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Acute Myocardial Infarction

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Chest





 pain is a common symptom of a heart attack.
Chest pain is a common symptom of a heart attack.
Although different people make different comparisons to express the discomfort they feel, some common symptoms include:

  • Chest discomfort: Most heart attacks involve discomfort in the center of the chest that lasts longer than 15 minutes, or goes away and comes back. Many people describe the discomfort as building to an uncomfortable pressure, squeezing, fullness, or burning pain; others report an unbearable crushing pain or persistent tightness in the chest.     
  • Discomfort in other areas of the upper body: Pain or discomfort may travel to one or both shoulders or arms, the back, neck, and even the jaw or teeth. Some people experience a sustained, burning discomfort in the upper abdomen near the breastbone that may feel like indigestion.     
  • Shortness of breath: Dyspnea, or shortness of breath, can accompany feelings of chest discomfort during a heart attack, but it also can occur before any chest pain is felt. Some people may also faint during a heart attack.     
  • Other symptoms: Some people report breaking out in a cold sweat, feeling dizzy, light-headed or nauseated, or belching or vomiting. Chest pain may not accompany these symptoms. Some people experience clammy skin or skin that turns pale or blue, particularly around the mouth.

Symptoms in Women. Although the most common heart attack symptom in women is chest pain, women often experience heart attack symptoms that are different from men, including:

  • Pain in the jaw or shoulder;
  • Sweating;
  • Nausea;
  • Shortness of breath;
  • Indigestion or heartburn; and
  • Weakness or unusual fatigue.

Some people experiencing a heart attack sense an overwhelming feeling of doom or anxiety.

CAUSES AND RISK FACTORS

The conditions that may predispose a person to myocardial infarction can be inherited. People with a family history of early heart attacks or CHD may be more likely to have a heart attack than people who do not have those conditions in their families. Additionally, the risk of having a heart attack rises with age.

Other risks that can increase the chances of a heart attack are factors that affect the development of coronary heart disease and include:

  • Smoking;     
  • Having diabetes mellitus;     
  • Having high cholesterol levels or other lipid disorders;     
  • Having hypertension, or high blood pressure;     
  • Eating a diet high in fat and cholesterol;     
  • Not exercising regularly;     
  • Being overweight; and     
  • Using cocaine.

DIAGNOSIS

More than 5 million people each year visit an emergency room with chest pains, but only 10 percent of them are diagnosed with myocardial infarction. In addition to obtaining a report of chest pain and blood-pressure monitoring, physicians use the electrocardiogram and a blood test that identifies chemicals associated with a heart attack to diagnose MI.

Electrocardiography (ECG): A heart attack can alter the normal electrical activity of the heart. ECG monitors this electrical activity and creates graphs known as electrocardiograms. Physicians look for certain patterns on electrocardiograms that suggest myocardial infarction. ECG can reveal which part of the heart is damaged, the extent of that damage, and whether the heart attack has caused an arrhythmia.

Angiography
 helps
 physicians determine how well blood is flowing through the heart's arteries.
Angiography helps physicians determine how well blood is flowing through the heart's arteries.
Blood test: Certain chemicals, such as enzymes, are released when heart muscle tissue suffers damage during a heart attack. These cardiac-specific biochemical markers will be present in the blood in abnormal levels after a myocardial infarction has occurred.

Angiography: Coronary angiography, also known as arteriography, helps physicians determine how well blood is flowing through the heart's arteries. It is often important to determine where any reduction in blood flow, blockage, or injury might be located. X ray pictures known as angiograms show the blood flow through the heart muscle. To perform angiography, the physician places a catheter at the beginning of the arteries that supply blood to the heart and injects a contrast dye. The dye moves through the heart's arterial system and is radiopaque, meaning that it blocks x rays from passing through it. The physician can trace the flow of the dye with an x ray machine to produce motion pictures of the heart's blood vessels. The pictures enable physicians to decide on courses of treatment.

TREATMENT APPROACH

Emergency care. The time that elapses between heart attack symptoms and medical attention is one of the most important factors affecting the severity and long-term effect of a heart attack. Most people who have a heart attack wait 1 or 2 hours or longer after their symptoms begin before they seek medical help. This delay can result in death or permanent heart damage. Roughly half the people who die from heart attacks each year die before reaching the hospital.


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