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Myocardial Infarct Danelle A. Harrison Dade Medical College April 13, 2011 Instructor Shirley Lamarre Med/Surg II

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A myocardial infarction, more commonly known as MI or acute myocardial infarction (AMI) or heart attack is a condition where there is interruption of blood supply to a part of the heart, which leads to eventual irreversible damage and cell death in that region of the heart. Heart attacks are one of the leading causes of death for both men and women worldwide. Although there are many different causes of myocardial infarction, one of the main causes is occlusion (partial or complete) of the coronary arteries. This mostly occurs as a result of a rupture of an atherosclerotic plaque. The pathophysiology of myocardial infarction entails the entire process of what causes a myocardial infarction and how it eventually happens. The most common etiological factor that is responsible for a myocardial infarction is the presence of an atherosclerotic plaque in the region of the coronary arteries. Plaque in arteries is a condition where there is the presence of a blockade in the form of a plug made of cholesterol, lipids and platelets among other cells. This leads to disruption in the flow of blood from the coronary arteries to the heart muscle cells. One of the most important factors in myocardial infarction pathophysiology is the fact that the size of the thrombus is what dictates the percentage of block. And it is the percentage of block which will decide the extent of damage rendered to the heart muscles. Symptoms of myocardial infarct include nausea, shortness of breath, sweating, Chest pain that radiates to the left arm or left side of the neck, anxiety, vomiting and abdominal discomfort, and fullness or squeezing sensation within the chest. The typical heart attack symptoms in women are less commonly observed than in men. It has been found less than 30% women report any kind discomfort or pain in the heart or chest. About 40% say they never experienced any

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kind of chest pain during any stage of the heart attack. But, it does not rule out that chest pain is definitely the most common heart attack symptom in men as well as women. The major symptoms of myocardial infarction in women include unusual fatigue, indigestion, weakness, cold sweat, and sleep disturbance. Myocardial Infarction can be diagnosed through laboratory testing such as cardiac enzymes. Other diagnostic testing may include an ECG better known as an electrocardiogram, a nuclear scan, or coronary angiography. Once a diagnosis has been confirmed treatment of myocardial infarction varies. The patient may be given blood thinning medication like aspirin. Beta blockers may be suggested to lower the heart rate as well as control the elevated blood pressure. In case of severe heart attack, the doctor may prescribe angiotensin-converting enzyme inhibitors (ACE) and other drugs like statins and niacins to lower the cholesterol. In certain emergency cases, angioplasty is performed. The prognosis after experiencing a myocardial infarction varies greatly, depending on a person's health, the extent of the heart damage and the treatment. According to the faculty at Harvard Medical School about 15% of patients who suffer a heart attack die before they reach a hospital, and another 15% die after they arrive. Among the remaining 70% who survive hospitalization, about 4% (1 in 25) will die within the first year after discharge. However, this risk is not the same for all age groups. For example, for patients older than 65, the death rate is 20% within the first month after a heart attack, and 35% within the first year. After one suffers from a myocardial infarct, it is very important to bring about a change in one's lifestyle. One has to avoid smoking, eating fatty food, increase physical activity, control high blood pressure and cholesterol. Eating healthy and keeping stress levels in check will help prevent occurrence of another MI.

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References

Myocardial infarct . (n.d.). Retrieved from sparkpeople.com

Heart attacks. (n.d.). Retrieved from buzzle.com

Prognosis after myocardial infarction . (n.d.). Retrieved from sciencedirect.com