Myocardial infarction (heart attack)

Chest | Emergency Medicine | Myocardial infarction (heart attack) (Disease)


A heart attack results when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle and heart muscle dies.

The most common symptom of heart attack is chest pain. The most common complications of a heart attack are heart failure and ventricular fibrillation.

Causes and Risk factors

The blood clot that causes the heart attack usually forms at the site of rupture of an atherosclerotic, cholesterol plaque on the inner wall of a coronary artery.

The risk factors for atherosclerosis and heart attack include elevated cholesterol levels, increased blood pressure, tobacco use, diabetes, male gender, and a family history of heart attacks at an early age.

Early reopening of blocked coronary arteries reduces the amount of damage to the heart and improves the prognosis for a heart attack.

Medical treatment for heart attacks may include antiplatelet, anticoagulant, and clot dissolving drugs as well as angiotensin converting enzyme (ACE) inhibitors, beta blockers, and oxygen.

Interventional treatment for heart attacks may include coronary angiography with percutaneous transluminal coronary angioplasty (PTCA), coronary artery stents, and coronary artery bypass grafting (CABG).

Diagnosis and Treatment

Heart attacks are diagnosed with electrocardiograms and measurement of cardiac enzymes in blood. Patients suffering a heart attack are hospitalized for several days to detect heart rhythm disturbances, shortness of breath, and chest pain.

Further heart attacks can be prevented by aspirin, beta blockers, ACE inhibitors, discontinuing smoking, weight reduction, exercise, good control of blood pressure and diabetes, following a low cholesterol and low saturated fat diet that is high in omega-3-fatty acids, taking multivitamins with an increased amount of folic acid, decreasing LDL cholesterol, and increasing HDL cholesterol. ...