Symptoms
A heart attack manifests itself in acute and severe pain and a feeling of tightness and pressure in the chest, which may also radiate to the arms, jaw or abdomen. Other symptoms include nausea, indigestion, shortness of breath, coughing, a break of sweat, pallor, fear of death, unconsciousness and dizziness. A myocardial infarction lasts more than 20 minutes and persists even after the administration of nitroglycerin. It may also be atypical and asymptomatic. Myocardial infarction is life-threatening and is a medical emergency. The mortality rate is 30 to 40 percent. The emergency medical services should be notified immediately, without delay, in many countries by calling 144, and life-saving immediate measures can be started until they arrive if they have received the appropriate training see also at http://www.helpbyswissheart.ch
Causes
The cause of a heart attack is usually a blood clot that occludes one of the large coronary arteries on a ruptured arteriosclerotic plaque, cutting off the supply of oxygen and nutrients to the heart muscle (myocardium) for an extended period of time. This results in damage to the myocardial cells and destruction of a portion of the heart muscle. This is often caused by atherosclerosis of the coronary arteries, which is the starting point for the development of the thrombus. Risk factors for suffering a heart attack include:
- Age
- Family facility
- Hypertension
- Unfavorable blood lipid levels (LDL, triglycerides, cholesterol, low HDL).
- Diabetes mellitus, high blood sugar
- Smoking, passive smoking
- Not enough physical activity, sedentary lifestyle.
- Overweight, abdominal fat
- Certain medications
- Intoxicants such as cocaine, amphetamines
- Stress
- Personal history
Diagnosis
Diagnosis and treatment are carried out in medical treatment based on clinical symptoms, physical examination with a stethoscope, with an ECG, laboratory diagnostics and imaging techniques, among others.
Nonmedical treatment
The main goal of acute treatment is to remove the occlusion in the arteries as quickly as possible, with nonmedication or medication (lysis therapy). This is to restore blood flow and protect the heart muscle from further damage. If possible, coronary angioplasty (percutaneous coronary intervention, PCI) is performed.
Drug treatment
The following drugs are used during treatment of acute myocardial infarction: Antithrombotics to dissolve the blood clot and prevent it:
- Antiplatelet agents such as acetylsalicylic acid.
- Low molecular weight heparins
- P2Y12 antagonists such as clopidogrel
- Fibrinolytics
Oxygen to supply tissues due to reduced cardiac output Analgesics for pain management:
- Opioids: morphine
Nitrates for the treatment of chest pain and vasodilatation:
- Nitroglycerin
Antihypertensive drugs to lower blood pressure and relieve the heart:
- Beta-blockers
- ACE inhibitors
- Sartans
Antithrombotics (acetylsalicylic acid, P2Y12 antagonists, vitamin K antagonists), antihypertensives, and statins are used for secondary drug prophylaxis after infarction.
Prevention
- Normalization of blood pressure, blood sugar and lipid levels.
- Do not smoke
- Pay attention to a healthy diet
- Sufficient physical exercise
- Aim for normal weight, reduce abdominal fat
- Do not consume illegal intoxicants
- Manage stress
- Medication prevention
