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Myocardial Infarction Heart Attack Outline What is an MI (or) Heart Attack What are the causes? Patho-physiology (disease process) What are the signs & symptoms? Management of diagnosis & treatment (How is it diagnosed & how is it treated?) What is a MI / Heart Attack? A heart attack (a.k.a. Myocardial Infarction) is the death of heart muscle from a sudden blockage of a coronary artery. Blockage of a coronary artery deprives the heart muscle of blood & oxygen, causing injury to the heart muscle. Etiology (cause) 1. 2. 3. 4. 5. 6. 7. Risk factors for developing heart attacks are: Atherosclerosis Angina HBC (High Blood Cholesterol) A high level of cholesterol in the blood HBP (High Blood Pressure/Hypertension) Tobacco Use (Smoking) Diabetes Family History of Heart Disease Etiology (cont’d) Patho-physiology (disease process ) Atherosclerosis: Which is a gradual process of plaques or collections of cholesterol are deposited in the artery 1. Cross Section of Artery With Atherosclerosis Artery Wall walls. Endothelium (Inner artery wall lining) Fatty Deposits of plaque Patho-physiology (cont’d) Angina This is chest pain that occurs when the blood & oxygen supply to the heart muscle cannot keep up with the needs of the heart muscle. 2. endothelium Artery wall plaque Signs & Symptoms Common symptoms of atherosclerosis & angina are: 1. Pressure, heaviness, squeezing or aching across the chest. 2. Pain may travel to the neck, jaw, arms, back, even teeth, and may be accompanied by shortness of breath, nausea, or cold sweat. Signs & Symptoms (cont’d) Angina can also occur during rest. Angina at rest more commonly indicates that a coronary artery has been narrowed to a critical degree. The heart is NOT receiving enough oxygen even at rest. Management (Diagnosis) Severe chest pain is usually a sign that a MI or heart attack is occurring, and tests can be performed that will confirm the MI. When symptoms of a heart attack do not include chest pain, the heart attack may not be suspected and appropriate tests may not be performed. The initial step in diagnosing a heart attack is to be suspicious that one has occurred. FYI About 160,440 people die each year from a heart attack. Upside down ST Segment Management (Diagnosis) (cont’d) Post Myocardial Infarction Post Myocardial Infarction (Pic #1) The patient clearly has risk factors for coronary artery disease, symptoms suggestive of angina and an abnormal ECG. (Pic #2) ECG as it appears while patient is having a MI. During heart attack, notice the atrial & ventricular spikes. (Pic #3) The patient has had a MI. Management (Diagnosis) (cont’d) There are different ways to diagnose a heart attack. 1. Electrocardiogram (ECG/EKG) 2. Blood Tests The most important factor in diagnosing a heart attack is prompt medical attn Management (Treatment) But, what is an Electrocardiogram (ECG/EKG)? 1. It is a recording of the electrical activity of the heart. It can identify the areas of heart muscle that are deprived of oxygen &/or areas of muscle that have died. It can also give a secure diagnosis of a heart attack, it can be made quickly in the ER so treatment can be started immediately. 2. 3. Management (Treatment) (cont’d) How is a heart attack treated? 1. Anti-platelet medications to prevent formation of blood clots in the arteries. Anti-coagulants to prevent growth of blood clots in the arteries. Clot- dissolving medications to open blocked arteries. Medications to prevent abnormal heart rhythms. Supplemental oxygen to increase the supply of oxygen to the heart muscle. 2. 3. 4. 5. Conclusion So as we have discussed & learned what an MI is, how it’s diagnosed & treated, what will you do to prevent one or at the least lower your chances of having one? We can all do our own part in answering that question for ourselves. Thank You