• Heart Attack

    Acute Myocardial Infarction (AMI), Myocardial Infarction (MI), ST-Segment-Elevation MI (STEMI), Transmural Myocardial infarction

    What is a heart attack?

    A heart attack occurs when blood flow to the heart muscle is interrupted. Oxygen cannot get to the heart muscle, causing tissue damage or tissue death.

    Heart Attack
    Heart Attack | Copyright © Nucleus Medical Media, Inc.

    What causes heart attacks?

    A heart attack may be caused by:

    • Thickening of the walls of the arteries feeding the heart muscle (coronary arteries)
    • Build up of fatty plaques in the coronary arteries
    • Narrowing of the coronary arteries
    • Spasm of the coronary arteries
    • Development of a blood clot in the coronary arteries
    • Embolism that affects the coronary arteries

    Heart attack risk factors

    The risk of heart attack is greater in males and older adults.

    Factors that may increase your chance of developing a heart attack include:

    Heart attack symptoms

    Symptoms include:

    • Squeezing, heavy chest pain behind breastbone, especially with:
      • Exercise or exertion
      • Emotional stress
      • Cold weather
      • A large meal
      • Usually comes on quickly
      • Pain in the left shoulder, left arm, or jaw
      • Shortness of breath
      • Sweating, clammy skin
      • Nausea
      • Weakness
      • Loss of consciousness
      • Anxiety, especially feeling a sense of doom or panic without apparent reason

    Unusual symptoms of heart attack – may occur more frequently in women:

    • Stomach pain
    • Back and shoulder pain
    • Confusion
    • Fainting

    If you think you are having a heart attack, call for emergency medical services right away.

    How heart attacks are diagnosed

    Your bodily fluids may be tested. This can be done with:

    • Blood tests – To look for certain enzymes found in the blood within hours or days after a heart attack
    • Urine tests – To look for certain substances found in the urine within hours or days after a heart attack

    Your heart function may be tested. This can be done with:

    • Electrocardiogram (EKG) – to look for evidence of blockage or damage
    • Echocardiogram – to examine the size, shape, function and motion of the heart
    • Stress test – Records the heart's electrical activity under increased physical stress, usually done days or weeks after the heart attack

    Images may be taken. This can be done with:

    • Nuclear scanning – show areas of the heart muscle where there is diminished blood flow
    • Electron-beam computed tomography (EBCT) – to make detailed pictures of the heart, coronary arteries and surrounding structures
    • Coronary angiography – To look for narrowing or blockage in the coronary arteries

    Treating heart attacks

    Treatment for a heart attack can include:

    • Aspirin
    • Oxygen
    • Pain-relieving medication
    • Nitrate medications
    • Other antiplatelet agents
    • Beta-blockers and/or angiotensin-converting enzyme (ACE) inhibitor medications
    • Anti-anxiety medication
    • Cholesterol-lowering medications such as statin drugs

    Within the first six hours after a heart attack, you may be given medications to break up blood clots in the coronary arteries.

    Surgery

    If you have severe blockages you may need surgery right away or after recovery, such as:

    Physical or Rehabilitative Therapy

    During recovery, you may need physical or rehabilitative therapy to help you regain your strength.

    Treatment for Depression

    You may feel depressed after having a heart attack. Therapy and medication can help relieve depression.

    Preventing a heart attack

    Preventing or treating coronary artery disease may help prevent a heart attack.


    RESOURCES

    American Heart Association – www.heart.org

    National Stroke Association – www.stroke.org

    References

    About heart attacks. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/AboutHeartAttacks/About-Heart-Attacks%5FUCM%5F002038%5FArticle.jsp. Updated September 2, 2014. Accessed September 29, 2014.

    ST-elevation myocardial infarction (STEMI). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115392/ST-elevation-myocardial-infarction-STEMI. Updated July 25, 2016. Accessed September 28, 2016.

    What is a heart attack? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/. Updated December 13, 2013. Accessed September 29, 2014.

    7/6/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115392/ST-elevation-myocardial-infarction-STEMI: Antithrombotic Trialists' (ATT) Collaboration, Baigent C, Blackwell L, et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet. 2009;373:1849-1860.

    2/3/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115392/ST-elevation-myocardial-infarction-STEMI: Finkle W, Greenland S, et al. Increased risk of non-fatal myocardial infarction following testosterone therapy prescription in men. PLoS One. 2014;9(1).

    Revision Information

    This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

    Copyright © 2012–2016 EBSCO Publishing. All rights reserved.

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