Acute myocardial infarction

What is it?

It is a disease affecting the coronary arteries, the arteries that carry blood to the heart. Over time, cholesterol increases and the function of the cells lining the vessels (endothelium) is impaired. This produces plaques that obstruct the vessel's lumen and reduce the blood supply. The clot (thrombosis) causes sudden fatigue of the heart and death of one of its parts (acute myocardial infarction).

Causes and risk factors

As a result of external factors such as stress, infections, anemia.

Infarction can be prevented (or at least the risk can be reduced) by:

  • controlling blood pressure;
  • controlling blood sugar levels if you have diabetes;
  • controlling cholesterol levels;
  • effective medicines to block the processes that cause thrombosis (thrombolytics).

In addition, the risk group includes:

  • men over 35-40 years old and post-menopausal women;
  • smokers;
  • diabetics;
  • people who suffer from arterial hypertension;
  • people suffering from hypercholesterolemia;
  • people whose relatives have heart problems before the age of 55.

Which are the symptoms?

- chest discomfort in the middle of the chest (angina pectoris)    
- sense of constriction, oppression, tightness in the throat    
- deep discomfort in the shoulders and sometimes in the arms on the lower side and the last two to three fingers of the hand    
- cold sweating    
- nausea    
- tiredness 
- breathlessness
- sense of fainting
- pain in the stomach (epigastrium), which can be confused with gastritis or indigestion
- syncope

How is it diagnosed?

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How is it treated?

If severe pain and one of the symptoms listed above occur, it is advisable to call the emergency services 118 immediately to get first aid within minutes: while waiting for the ambulance, you should remain in a supine position and, if possible, take medication such as Carvasin, Trinitrin or Natispray.

If the pain is not severe and there are no other abnormalities, it is best to be escorted to the emergency room or contact your physician immediately.

After admission to the emergency room, the physician will assess the degree of urgency and subject the patient to:

  • a thorough examination;
  • one or more electrocardiograms (to look for signs of cardiac distress);
  • some blood samples.

At this stage it is important to provide all the information about the type of pain experienced, the mode of onset and the drugs taken, showing any electrocardiograms or past cardiological examinations.
If the patient is hospitalized for a few hours it is to exclude with greater certainty cardiac causes from the symptoms complained of. In these cases, the following exams are performed:

  • chest X-ray;
  • echocardiogram;
  • myocardial enzyme monitoring;
  • telemetry electrocardiography focused on possible ischemia.

If the assessed risk is minimal, the procedure is completed. Otherwise, during another assessment, the physicians make a diagnosis and determine the most appropriate department for hospitalization: Coronary Disease Unit, Semi-Intensive Coronary Care Unit or Emergency Department.

If there is a desire to add additional tests to the diagnostic algorithm, an Outpatient Assessment Unit is involved, which takes responsibility for several days of diagnostic tests (stress test, stress-echocardiography, ECG Holter monitoring), at the end of which the cardiologist gives the final assessment.

Death from a heart attack occurs in most patients before arrival at the hospital, mostly due to arrhythmia. Timely arrival to an equipped medical center, in turn, allows not only to combat complications, but, most importantly, to perform urgent revascularization with an excellent opportunity to noticeably reduce the consequences of the heart attack.


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