or embolus) myocardial infarction (mīˈ·ō·kärˑ·dē· l in·färkˑ·sh n), n necrosis of cardiac muscle tissue caused by a coronary artery obstruction linked to a spasm, thrombosis, or atherosclerosis. Also called heart attack. my·o·car·di·al in·farc·tion (MI) (mī'ō-kahr'dē-ăl in-fahrk'shŭn) Infarction of an area of the heart muscle, usually as a result of occlusion of a coronary artery.

Myocardial Infarction - definition, symptoms, treatment and ECG | Health Dictionary Myocardial Infarction - definition, symptoms, treatment and ECG Myocardial Infarction - definition, symptoms, treatment and ECG What is Myocardial Infarction and Definition Death of HEART tissue. The most common cause of myocardial infarction is occlusion of the CORONARY ARTERIES such as occurs as a consequence of CORONARY ARTERY DISEASE (CAD) or less frequently of coronary ARTERY spasm. Myocardial infarction is the clinical term doctors use for HEART ATTACK . The MYOCARDIUM has very high oxygen needs, as oxygen is the only energy source for myocardial cells (unlike most other cells in the body, except the BRAIN, that also use GLUCOSE for energy). Myocardial tissue does not have significant ability to regenerate. Myocardial tissue that dies not only can no longer contract to aid in the heart’s function but also cannot conduct electrical impulses to reach undamaged tissue.

Myocardial infarction results in “dead” areas of the heart MUSCLE that cannot participate in the CARDIAC CYCLE , which often results in ARRHYTHMIA as well as ineffective pumping ability. The cellular structure of these areas changes, initially becoming soft and subsequently becoming fibrous (scarlike). New arteries are often able to develop, through a process called angiogenesis, to carry BLOOD around infarcted areas of the heart. This helps the rest of the heart remain functional. However, large infarctions may overcome the heart, resulting in heart attack or CARDIAC ARREST . Diagnosis Myocardial Infarction and Treatment ELECTROCARDIOGRAM (ECG) and ECHOCARDIOGRAM are the diagnostic procedures that typically identify myocardial infarction. Treatment includes eliminating the cause of the infarction, such as coronary artery occlusion, and stabilizing the heart’s function to the best extent possible with medications. Because CAD is nearly always the culprit, ANGIOPLASTY or CORONARY ARTERY BYPASS GRAFT (CABG) are nearly always among the treatment options.

Open discussion on the topic Myocardial Infarction - definition, symptoms, treatment and ECG only title Acute Myocardial Infarction: Causes, Symptoms & Diagnosis Acute Myocardial Infarction Written by Brindles Lee Macon, Winnie Yu, and Lauren Reed-Guy Medically Reviewed by Email addresses will not be shared with 3rd parties. See privacy policy Thank you. Your message has been sent. OK We're sorry, an error occurred. We are unable to collect your feedback at this time. However, your feedback is important to us. Please try again later. Close What Is Acute Myocardial Infarction? Highlights Acute myocardial infarction is the medical name for a heart attack. Heart attacks occur when the flow of blood to the heart becomes blocked. They can cause tissue damage and can even be life-threatening. A number of different factors may increase your risk for a heart attack, including high blood pressure, high cholesterol, and diabetes. Call 911 immediately if you believe you or someone you know may have had a heart attack. Getting prompt medical treatment will greatly improve the chances of recovery. 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 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. Call 911 right away if you think that you or someone you know may be having a heart attack. What Are the Symptoms of Acute Myocardial Infarction? 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 nausea vomiting In fact, some women who have had a heart attack report that their symptoms felt like the symptoms of the flu. What Causes Acute Myocardial Infarction? 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 coronary arteries.

They take oxygen-rich blood to all of the organs in your body, including your heart. 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. Who Is at Risk for Acute Myocardial Infarction? 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 the use of certain illegal drugs, including cocaine and amphetamines a history of preeclampsia , or high blood pressure during pregnancy How Is Acute Myocardial Infarction Diagnosed? 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 How Is Acute Myocardial Infarction Treated? Heart attacks require immediate treatment, so most treatments begin in the emergency room. A surgical 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. What Can Be Expected After Treatment? Your chances of recovering from a heart attack depend on how much damage there is to your heart and how quickly you receive emergency care.

The sooner you receive treatment, the more likely you are to survive. However, if there’s substantial damage to your heart muscle, your heart may be unable to pump an adequate amount of blood throughout your body. This can lead to heart failure . Heart damage also increases your risk of developing abnormal heart rhythms, or arrhythmias. Your risk of having another heart attack will be higher as well. Many people who’ve had heart attacks experience anxiety and depression. It’s important to speak with your doctor about your concerns during recovery. It may also be beneficial to join a support group or to speak with a counselor about what you’re going through. Most people are able to resume their normal activities after a heart attack. However, you’ll need to ease back into any intense physical activity. Your doctor will help you develop a specific plan for recovery. You may be required to take medications or undergo a cardiac rehabilitation program. This type of program can help you slowly regain your strength, teach you about healthy lifestyle changes, and guide you through treatment. How Can Acute Myocardial Infarction Be Prevented? 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 You should also reduce the amount of the following in your diet: sugar 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. Myocardial Infarction (Heart Attack) Causes and Warning Signs What Causes a Heart Attack? What Is a Heart Attack? The heart requires its own constant supply of oxygen and nutrients , like any muscle in the body. Two large, branching coronary arteries deliver oxygenated blood to the heart muscle. If one of these arteries or branches becomes blocked suddenly, a portion of the heart is starved of oxygen, a condition called "cardiac ischemia ." If cardiac ischemia lasts too long, the starved heart tissue dies.

This is a heart attack , otherwise known as a myocardial infarction -- literally, "death of heart muscle." Most heart attacks occur during several hours -- so never wait to seek help if you think a heart attack is beginning. In some cases there are no symptoms at all, but most heart attacks produce some chest pain . Other signs of a heart attack include shortness of breath, dizziness , faintness, or nausea . The pain of a severe heart attack has been likened to a giant fist enclosing and squeezing the heart. If the attack is mild, it may be mistaken for heartburn . The pain may be constant or intermittent. Also, women are less likely to experience the classic symptoms of chest pain than men are. Angina: Early Warning Sign of a Heart Attack Many heart attack victims are warned of trouble by episodes of angina , which is chest pain that, like a heart attack, is provoked by ischemia. The difference is mainly one of degree: With angina, blood flow is restored, pain recedes within minutes, and the heart is not permanently damaged. With a heart attack, blood flow is critically reduced or fully blocked, pain lasts longer, and heart muscle dies without prompt treatment.

About 25% of all heart attacks occur without any previous warning signs. They are sometimes associated with a phenomenon known as "silent ischemia" -- sporadic interruptions of blood flow to the heart that, for unknown reasons, are pain-free, although they may damage the heart tissue. The condition can be detected by ECG ( electrocardiogram ) testing. People with diabetes often have silent ischemia. A quarter of all heart attack victims die before reaching a hospital; others suffer life-threatening complications while in the hospital. Serious complications include stroke , persistent heart arrhythmias (irregular heart beats), heart failure , formation of blood clots in the legs or heart, and aneurysm , or bulging, in a weakened heart chamber. But those who survive the initial heart attack and are free from major problems a few hours later stand a better chance of full recovery. Continued Recovery is always a delicate process, because any heart attack weakens the heart to some degree. But generally, a normal life can be resumed.

Depending on the severity of a heart attack, a person may experience: Heart failure , where the heart doesn't pump well enough to meet the body's needs Arrhythmias or abnormal heart rhythms Cardiac arrest or sudden cardiac death, where the heart stops beating Cardiogenic shock, where the heart is so damaged from the heart attack that a person goes into shock, which may result in damage of other vital organs like the kidneys or liver Death What Causes a Heart Attack? Most heart attacks are the result of coronary artery disease , also known as atherosclerosis or "hardening of the arteries," a condition that clogs coronary arteries with fatty, calcified plaques over time. The typical trigger for a heart attack is often a blood clot that blocks the flow of blood through a coronary artery. In the early 1980s, researchers confirmed that the trigger for nearly all heart attacks is not the obstructive plaque itself, but the sudden formation of a blood clot -- like a scab -- on top of plaque that cuts off blood flow in an already narrowed vessel.

This is called "plaque rupture." Contrary to prior belief, doctors now recognize that the less severe plaques are the cause of most heart attacks: It's the milder blockages that rupture and then cause the blood clot to form. Heart attacks may also be caused by coronary artery spasm, where a heart artery is temporarily constricted, although this is a fairly rare cause. New research shows that inflammation also plays a role in the evolution of heart attacks. It appears that the coronary artery walls become inflamed over time, further increasing the buildup of fatty plaques. While the step-by-step process leading to a heart attack is not fully understood, major risk factors for coronary artery disease are well-known. Some can be controlled, including high blood pressure , high cholesterol , obesity , smoking , and a sedentary lifestyle. Stress is also said to raise the risk, and exertion and excitement can act as triggers for a heart attack. Other risk factors include having diabetes and having a family history of heart disease . WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on February 28, 2015 Sources Heart Attack information.

Signs of a heart attack at Patient | Patient 1041 A heart attack (myocardial infarction) is usually caused by a blood clot, which stops the blood flowing to a part of your heart muscle. You should call for an ambulance immediately if you develop severe chest pain. Treatment with a clot-busting medicine or an emergency procedure to restore the blood flow through the blocked blood vessel are usually done as soon as possible. This is to prevent or minimise any damage to your heart muscle. Other treatments help to ease the pain and to prevent complications. Reducing various risk factors can help to prevent a heart attack. Understanding the heart and coronary arteries The heart is mainly made of special muscle (myocardium). The heart pumps blood into blood vessels (arteries) which take the blood to every part of the body. Like any other muscle, the heart muscle needs a good blood supply. The coronary arteries take blood to the heart muscle. The main coronary arteries branch off from the aorta. The aorta is the large artery which takes oxygen-rich blood from the heart chambers to the body. The main coronary arteries divide into smaller branches which take blood to all parts of the heart muscle.

See separate leaflet called The Heart and Blood Vessels for more details . What happens to your heart with a heart attack? If you have a heart attack, a coronary artery or one of its smaller branches is suddenly blocked. The part of the heart muscle supplied by this artery loses its blood (and oxygen) supply if the vessel is blocked. This part of the heart muscle is at risk of dying unless the blockage is quickly removed. When a part of the heart muscle is damaged it is said to be infarcted. The term myocardial infarction (MI) means damaged heart muscle. If a main coronary artery is blocked, a large part of the heart muscle is affected. If a smaller branch artery is blocked, a smaller amount of heart muscle is affected. After a heart attack, if part of the heart muscle has died, it is replaced by scar tissue over the following few weeks. Some newer terms used by doctors A heart attack and myocardial infarction (MI) are commonly used terms, and mean the same thing. However, the term MI is used less often now by doctors. This is because there are actually a range of conditions that can be caused by a sudden reduction in blood flow in a coronary artery.

This range of conditions has an overall term called acute coronary syndrome (ACS). Two main sub types of ACS can be diagnosed by what is seen on your heart tracing (electrocardiograph, or ECG). The two main types are called ST-elevation MI (STEMI) and non-ST-elevation MI (NSTEMI). The ST elevation refers to a section on the ECG tracing. NSTEMI can also include unstable angina. Most people with angina chest pains only have pain with a certain amount of exertion. This is called stable angina. If the pattern of your pain changes suddenly and the pains develop after minimal exertion, or while you are resting, this is called unstable angina. This is an emergency and needs immediate medical care. See separate leaflet called Angina for further information . In STEMI, the artery supplying an area of the heart muscle is completely blocked. However, in NSTEMI, the artery is only partly blocked, so only part of the heart muscle supplied by the affected artery is affected. Your treatment can depend upon which type you have - STEMI or NSTEMI. This leaflet mainly discusses STEMI - which is just referred to as a heart attack from now on.

See separate leaflet called Acute Coronary Syndrome for more details on NSTEMI, unstable angina and ACS . What causes a heart attack? Blood clot (thrombosis) - the cause in most cases The most common cause of a heart attack is a blood clot that forms inside a coronary artery, or one of its branches. This blocks the blood flow to a part of the heart. Blood clots do not usually form in normal arteries. However, a clot may form if there is some atheroma within the lining of the artery . Atheroma is like fatty patches or plaques that develop within the inside lining of arteries. (This is similar to water pipes that get furred up.) Plaques of atheroma may gradually form over a number of years in one or more places in the coronary arteries. Each plaque has an outer firm shell with a soft inner fatty core. What happens is that a crack develops in the outer shell of the atheroma plaque. This is called plaque rupture. This exposes the softer inner core of the plaque to blood. This can trigger the clotting mechanism in the blood to form a blood clot. Therefore, a build-up of atheroma is the root problem that leads to most cases of ACS.

(The diagram below shows four patches of atheroma as an example. However, atheroma may develop in any section of the coronary arteries.) Treatment with clot-busting medication or a procedure called angioplasty (see below) can break up the clot and restore blood flow through the artery. If treatment is given quickly enough this prevents damage to the heart muscle, or limits the extent of the damage. Uncommon causes Various other uncommon conditions can block a coronary artery - for example: Inflammation of the coronary arteries (rare). A stab wound to the heart. A blood clot forming elsewhere in the body (for example, in a heart chamber) and travelling to a coronary artery where it gets stuck. Taking cocaine, which can cause a coronary artery to go into spasm. Complications from heart surgery. Some other rare heart problems. These are not dealt with further in this leaflet. The rest of this leaflet deals only with the common cause - thrombosis over an atheroma plaque. Who is at risk of having a heart attack? Heart attacks are common. About 146,000 people in the UK have a heart attack every year.

Most occur in people aged over 50 and it becomes more common with increasing age. Sometimes younger people are affected. A heart attack is three times more common in young men than in young women. However, after the menopause, the female hormones no longer protect the heart so the risk is then the same for men and women. A heart attack may occur in people known to have heart disease, such as people with chest pain called angina. It can also happen out of the blue in people with no previous symptoms of heart disease. This is because fatty patches or plaques (called atheroma) often develop without any symptoms at first. Certain risk factors increase the risk of more atheroma forming. This can lead to ACS. See separate leaflet called Preventing Cardiovascular Diseases for more details . Briefly, risk factors that can be modified and may help to prevent a heart attack include: Diet. You should aim to eat a healthy diet . Diabetes. People with diabetes have a higher risk of having ACS . This risk can be reduced by ensuring your blood pressure, cholesterol levels and blood sugar (glucose) levels are well controlled. Family history.

Your risk is increased if there is a family history of heart disease or a stroke that occurred in your father or brother aged below 55, or in your mother or sister aged below 65. Ethnic group. Certain ethnic groups - for example, British Asians - have a higher risk of developing cardiovascular diseases. What are the symptoms of a heart attack? The most common symptom is severe chest pain, which often feels like a heavy pressure feeling on your chest. The pain may also travel up into your jaw and down your left arm or down both arms. You may also sweat, feel sick and feel faint. You may also feel short of breath. The pain may be similar to angina, but it is usually more severe and lasts longer. ( Angina usually goes off after a few minutes . Heart attack pain usually lasts more than 15 minutes - sometimes several hours.) However, some people have only a mild discomfort in their chest. The pain can sometimes feel like indigestion or heartburn. Occasionally, a heart attack happens without causing any pain. This is usually diagnosed when you have a heart tracing (electrocardiograph, or ECG) at a later stage.

Some people collapse and die suddenly, if they have a large portion of heart muscle damaged. This is not very common. What should I do if I think I am having a heart attack? Dial 999/112/911 for an ambulance immediately. Then, if you have some, take one aspirin tablet (see below for the reason for this). You will normally be admitted straight to hospital. How is a heart attack diagnosed and assessed? Many people develop chest pains that are not due to a heart attack. For example, you can have quite bad chest pains with heartburn, gallbladder problems or with pains from conditions of the muscles in the chest wall. Therefore, tests are usually done to confirm a heart attack. These are: A heart tracing (electrocardiograph, or ECG) . There are typical changes to the normal pattern of the ECG in a heart attack. Patterns that occur include things called pathological Q waves and ST elevation. However, it is possible to have a normal ECG even if you have had a heart attack. Blood tests . A blood test that measures a chemical called troponin is the usual test that confirms a heart attack. This chemical is present in heart muscle cells.

Damage to heart muscle cells releases troponin into the bloodstream. In a heart attack the blood level of troponin increases within 3-12 hours from the onset of chest pain, peaks at 24-48 hours and returns to a normal level over 5-14 days. A rough idea as to the severity of the heart attack (the amount of heart muscle that is damaged) can be gauged by: The degree of abnormality of the ECG; and The level of troponin in the blood. Another chemical that may be measured in a blood test is called creatine kinase. This too is released from heart muscle cells during a heart attack. Your ECG will be monitored for a few days to check on the heart rhythm. Various blood tests will be done to check on your general well-being. Other tests may be done in some cases. This may be to clarify the diagnosis (if the diagnosis is not certain) or to diagnose complications such as heart failure if this is suspected. For example, an ultrasound scan of the heart (echocardiogram) or a test called a myocardial perfusion scan may be done.

Also, before discharge from hospital, you may be advised to have tests to assess the severity of the fatty patches or plaques (atheroma) in the coronary arteries - for example: An ECG taken whilst you exercise on a treadmill or bike (exercise tolerance test) . An angiography of the coronary arteries may also be performed. In this test a dye is injected into the coronary arteries. The dye can be seen by special X-ray equipment. This shows up the structure of the arteries (like a road map) and can show the location and severity of any atheroma. What is the treatment for a heart attack? The following is a typical situation and mentions the common treatments that are usually offered. However, each case is different and treatments may vary depending on your situation. Read more blog posts Aspirin and other antiplatelet medicines As soon as possible after a heart attack is suspected you will be given a dose of aspirin. Aspirin reduces the stickiness of platelets . Platelets are tiny particles in the blood that trigger the blood to clot. It is the platelets that become stuck on to a patch of atheroma inside an artery that go on to form the clot.

Other antiplatelet medicines called clopidogrel or ticagrelor may be given. They work in a different way to aspirin and help reduce platelet stickiness. Injections of heparin or a similar medicine These are usually given for a few days to help prevent further blood clots from forming. Pain relief A strong painkiller such as morphine is given by injection into a vein to ease the pain. Treatment to restore blood flow in the blocked coronary artery The part of the heart muscle starved of blood does not die immediately. If blood flow is restored within a few hours, much of the heart muscle that would have been damaged and die will survive. This is why a heart attack is a medical emergency and treatment is given urgently. The quicker the blood flow is restored, the better the outlook. There are two treatments that can restore blood flow back through the blocked artery: Emergency angioplasty. Ideally this is the best treatment if it is available and can be done within a few hours of symptoms starting. In this procedure a tiny wire with a balloon at the end is put into a large artery in the groin or arm.

It is then passed up to the heart and into the blocked section of a coronary artery, using special X-ray guidance. The balloon is blown up inside the blocked part of the artery to open it wide again. A stent may be left in the widened section of the artery. A stent is like a wire mesh tube which gives support to the artery and helps to keep the artery widened. See separate leaflet called Coronary Angioplasty for more details . An injection of a clot-busting medicine is an alternative to emergency angioplasty. It can be given easily and quickly in most situations. Some ambulance crews are trained to give this. Note: a common clot-busting medicine used in the UK is called streptokinase. If you are given this medicine you should not be given it again if you have another heart attack in the future. This is because antibodies develop to it and it will not work so well a second time. An alternative clot-busting medicine should be given. Both the above treatments usually work well to restore blood flow and greatly improve the outlook. The most crucial factor is the speed at which one or other treatment is given after symptoms have started.

A beta-blocker medicine Beta-blocker medicines block the action of certain hormones such as adrenaline (epinephrine). These hormones increase the rate and force of the heartbeat. Beta-blocker medicines have some protective effect on the heart muscle and they also help to prevent abnormal heart rhythms from developing. Beta-blocker medicines will also help to prevent another heart attack. More related content Insulin Some people have a raised blood sugar level when they have a heart attack, even if they do not have diabetes. If this occurs then your blood sugar (glucose) levels may need to be controlled with insulin. If you have diabetes then it is also likely that you will need to be treated with insulin to control your blood glucose levels when you are in hospital. Oxygen You may be given oxygen which works to reduce the risk of damage to your heart muscle. Treatment after you have had a heart attack Normally you will be advised to take regular medication for the rest of your life. See separate leaflet called Medication After a Heart Attack (Myocardial Infarction) for more details . Many people recover well from a heart attack and have no complications. Before discharge from hospital, it is common for a doctor or nurse to advise you how to reduce any risk factors (see above).

This advice aims to reduce your risk of a future heart attack as much as possible. How serious is a heart attack? This often depends on the amount of heart muscle that is damaged. In many cases, only a small part of the heart muscle is damaged and then heals as a small patch of scar tissue. The heart can usually function normally with a small patch of scar tissue. A larger heart attack is more likely to be life-threatening or cause complications. Even before treatments became available to restore blood flow, many people made a full recovery. With the help of modern treatment, particularly if you are given treatment within a few hours to restore blood flow, a higher percentage of people now make a full recovery. Some possible complications include the following: Heart failure. If a large area of the heart muscle is damaged then the pumping ability of the heart may be reduced. Less blood than usual is then pumped around the body, especially when extra blood is needed when you exercise. Symptoms such as breathlessness, tiredness and swollen ankles may develop. Mild heart failure can often be treated with medication. Severe heart failure can be serious and even life-threatening. See separate leaflet called Heart Failure for more details .

Abnormal heart rhythms may occur if the electrical activity of the heart is affected. The main risk of this happening is within the first few hours after a heart attack. Sudden, chaotic, fast heartbeats may occur. This is called ventricular fibrillation and is the common cause of cardiac arrest. This needs immediate treatment with an electrical shock given by a defibrillator. Otherwise, collapse and sudden death are likely. Other less serious abnormal heart rhythms can also occur which can often be treated with medicines. See separate leaflet called Abnormal Heart Rhythms (Arrhythmias) for more details . A further heart attack may occur sometime in the future. This is more likely if the coronary arteries are badly affected with atheroma, or further build-up of atheroma continues. If the risk of this is thought to be high then surgery may be advised to bypass or widen severely narrowed coronary arteries. The most crucial time is during the first day or so. If no complications arise and you are well after a couple of weeks then you have a good chance of making a full recovery. A main objective then is to get back into normal life and to minimise the risk of a further heart attack.

Related Wellbeing See all Wellbeing After having a heart attack When recovering from a heart attack, it is natural to wonder if there are any dos and don'ts. In the past, well-meaning but bad advice to 'rest and take it easy from now on' caused some people to become over-anxious about their hearts. Some people gave up their jobs, hobbies, and any activity that caused exertion, for fear of straining the heart. However, quite the opposite is true for most people who recover from a heart attack. Regular exercise and getting back to normal work and life are usually advised. Much can be done to reduce the risk of a further heart attack. See separate leaflet called After a Heart Attack (Myocardial Infarction) for more details . Further help & information Heart attack - Mayo Clinic Heart attack Heart attack A heart attack occurs when the flow of blood to the heart is blocked, most often by a build-up of fat, cholesterol and other substances, which form a plaque in the arteries that feed the heart (coronary arteries). The interrupted blood flow can damage or destroy part of the heart muscle.

A heart attack, also called a myocardial infarction, can be fatal, but treatment has improved dramatically over the years. It's crucial to call 911 or emergency medical help if you think you might be having a heart attack. What is a heart attack? National Heart, Lung, and Blood Institute. Accessed Sept. 12, 2014. Reeder GS, et al. Criteria for the diagnosis of acute myocardial infarction. Accessed Sept. 12, 2014. Heart attack answers and questions. American Heart Association. Accessed Sept. 12, 2014. 2014 Hands-Only CPR fact sheet. American Heart Association. Accessed Sept. 14, 2014. Lifestyle changes for heart attack prevention. American Heart Association. Accessed Sept. 14, 2014. Crawford MH, ed. Current Diagnosis & Treatment: Cardiology. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2009. Accessed Sept. 14, 2014. Pahlm O, et al.

Multimodal Cardiovascular Imaging: Principles and Clinical Applications. New York, NY: McGraw-Hill; 2011. Accessed Sept. 14, 2014. Products and Services Heart attack: MedlinePlus Medical Encyclopedia Many risk factors may lead to the development of plaque buildup and a heart attack . Symptoms A heart attack is a medical emergency. If you have symptoms of a heart attack, call 911 or your local emergency number right away. DO NOT try to drive yourself to the hospital. DO NOT WAIT. You are at greatest risk of sudden death in the early hours of a heart attack. Chest pain is the most common symptom of a heart attack. You may feel the pain in only one part of your body OR Pain may move from your chest to your arms, shoulder, neck, teeth, jaw, belly area, or back The pain can be severe or mild. It can feel like: A tight band around the chest Something heavy sitting on your chest Squeezing or heavy pressure The pain most often lasts longer than 20 minutes. Rest and a medicine to relax the blood vessels (called nitroglycerin) may not completely relieve the pain of a heart attack.

Symptoms may also go away and come back. Other symptoms of a heart attack can include: Shortness of breath Sweating , which may be very heavy Some people (the older adults, people with diabetes, and women) may have little or no chest pain. Or, they may have unusual symptoms such as shortness of breath, fatigue, and weakness. A "silent heart attack" is a heart attack with no symptoms. Exams and Tests A health care provider will perform a physical exam and listen to your chest using a stethoscope. The provider may hear abnormal sounds in your lungs (called crackles), a heart murmur , or other abnormal sounds. You may have a fast or uneven pulse. Your blood pressure may be normal, high, or low. You will have an electrocardiogram (ECG) to look for heart damage. Most of the time, certain changes on the ECG indicate you are having a heart attack. Sometimes these changes are not present, even though other tests indicate you have had a heart attack. This can be called non-ST elevation myocardial infarction (NSTEMI). A blood test can show if you have heart tissue damage. This test can confirm that you are having a heart attack.

You will likely have this test 3 times over the first 6 to 12 hours. Coronary angiography may be done right away or when you are more stable. This test uses a special dye and x-rays to see how blood flows through your heart. It can help your doctor decide which treatments you need next. Other tests to look at your heart that may be done while you are in the hospital: Echocardiography with or with stress testing Treatment IMMEDIATE TREATMENT You will be hooked up to a heart monitor, so the health care team can see how regularly your heart is beating. You will receive oxygen so that your heart doesn't have to work as hard. An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV. You may get nitroglycerin and morphine to help reduce chest pain. You may receive aspirin, unless it would not be safe for you. In that case, you will be given another medicine that prevents blood clots. Dangerous abnormal heartbeats ( arrhythmias ) may be treated with medicine or electric shocks.

EMERGENCY PROCEDURES Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. Angioplasty is often the first choice of treatment. It should be done within 90 minutes after you get to the hospital, and usually no later than 12 hours after a heart attack. A stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is usually placed after or during angioplasty. It helps prevent the artery from closing up again. You may be given drugs to break up the clot. This is called thrombolytic therapy . It is best if these drugs are given soon after the onset of symptoms, usually no later than 12 hours after it and ideally within 30 minutes of arriving to the hospital. Some people may also have heart bypass surgery to open narrowed or blocked blood vessels that supply blood to the heart. This procedure is also called coronary artery bypass grafting and/or open heart surgery . TREATMENT AFTER A HEART ATTACK After several days, you will be discharged from the hospital. You will likely need to take medicines, some for the rest of your life.

Always talk to your provider before stopping or changing how you take any medicines. Stopping certain medicines can be deadly. While under the care of your health care team, you will learn: How to take medicines to treat your heart problem and prevent more heart attacks How to eat a heart-healthy diet What to do when you have chest pain How to stop smoking Strong emotions are common after a heart attack. You may feel sad You may feel anxious and worry about being careful about everything you do All of these feelings are normal. They go away for most people after 2 or 3 weeks. You may also feel tired when you leave the hospital to go home. Most people who have had a heart attack take part in a cardiac rehabilitation program. Support Groups Many people benefit from taking part in support groups for people with heart disease . Outlook (Prognosis) After a heart attack, you have a higher chance of having another heart attack. How well you do after a heart attack depends on several factors such as: The amount of damage to your heart muscle and heart valves Where that damage is located Your medical care after the heart attack If your heart can no longer pump blood out to your body as well as it used to, you may develop heart failure .

Abnormal heart rhythms can occur, and they can be life threatening. Most people can slowly go back to normal activities after a heart attack. This includes sexual activity. Talk to your provider about how much activity is good for you. Alternative Names Myocardial infarction; MI; Acute MI; ST - elevation myocardial infarction; Non-ST - elevation myocardial infarction; NSTEMI; CAD - heart attack; Coronary artery disease - heart attack Images Jaw pain and heart attacks References Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;64(24):e139-e228. PMID: 25260718 . Anderson JL. ST segment elevation acute myocardial infarction and complications of myocardial infarction. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed.

Philadelphia, PA: Elsevier Saunders; 2016:chap 73. O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;61(4):485-510. PMID: 23256913 . Scirica BM, Morrow DA. ST-elevation myocardial infarction. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 51. Read More

Question: What is the common term for Myocardial Infarction?
Answer: Heart Attack