Myocardial infarction - Wikipedia. Myocardial infarction. Synonyms. Acute myocardial infarction (AMI), heart attack. Diagram showing the blood supply to the heart by the two major blood vessels, the left and right coronary arteries (labelled LCA and RCA). A myocardial infarction (2) has occurred with blockage of a branch of the left coronary artery (1). Specialty. Cardiology.
Symptoms. Chest pain, shortness of breath, nausea, feeling faint, cold sweat, feeling tired. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Often it is in the center or left side of the chest and lasts for more than a few minutes. The discomfort may occasionally feel like heartburn. Other symptoms may include shortness of breath, nausea, feeling faint, a cold sweat, or feeling tired. It is a type of acute coronary syndrome, which describes a sudden or short- term change in symptoms related to blood flow to the heart. An MI is different from—but can cause—cardiac arrest, where the heart is not contracting at all or so poorly that all vital organs cease to function.
It is also distinct from heart failure, in which the pumping action of the heart is impaired. However, an MI may lead to heart failure. Pain radiates most often to the left arm, but may also radiate to the lower jaw, neck, right arm, back, and upper abdomen.
- Clinical Therapeutics. Phototherapy for Neonatal Jaundice. Jeffrey Maisels, M.B., B.Ch., and Antony F. McDonagh, Ph.D. N Engl J Med 2008; 358:920-928 February 28.
- This is a thorough revision and update of the highly successful first edition, which which achieved sales in excess of 4,500. The text serves as a comprehensive.
- Original Article. Optimal Medical Therapy with or without PCI for Stable Coronary Disease. Boden, M.D., Robert A. O'Rourke, M.D., Koon K. Teo, M.B., B.Ch.
- The Oxford Textbook of Medicine is the foremost international textbook of medicine. Unrivalled in its coverage of the scientific aspects and clinical practice of.
- The University of Nevada, Reno site map offers links to colleges, departments, faculty pages, and much more. Find what you're looking for.
Such silent myocardial infarctions represent between 2. In people with diabetes, differences in pain threshold, autonomic neuropathy, and psychological factors have been cited as possible explanations for the lack of symptoms. Eating polyunsaturated fat instead of saturated fats is associated with a decreased risk of myocardial infarction. The following genes have an association with MI: PCSK9, SORT1, MIA3, WDR1. MRAS, PHACTR1, LPA, TCF2.
Myocardial infarction; Synonyms: Acute myocardial infarction (AMI), heart attack: Diagram showing the blood supply to the heart by the two major blood vessels, the. This Website, does not provide medical advice,diagnosis or treatment. Content (text, video) on this website is only intended to provide general information to the. JAYPEE BROTHERS: MEDICAL PUBLISHERS. Title Edition Author ISBN; 100 Cases Histories in Clinical Medicine for MRCP (Part-1).
MTHFDSL, ZC3. HC1, CDKN2. A, 2. B, ABO, PDGF0, APOA5, MNF1. ASM2. 83, COL4. A1, HHIPC1, SMAD3, ADAMTS7, RAS1, SMG6, SNF8, LDLR, SLC5. A3, MRPS6, KCNE2. Calcium seen in coronary arteries can provide predictive information beyond that of classical risk factors. Blockage of an artery can lead to tissue death in tissue being supplied by that artery. Over time, they become laden with cholesterol products, particularly LDL, and become foam cells.
A cholesterol core forms as foam cells die. In response to growth factors secreted by macrophages, smooth muscle and other cells move into the plaque and act to stabilize it. A stable plaque may have a thick fibrous cap with calcification. If there is ongoing inflammation, the cap may be thin or ulcerate. Exposed to the pressure associated with blood flow, plaques, especially those with a thin lining, may rupture and trigger the formation of a blood clot (thrombus).
A myocardial infarction may result from a heart with a limited blood supply subject to increased oxygen demands, such as in fever, a fast heart rate, hyperthyroidism, too few red blood cells in the bloodstream, or low blood pressure. Damage or failure of procedures such as percutaneous coronary intervention or coronary artery bypass grafts may cause a myocardial infarction. Spasm of coronary arteries, such as Prinzmetal's angina may cause blockage. A collagenscar forms in their place. ATP is required for the maintenance of electrolyte balance, particularly through the Na/K ATPase.
This leads to an ischemic cascade of intracellular changes, necrosis and apoptosis of affected cells. The size and location puts a person at risk of abnormal heart rhythms (arrhythmias) or heart block, aneurysm of the heart ventricles, inflammation of the heart wall following infarction, and rupture of the heart wall that can rupture with catastrophic consequences. These are based on changes to an ECG. This classifies myocardial infarctions into five types.
Troponins, measured through a blood test, are considered to be the best. The gross value of the troponin, as well as a change over time, are useful in measuring and diagnosing or excluding myocardial infarctions, and the diagnostic accuracy of troponin testing is improving over time.
Elevation of the ST segment can be seen in some leads. Electrocardiograms (ECGs) are a series of leads placed on a person's chest that measure electrical activity associated with contraction of heart muscle. A rise must be new, in two adjacent adjacent ECG leads, greater than 2 mm (0. V) for males and greater than 1. V) in females in all leads except for V2 and V3, where it must be greater than 1 mm (0. V). The flow of blood can be imaged, and contrast dyes may be given to improve image. Treatment aims to preserve as much heart muscle as possible, and to prevent further complications.
A 2. 01. 4 review of P2. Y1. 2 inhibitors such as clopidogrel found they do not change the risk of death when given to people with a suspected NSTEMI prior to PCI.
The probes are then used to identify and clear blockages using small balloons, which are dragged through the blocked segment, dragging away the clot, or the insertion of stents. These medications include tissue plasminogen activator, reteplase, streptokinase, and tenecteplase. Situations in which thrombolysis may be considered, but with caution, include recent surgery, use of anticoagulants, pregnancy, and proclivity to bleeding. Furthermore, those with cardiac arrest, and ST elevation at any time, should usually have angiography. It should start soon after discharge from the hospital. The program may include lifestyle advice, exercise, social support, as well as recommendations about driving, flying, sport participation, stress management, and sexual intercourse.
This may be part of regional cardiovascular disease prevention programs, or through the health impact assessment of regional and local plans and policies. Based on numerous studies in different groups (e. However, 1 in 2. 00 people were prevented from a repeat heart attack, and another 1 in 2.
Additionally, for 1 in 9. This is provided there is no evidence of worsening kidney failure, high potassium, low blood pressure, or known narrowing of the renal arteries. Other medications, such as ezetimibe, may also be added with this goal in mind. This is particularly if there are any ongoing signs of heart failure, with a low left ventricular ejection fraction and a New York Heart Association grade II or III after 4. Disturbances of heart rhythms, including atrial fibrillation, ventricular tachycardia and fibrillation and heart block can arise as a result of ischemia, cardiac scarring, and infarct location. Cardiogenic shock is the largest cause of in- hospital mortality.
Aneurysm of the left ventricle myocardium develops in about 1. MI and is itself a risk factor for heart failure, ventricular arrhythmia and the development of clots. The World Health Organization estimated in 2. For example, in India, IHD had become the leading cause of death by 2.
IHD were expected to double during 1. This can create coverage issues in the administration of no- fault insurance schemes such as workers' compensation. In general, a heart attack is not covered. In some countries or states, a person having suffered from an MI may be prevented from participating in activity that puts other people's lives at risk, for example driving a car or flying an airplane. September 2. 9, 2. Retrieved 2. 3 February 2. December 1. 7, 2.
Retrieved 2. 4 February 2. Jul 3. 0, 2. 01. 4.
Retrieved 2. 4 February 2. Trends in Cardiovascular Medicine.
PMC 4. 33. 68. 25 . PMID 2. 54. 53. 98. Global atlas on cardiovascular disease prevention and control(PDF) (1st ed.). Geneva: World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization.
ISBN 9. 78- 9. 2- 4- 1. December 1. 7, 2. Retrieved 2. 4 February 2. European Heart Journal. PMID 2. 29. 22. 41. Circulation. 1. 22 (1. Suppl 3): S7. 87–8.
PMID 2. 09. 56. 22. PMC 5. 05. 55. 77 . PMID 2. 77. 33. 28. Heart & lung : the journal of critical care. PMID 2. 20. 00. 67. Arch Cardiovasc Dis. PMID 2. 14. 97. 30.
December 1. 7, 2. Retrieved 2. 4 February 2. Critical care (London, England). PMC 2. 37. 46. 27 .
All rights reserved.