All About Heart Attack Part 1

DEFINITION
Heart attack (myocardial infarction), (myocardial infarct), (myocardial infarction), is a situation where all of a sudden happen restriction or termination of blood flow to the heart, which causes the heart muscle (myocardium) to die from lack of oxygen.


CAUSE
A heart attack usually occurs when a blockage in a coronary artery results in limited or cut off blood flow to a part of the heart. If you cut off or reduced blood flow lasts more than a few minutes, the heart tissue will die.

Pumping ability of the heart after a heart attack is directly related to the extent and location of tissue damage (infarct). If more than half of the damaged heart tissue, the heart can not function normally and the possibility of death. Even though the damage was not extensive, the heart can not pump properly, resulting in heart failure or shock.

Damaged heart can be enlarged, and partly an attempt to compensate for the ability of the heart that pumps it down (because of the larger heart will beat stronger). The enlarged heart is also a picture of the damage to heart muscle itself. Enlargement of the heart after a heart attack gives a worse prognosis.

Other causes of heart attack are:

    A clot from the heart itself.
    Sometimes a clot (embolus) is formed in the heart, then broke and stuck in the coronary arteries.
    Spasm of the coronary arteries leading to cessation of blood flow.
    Seizures can be caused by drugs (like cocaine) or by smoking, but sometimes the cause is unknown.


SYMPTOMS
About 2 out of 3 people who had a heart attack, a few days before the occurrence of chest pain attacks of relapsing-remitting, shortness of breath, or fatigue. Chest pain more often arise even after a mild physical activity. Unstable angina like this could end up being a heart attack.

At mid-chest pain radiating to the back, jaw, or left arm, or more rarely spread to the right arm. Pain can occur in places without chest pain at all.

Pain in heart attacks of pain in angina is similar to but more intense and longer, the symptoms are not relieved by rest or administration nitroglliserin. Sometimes the pain is felt in the abdomen and misinterpreted as one meal, especially since after burping pain sufferers somewhat diminished or disappeared for a while.

Other symptoms are feeling like going to faint and palpitations. Abnormal heart rhythms (arrhythmias) can affect the heart's pumping ability or may lead to cardiac arrest (heart stops pumping effectively), resulting in impairment of consciousness or death.

During the attack, the patient may feel anxious, sweaty, and anxious, and could feel his end will come soon enough. Lips, hands, and feet appear bluish. Elderly patients can be disoriented (dazed).

As many as 1 in 5 people who had a heart attack, have only mild symptoms or no symptoms at all. Heart attack like this could only be identified from routine ECGs over time.


COMPLICATIONS
Frequent complication is myocardial rupture, blood clots, arrhythmia (heart rhythm disorder), heart failure or shock, or pericarditis.

Myocardial rupture
Damaged heart muscle becomes weak, so that sometimes have tears because of pressure from the pumping action. The two parts of the heart that often have a tear during or after a heart attack is heart muscle wall, and muscles that control the opening and closing of one of the heart valves (valves mitralis). If a muscle tear, the valve can not function so that a sudden severe heart failure.

Cardiac muscle in the wall that limits both ventricles (septum) or the outer wall of the heart muscle may also have a tear. A torn septum can sometimes be corrected through surgery, but a tear in the outer wall is almost always fatal.

Heart muscle damaged by heart attack will not contract properly, although not experiencing tear. Damaged muscle is replaced by fibrous scar tissue is rigid and can not contract. Sometimes this section will be bulging at the time of contracting. To reduce the extent of areas that do not work could be given an ACE-inhibitor.

Damaged muscle could form a small protrusion on the heart wall (aneurysm). The existence of the aneurysm can be known from an abnormal EKG, and to reinforce this notion can be performed an echocardiogram. Aneurysm would not have a tear, but can cause irregular heart rhythm and can lead to reduced cardiac pumping ability. Blood flow through the aneurysm will be slower, because it may form clots within the heart chambers.

Blood clot
In about 20-60% of people who have had heart attacks, blood clots form inside the heart. At 5% of these patients, the clot may break, flow in the artery and lodged in smaller blood vessels throughout the body, causing blockage of blood flow to part of the brain (causing stroke) or to other organs. To find a clot in the heart or to know the predisposing factors that are owned by the patient, performed an echocardiogram.

To help prevent blood clot formation, is often given anticoagulants (eg heparin and warfarain). This medicine is usually taken for 3-6 months after a heart attack.