Myocardial infarction

Myocardial infarction

Myocardial infarction (MI), commonly known as a heart attack , occurs when blood flow decreases or stops in one of the arteries of the heart, causing infarction (tissue death) to the heart muscle.

Risk factors

Age

Smoking

Diabetes mellitus

Arterial hypertension

Heredity

The most common cause of a myocardial infarction is the rupture of an atherosclerotic plaque on an artery supplying heart muscle. Plaques can become unstable, rupture, and additionally promote the formation of a blood clot that blocks the artery.

Typical symptoms

• Pressure or burning pain behind the breastbone, which can radiate to the left arm, shoulder, neck, jaw.
• Pain lasting more than 20 minutes, not relieved by nitroglycerin

• Shortness of breath, feeling short of breath.
• Sweating, weakness.
• Nausea, dizziness.
• Feeling of anxiety.
• tachycardia

Atypical symptoms

• Asthmatic variant
• Abdominal variant
• Cerebral variant

• Arrhythmic variant
• Peripheral variant
• Asymptomatic variant

Complications:

Cardiogenic shock.

Heart break.

Rhythm and conduction disorders (ventricular fibrillation).

Acute heart failure.

Left ventricular aneurysm development.

Development of Dressler's syndrome.

Development of chronic heart failure .

Diagnosis is based on three key pillars:

Symptoms: Characteristic chest pain .

ECG: Detects electrical disturbances (ST-segment changes) and identifies the type of heart attack.

Blood Test: Elevated Troponin levels confirm heart muscle damage.

The most critical step is to immediately call emergency services —do not drive yourself. While waiting, help the patient sit or lie down in a comfortable position, usually with the head and shoulders raised to ease breathing. If the person is conscious and not allergic, have them chew and swallow a 300mg aspirin to help break up the clot. If they become unconscious and stop breathing normally, begin CPR immediately.

The primary goal of treatment is to quickly restore blood flow to the heart muscle. The gold standard is emergency angioplasty (PCI) , where a stent is inserted to open the blocked artery. If this is not immediately available, clot-busting drugs (fibrinolysis) are used. This is followed by long-term medications like aspirin and statins to prevent future events.

The key to preventing a heart attack is controlling three main parameters: blood pressure, cholesterol, and blood sugar levels. This requires regular physical activity (at least 150 minutes per week) and smoking cessation. The basis of nutrition should be a Mediterranean diet rich in vegetables and fish, while limiting red meat, salt, and fast carbohydrates.

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