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Acute Mi

Overview

A disorder in which damage to an area of heart muscle occurs because of an inadequate supply of oxygen to that area.


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Causes

Causes include clot formation or spasm in one of the arteries that supply the heart muscle (a coronary artery). These and othersimilar conditions block the supply of oxygen to an area of the heart, leading to damage or death of the cells in that area. Mostoften, this occurs in a coronary artery that has been narrowed from changes related to atherosclerosis . The damaged tissueresults in a permanent loss of contraction of this portion of the heart muscle.Risk factors for MI include smoking, hypertension, diabetes mellitus, high fat diet, high blood cholesterol (LDL) levels, obesity,male gender, age over 65, and heredity. A personal or family history of coronary artery disease, cerebrovascular disease,peripheral vascular disease, angina (particularly unstable angina) , or kidney failure requiring hemodialysis indicates increasedrisk for MI. Occasionally, sudden overwhelming stress can trigger an MI, but this is rare. In older persons, straining to have abowel movement can be a risk factor.Chest pain is the cardinal symptom of MI, but in many cases the pain may be subtle or even completely absent, especially in theelderly and diabetics. Other symptoms such as weakness, shortness of breath, nausea, or vomiting may predominate.Acute MI occurs in approximately 2 out of 1,000 people per year. It is a major cause of sudden death in adults.


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Signs & Symptoms

chest pain below the sternum (breastbone)- back pain- abdominal pain- pain may radiate- to the chest, arms, shoulder- to the neck, teeth and jaw (See toothaches, face pain)- to the back- pain is prolonged, typically greater than 20 minutes- pain similar to angina but not relieved by rest or nitroglycerin- any prolonged chest pain, back pain, or abdominal pain- pain that may be described as:- "bad indigestion".- intense, severe, subtle, or absent- squeezing or heavy pressure- a tight band on the chest- "an elephant sitting on my chest"- shortness of breath- sudden- may or may not be accompanied by pain- cough- lightheadedness - dizzy- fainting

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Prevention

Control cardiac risk factors whenever possible. Control blood pressure and total cholesterol levels, reduce or avoid smoking,modify diet (increase high density lipoproteins & decrease low density lipoproteins) if necessary, control diabetes, lose weight ifobese . Follow an exercise program to improve cardiovascular fitness. (Consult the health care provider first.)After an MI, followup care is important to reduce the risk of developing a new MI. Often, a cardiac rehabilitation program isrecommended to aid in gradual return to a "normal" lifestyle. Follow the exercise, diet, and/or medication regimen prescribedby your doctor.


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Treatments
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