Unlike the other type of acute coronary syndrome, unstable angina, a myocardial infarction occurs when there is cell death, which can be estimated by measuring by a blood test for biomarkers (the cardiac protein troponin). 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. Myocardial infarction (MI) refers to tissue death ( infarction) of the heart muscle ( myocardium) caused by ischemia, the lack of oxygen delivery to myocardial tissue. In 2011, an MI was one of the top five most expensive conditions during inpatient hospitalizations in the US, with a cost of about $11.5 billion for 612,000 hospital stays. Rates of MI for a given age have decreased globally between 19. In the developed world, the risk of death in those who have had a STEMI is about 10%. About one million people have an MI each year in the United States. STEMIs occur about twice as often in men as women. More than 3 million people had an ST elevation MI, and more than 4 million had an NSTEMI. Worldwide, about 15.9 million myocardial infarctions occurred in 2015. After an MI, lifestyle modifications, along with long-term treatment with aspirin, beta blockers and statins, are typically recommended. In people with blockages of multiple coronary arteries and diabetes, coronary artery bypass surgery (CABG) may be recommended rather than angioplasty. People who have a non-ST elevation myocardial infarction ( NSTEMI) are often managed with the blood thinner heparin, with the additional use of PCI in those at high risk. In a STEMI, treatments attempt to restore blood flow to the heart and include percutaneous coronary intervention (PCI), where the arteries are pushed open and may be stented, or thrombolysis, where the blockage is removed using medications. Supplemental oxygen is recommended in those with low oxygen levels or shortness of breath. Nitroglycerin or opioids may be used to help with chest pain however, they do not improve overall outcomes. Aspirin is an appropriate immediate treatment for a suspected MI. Commonly used blood tests include troponin and less often creatine kinase MB. An ECG, which is a recording of the heart's electrical activity, may confirm an ST elevation MI ( STEMI), if ST elevation is present. Many tests are helpful to help with diagnosis, including electrocardiograms (ECGs), blood tests and coronary angiography. MIs are less commonly caused by coronary artery spasms, which may be due to cocaine, significant emotional stress (often known as Takotsubo syndrome or broken heart syndrome) and extreme cold, among others. The complete blockage of a coronary artery caused by a rupture of an atherosclerotic plaque is usually the underlying mechanism of an MI. Risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, and excessive alcohol intake. Most MIs occur due to coronary artery disease. An MI may cause heart failure, an irregular heartbeat, cardiogenic shock or cardiac arrest. Among those over 75 years old, about 5% have had an MI with little or no history of symptoms. Women more often present without chest pain and instead have neck pain, arm pain or feel tired. About 30% of people have atypical symptoms. Other symptoms may include shortness of breath, nausea, feeling faint, a cold sweat, feeling tired, and decreased level of consciousness. The discomfort may occasionally feel like heartburn. Often such pain occurs in the center or left side of the chest and lasts for more than a few minutes. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck or jaw. STEMI 10% risk of death (developed world) Ī myocardial infarction ( MI), commonly known as a heart attack, occurs when blood flow decreases or stops in one of the coronary arteries of the heart, causing infarction (tissue death) to the heart muscle. Percutaneous coronary intervention, thrombolysis High blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol Įlectrocardiograms (ECGs), blood tests, coronary angiography Heart failure, irregular heartbeat, cardiogenic shock, coma, cardiac arrest Acute myocardial infarction (AMI), heart attackĪ myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, causing catastrophic thrombus formation, totally occluding the artery and preventing blood flow downstream to the heart muscle.Ĭhest pain, shortness of breath, nausea/vomiting, dizziness or lightheadedness, cold sweat, feeling tired arm, neck, back, jaw, or stomach pain, decreased level or total loss of consciousness
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