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Acute Myocardial Infarction - Acute Myocardial Infarction Treatment Info


Acute Myocardial Infarction
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Wolf Parkinson White Syndrome

Acute Myocardial Infarction is defined as the sudden blockage of one or more coronary arteries as a result of coronary atheroslerosis, thrombus, embolus. In myocardial infarction (MI), also known as heart attack, reduced blood flow through one of the coronary arteries results in myocardial ischemia and necrosis. In cardiovascular disease, the leading cause of death in the United States and western Europe, death usually results from the cardiac damage or complications of MI. Acute Myocardial Infarction is one of the commonest heart ailments in middle aged andelderly individuals.

Acute myocardial infarction (MI) is defined as death or necrosis of myocardial cells. . Heart attacks are usually heralded by characteristic severe chest pain and autonomic phenomena ( looking pale , sweating , feeling sick).This usually results from plaque rupture with thrombus formation in a coronary vessel, resulting in an acute reduction of blood supply to a portion of the myocardium Initial measures include oxygen , aspirin , glyceryl trinitrate spray and pain relief . An interruption in the supply of myocardial oxygen and nutrients occurs when a thrombus is superimposed on an ulcerated or unstable atherosclerotic plaque and results in coronary occlusion. MINAP provides data to ambulance services to help monitor patient outcomes and support improvements in training and care delivery. MINAP also provides data to cardiac networks to support service improvement. Treatment may be with medication (especially thrombolysis ), angioplasty or bypass surgery . Coronary care unit admission is indicated, where complications (e.g. abnormal heart rhythms ) can be treated rapidly and safely. Nonatherosclerotic causes of MI include coronary vasospasm as seen in variant (Prinzmetal) angina and in patients using cocaine and amphetamines; coronary emboli from sources such as an infected heart valve; occlusion of the coronaries due to vasculitis, or other causes leading to mismatch of oxygen supply and demand, such as acute anemia from GI bleeding. Coronary blood flow is reduced during systole because of Venturi effects at the coronary orifices and compression of intramuscular arteries during ventricular contraction.

Ischemic heart disease is caused by an imbalance between the myocardial blood flow and the metabolic demand of the myocardium. The phrase "heart attack" sometimes refers to heart problems other than MI, such as unstable angina pectoris and sudden cardiac death .Although the clinical presentation of a patient is a key component in the overall evaluation of the patient with MI, many events are either "silent" or are clinically unrecognized, evidencing that patients and physicians often do not recognize symptoms of a MI. The term myocardial infarction is derived from myocardium (the heart muscle) and infarction (tissue death due to oxygen starvation or ischemia ). Plaque rupture with subsequent exposure of the basement membrane results in platelet aggregation, thrombus formation, fibrin accumulation, hemorrhage into the plaque, and varying degrees of vasospasm. Continuous online analyses in comparison to aggregate data are available to hospitals. Quarterly reports are available for hospitals, Strategic Health Authorities, and the Department of Health. MINAP has now relocated from the RCP to the National Institute for Clinical Outcomes Research based in Professor Sir Bruce Keogh's unit at the Heart Hospital. It has established a MINAP Academic Group to develop the research potential of the database

Causes of Acute Myocardial Infarction

The common Causes of Acute Myocardial Infarction :

  • Ventricular hypertrophy (eg, left ventricular hypertrophy [LVH], idiopathic hypertrophic subaortic stenosis [IHSS], underlying valve disease)
  • Hypoxia due to carbon monoxide poisoning or acute pulmonary disorders (Infarcts due to pulmonary disease usually occur when demand on the myocardium dramatically increases relative to the available blood supply.)
  • Increased afterload or inotropic effects, which increase the demand on the myocardium .
  • Smoking .
  • Poorly controlled hypertension .
  • Poor blood cholesterol levels, especially high LDL ("bad") cholesterol and low HDL ("good") cholesterol.
  • Diabetes.
  • High blood pressure.

Symptoms of Acute Myocardial Infarction

Some are common Symptoms of Acute Myocardial Infarction :

  • Shortness of breath.
  • Cough .
  • Lightheadedness - dizziness .
  • Fainting .
  • Nausea or vomiting .
  • Squeezing or heavy pressure .
  • A tight band on the chest .
  • Anxiety .
  • Feeling of impending doom..

Treatment of Acute Myocardial Infarction

Here is the list of the methods for treating Acute Myocardial Infarction :

  • All patients being transported for chest pain should be managed as if the pain were ischemic in origin unless clear evidence to the contrary is established.
  • Prehospital notification by Emergency Medical Services (EMS) personnel should alert ED staff to the possibility of a patient with MI. EMS personnel should receive online medical advice for a patient with high-risk presentation.
  • Nitroglycerin for active chest pain, given sublingually or by spray .
  • The goals of treatment are to stop the progression of the heart attack, to reduce the demands on the heart so that it can heal, and to prevent complications.
  • A major surgery, organ biopsy , or major trauma within the past 6 weeks .
  • Head trauma within the past month.
  • Current severely elevated high blood pressure .