What is the definition of myocardial infarction?
Myocardial infarction (MI) means the tissue death of the heart muscle, it's a type of
acute coronary syndrome. The phrase "heart attack" is often used non-specifically to refer to a myocardial infarction and to sudden cardiac death.
MI is different from, but can cause
cardiac arrest, where the heart is not contracting at all or so poorly that all vital organs cease to function, thus causing death. It is also distinct from
heart failure, in which the pumping function is impaired.
MI occurs mostly
after middle age and can trigger severe and long-lasting symptoms like anterior chest pain, palpitations, wheezing, weak pulse, and decreased blood pressure, and
taking nitroglycerin can cause serious consequences. Treatment should be performed
immediately after the onset of this illness.
What causes myocardial infarction?
Any physical or mental factors that increase myocardial oxygen consumption or induce coronary spasm may trigger acute myocardial infarction in patients with coronary heart disease. The
common causes are as follows:
Defatigation:
Excessive physical activity, or continuous stress and fatigue can significantly increase the burden on the heart, and the myocardial oxygen demand. The coronary artery of patients with coronary heart disease can't fully expand if experiencing defatigation, thus causing
short-term blood deficiency, and in severe cases, causing acute myocardial infarction.
Excitement:
Intense emotional changes such as agitation, nervousness, and anger can induce myocardial infarction.
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Overeating:
After eating a large amount of food containing
high fat and high calorie, an increase in blood lipid concentration, an increase in blood viscosity, and an increase in platelet aggregation may occur. thus causing acute myocardial infarction.
Cold Stimulation:
Sudden cold stimulation may induce acute myocardial infarction, which is the reason for the high incidence of acute myocardial infarction
in winter and spring.
Constipation:
Forceful breath holding during constipation can lead to myocardial infarction.
What are the symptoms of myocardial infarction?
The
common symptoms of myocardial infarction are as follows:
Extreme Pains:
The sites and the nature of the pain are the same as
angina pectoris, often occur during rest or sleeping, the duration of the extreme pains can be as long as
several hours or days. Having rest or taking nitroglycerin tablets can not even alleviate them, and patients are often
irritable, sweaty, fearful, and feeling of sudden death.
Fever:
The body temperature is generally around 38 ° C,
rarely exceeding 39 ° C. It may last for
about a week.
Gastrointestinal Symptoms:
About
one-third of patients may experience
nausea, vomiting, and upper abdominal pain in the
early stages of the disease.
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Arrhythmia:
75%-95% of arrhythmia occur more frequently within
1-2 weeks after onset.
Hypotension and Shock:
During the pain, blood pressure will drop, and it will continue to rise after several weeks, but often can't be restored to the previous level. If the pain is relieved and the systolic blood pressure is lower than
80mmHg, the patient will present symptoms like
irritability, paleness, wet skin, and even fainting, all of which are signs of shock.
Cardiac Failure:
It is mainly the
acute left heart failure, which can occur within the
first few days of onset or during the period of pain and shock. The incidence rate is about
20%-48%, which is caused by a significant decrease in cardiac contractility after infarction.
What are the types of myocardial infarction?
Generally, myocardial infarction can be divided into
ST elevation MI (STEMI) and
non-ST elevation MI (NSTEMI). STEMIs make up about
25%-40% of myocardial infarctions.
Specifically, myocardial infarction can also be divided into the following types:
- Spontaneous MI related to plaque erosion or rupture.
- MI related to ischemia.
- Associated with coronary angioplasty or stents.
- Associated with CABG.
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How to diagnose myocardial infarction?
Common diagnosis measures are as follows:
Cardiac biomarkers:
Cardiac biomarkers like
troponins, CK-MB or myoglobin can be used to determine the presence of cardiac muscle damage.
Electrocardiogram:
Electrocardiograms (ECGs) are a
series of leads placed on a person's chest that measure electrical activity associated with contraction of heart muscle.
Imaging:
Tests such as chest
X-rays can be used to explore and exclude alternate causes of a person's symptoms. Tests such as
stress echocardiography and
myocardial perfusion imaging can
confirm a diagnosis.
Echocardiography, an ultrasound scan of the heart, is able to visualize
abnormal motions of the heart walls as they beat.
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