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Heart attack

Heart attack



Heart attack or Myocardial infarction occurs when the blood flow decreases or stops to parts of the heart muscle.

It’s defined as a complete stop of blood supply that supports the myocardium or cardiac muscle, causing the damage of this muscle. The blood supply stops in the coronary artery that feeds all the biological systems in the human body including the heart.

The blood flow stops due to some risk factors that cause coronary artery stenosis or complete stop of blood flow that causes the symptoms of myocardial infarction or other heart diseases.


Pathophysiology of heart attack:


The most common cause of Myocardial infarction or Heart attack is the rupture of Atherosclerotic plaque in the arteries that supply the heart muscle.

Atherosclerosis or artery stenosis is caused due to the accumulation of some particles on the wall of arteries feeding the heart.

The trigger factors of atherosclerosis can cause accumulation of cholesterol particles on the wall of the artery. These particles can stimulate the immune system of the body as it causes severe inflammation to the artery wall.

This inflammation can promote the production of Macrophage cells that interact with cholesterol particles and produce the foam cell or cholesterol plaques.

The gradual formation of cholesterol plaques on the arterial wall is over decades. These plaques are covered with fibrous tissue and calcified during calcification or calcium accumulation.

Due to the high blood pressure in the lumen of the artery in addition to the atherosclerotic plaques lining the wall.

This pressure on the muscular thin wall of the artery can cause rupture of atherosclerotic plaque and trigger the formation of blood clot that cause the stop of blood supply.

This may cause heart muscle damage and promote the symptoms of heart attack or myocardial infarction.

There are other risk factors that can cause coronary artery stenosis such as alcohol, tobacco or some illicit drugs.


Symptoms and of heart attack:


chest pain or pressure.
shortness of breath.
cold sweat.
fatigue.
nausea or abdominal pain.
dizziness or lightheadedness.

Not all the patients have the same symptoms.
Some patients have the symptoms and some don’t have all the symptoms, these symptoms vary in severity and onset.


Risk factors of heart attack:


age: the older people have the risk of this disease within the patients according to scientific studies.

high blood pressure: the high blood pressure is a risk factor to heart attack as it can cause damage to the blood vessels due to accumulation of harmful substances that narrow the lumen of the artery and cause the stenosis of the vessel and high blood pressure.

high blood cholesterol level: accumulation of bad type of cholesterol which is called low density lipoprotein on the wall of the blood vessel can narrow the lumen of the vessel and suppress the blood flow.

obesity: due to high level of blood low density lipoprotein or triglycerides or high blood pressure.

family history of heart attack: patients of family history of this disease or other cardiac diseases have the risk factor of heart attack.

smoking: long term consumption of tobacco can cause a risk factor of the disease.

illicit drugs: such as cocaine or amphetamines that have neurological stimulation effects can cause the spasm or stenosis of blood vessels.

autoimmune disease: patients with autoimmune disease such as rheumatoid arthritis have the risk of heart attack more than others.


Complications of heart attack:


This disease can cause disturbance in the electrical cardiogram or cardiac rhythm that can promote cardiac arrhythmia.

This disease is characterized by inability of the heart to pump the blood through vessels and incomplete ejection fraction of the blood leading to deteriorations in cardiac muscle and other complications.


Treatment of heart attack:


Immediate treatment:

call for emergency: the patients have to get emergency help to prevent the complications and promote treatment.
nitroglycerin for emergency cases.
aspirin can prevent the blood clot formation.


Diagnosis:

The doctor can check the patient by physical exam, diagnosis and reviewing the family history.

Then the patient is conducted to ECG test to monitor the cardiac rhythm and prevent the complications of heart attack and help in treatment.

During treatment the doctor can use cardiac catheterization to determine the damage of the blood vessel and treat the stenosis of the artery and repair the damaged tissue. Some cases need surgical procedures to prevent symptoms and complications.


Prevention of heart attack:


  • lifestyle factors: maintaining a good and healthy lifestyle protects from most diseases. diet and food can decrease the harmful elements produced in the human body.
  • exercise: exercise is very useful for renewing and monitoring the blood circulation around the body, it helps the blood to carry oxygen and good fatty substances to the different tissues.
  • avoid smoking: the most common risk factor of heart attack or myocardial infarction is smoking. It contains tobacco that causes cardiovascular diseases.
  • some drugs: statin drugs that decrease the level of harmful blood fatty substances or aspirin that prevents the blood clot formation or other cardiovascular diseases.
  • avoid alcohol consumption.
  • maintain good habits and avoid stress.

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