The blockage of the coronary artery leads to a heart attack. The medical term used for a heart attack is myocardial infarction (MI). It happens when the portion of the heart does not receive proper oxygen due to blockage of the coronary artery. Oxygenated blood is transported via coronary arteries to the heart muscles (myocardium)¹. 

Myocardial infarction is a serious and life-threatening condition when blood supply to the heart is cut off and leads to tissue damage. The accumulation of plaque causes blockage. A plaque is a substance made of cholesterol and fat and cellular waste products². 

 

Risk of myocardial infarction

The following are the factors that increase the risk of myocardial infarction. 

 

High blood pressure

If you have hypertension, then you have a high risk of myocardial infarction.  120/80 mm Hg is normal blood pressure, the risk of heart attack increases with the increase in blood pressure. High blood pressure increases the plaque buildup and also damages your arteries. 

 

High cholesterol levels

High blood cholesterol levels also increase the risk of myocardial infarction.  You can control or lower blood cholesterol by using medications called statins or by diet modification.  Avoiding fatty foods helps you to lower cholesterol levels in the blood. 

 

High triglyceride levels

The risk of myocardial infarction also increases with high levels of triglycerides. These are kinds of fats that clog up your arteries.  Triglycerides are stored in the body after you consume them from food. Then they travel to your bloodstream. 

 

Diabetes and high blood sugar levels

Diabetes is a disease in which a person has high glucose or high blood sugar levels. Diabetes can lead to coronary artery disease because high blood sugar levels damage blood vessels.  Coronary artery disease is a serious condition that can increase the risk of myocardial infarction.  

 

Obesity

Overweight and obese people have more chance of a heart attack. Obesity is linked with many health complications that lead to heart attack, such as 

• Diabetes 
• High cholesterol levels
• High blood pressure 
• High triglyceride levels 

 

Smoking

The risk of heart diseases increases with the use of tobacco products. Smoking causes many complications that include respiratory problems and cardiovascular diseases.  With the advancing age, the risk of heart diseases also increases.  The risk of a heart attack in men is higher, in men after 45 years and in women after 55 years. 

 

Family history

Heart diseases usually run in families. The chances of a heart attack are higher if you have a family history of heart diseases. The following are the factors that increase the risk of a heart attack. 

• Stress 
• High blood pressure during pregnancy or preeclampsia 
• Lack of physical activity (exercise)
• Illegal drug use including amphetamine and cocaine that trigger a spasm of coronary arteries that cause heart attack³

 

Stress

Stress and anxiety create a depression that increases the risk of a heart attack. 

 

Lack of physical activity

The level of cholesterol increases due to a lack of physical activity and obesity. People have better heart health and blood pressure who do regular exercise. 

 

An autoimmune condition

The risk of heart attack increases with autoimmune diseases such as rheumatoid arthritis or lupus⁵. 

 

Symptoms of myocardial infarction 

 

The most common heart attack symptom is chest pain, which is usually characterized by squeezing, heavy, crushing, pressing, burning, or stabbing. It usually originates from the center of the chest or just below the rib cage, it can spread to the abdomen, arms, neck or lower jaw or neck. 

Other heart attack symptoms include 

• Nausea
• Vomiting 
• Lightheadedness 
• Breathlessness 
• Weakness⁶ 

 

Treatment of Myocardial infarction 

 

Prehospital care: 

It requires the use of nitrates, aspirin, and oxygen. 

 

Drug treatment:

Drug treatment is essential for heart attack. Medicines for the heart do not cure the heart conditions but manage your condition. Commonly used medications are antianginal drugs, anticoagulants, and antiplatelet drugs. 

Other drugs used include 

• To improve the flow of blood through narrow arteries, blood thinners such as aspirin are used. 
• To prevent the formation of new clots, antiplatelet drugs are commonly used, including clopidogrel. It also restricts the growth of existing clots. 
• Nitroglycerin is used to open up blood vessels. 
• Beta-blockers are very useful drugs that relax heart muscles and lower blood pressure. They control the severity of damage to your heart. 
• ACE inhibitors are used to decrease stress on the heart and also lower blood pressure. 

 

 Reperfusion therapy: 

Reperfusion therapy is performed with clot-dissolving drugs called thrombolytics including tissue plasminogen activator (tPA). It also includes angiography with percutaneous coronary intervention or coronary artery bypass surgery⁷. 

  

Diagnosis of Myocardial infarction 

 

The diagnosis of a heart attack can be done by observing symptoms. Blood studies and ECG help in the diagnosis of a heart attack. The treatment aims to prevent heart muscle damage. 

The following are the tests or methods that contribute to the diagnosis of a heart attack. 

 

12-lead ECG: 

 

It determines the type of heart attack; it is also called EKG or electrocardiogram. 

 

Blood studies: 

 

Blood tests determine the levels of biochemical markers. The size of the heart attack is determined by doctors by measuring the levels of biochemical markers. 

Other procedures and test can be done that include:

• Echocardiogram (echo)
• Cardiac catheterization (cath)⁸

  

References

 

1. Conditions We Treat: Myocardial Infarction (Heart Attack). [internet]. [cited 2020 September 12]; Available from  https://www.hopkinsmedicine.org/heart_vascular_institute/conditions_treatments/conditions/myocardial_infarction.html
2. Acute Myocardial Infarction. [internet]. [cited 2020 September 12]; Available from  https://www.healthline.com/health/acute-myocardial-infarction
3. Acute Myocardial Infarction (Heart Attack). [internet]. [cited 2020 September 12]; Available from  https://www.healthline.com/health/acute-myocardial-infarction#risk-factors
4. Conditions We Treat: Myocardial Infarction (Heart Attack). [internet]. [cited 2020 September 12]; Available from  https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106
5. Myocardial Infarction (Heart Attack). [internet]. [cited 2020 September 12]; Available from  https://www.health.harvard.edu/a_to_z/heart-attack-myocardial-infarction-a-to-z
6. Acute Myocardial Infarction (MI). [internet]. [cited 2020 September 12]; Available from  https://www.msdmanuals.com/professional/cardiovascular-disorders/coronary-artery-disease/acute-myocardial-infarction-mi
7. Heart Attack (Myocardial Infarction): Diagnosis and Tests.  [internet]. [cited 2020 September 12]; Available from  https://my.clevelandclinic.org/health/diseases/16818-heart-attack-myocardial-infarction/diagnosis-and-tests

 

 

 

 

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