heartattack

Acute Myocardial Infarction or more commonly known as Heart attack occurs when there is a prolonged deficiency or lack of oxygen in the Heart.

Often this comes as a result of a thrombus that occludes the vessels leading to the heart.

A thrombus is basically a blockage in the heart that doesn’t allow blood to flow.

When the blood can’t flow – oxygen deprivation of the tissue occurs.

The heart muscle can be damaged.

The damaged area can be temporary – if blood flow is restarted quickly – but it is more often permanent.

The event is considered “acute” if it is sudden and very serious.

Often a thrombus rests or starts from at a preexisting site of Atherosclerosis.

This area has a build-up of plaques and lipids such as cholesterol.

The location of MI depends on which artery is affected.

A “silent” heart attack occurs when the patient doesn’t have typical or any chest pains.

 

Other causes of a Heart Attack

  • Vasospasm
  • Hypotension
  • Coronary artery dissection
  • Cocaine
  • and more

 

Locations:

1.)  Anterior descending branch of left coronary artery = Anterior Left Ventricle and Interventricular septum

2.)  Left circumflex artery = Anterolateral or Posterolateral

3.)  Right Coronary = Posteroinferior of Left Ventricle

4.)  Right Coronary = AV node and Sinus node

 

Q wave vs. Non Q wave infarction

  • Related to ST segment elevation

 

Risk Factors

 

Symptoms

  • Chest Pain
  • Chest Discomfort
  • Nausea
  • Vomiting
  • Angina that doesn’t resolve with nitroglycerin
  • Sweating
  • Heart racing
  • Anxiety
  • Light-headness
  • Fatigue -can be- more often in women
  • Weakness -can be- more often in women

 

Laboratory Findings

  • CK-MB
  • Troponin I
  • Troponin T

 

Possible ECG Findings

  • Peaked T waves
  • ST segment elevation
  • Q wave development
  • T wave inversion
  • Many heart attacks are similar and will have similar ECG findings
  • But not all heart attacks will always have the same ECG findings.

mi-ekg

 

Diagnosis

Chest X-ray may be helpful

Echocardiography can shows functionality of heart

Technetium-99m pyrophosphate scintigraphy can help diagnoses acute MI

MRI can show extent of MI

 

Angiography

  • Can occasionally return blood flow.
  • A catheter is inserted
  • Done under fluoroscopy (set of specialized X-rays)

 

Treatment

Medications

Nitroglycerin
Aspirin
Clopidogrel (Plavix)
.  Oxygen
Morphine
Alteplase
Reteplase
Tenecteplase
Heparin

Coronary Angiography

Primary Percutaneous Coronary Intervention

Coronary artery bypass surgery

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