Myocardial Infarction " Heart Attack " MI

Myocardial infarction " heart attack " MI

Heart Attack

Myocardial Infarction

 Definition:

An acute condition characterized by the severe cut of blood supply to a portion of the heart muscle resulting in necrosis of that portion due to a reduced coronary blood flow.

Aetiology:

1- Occlusion of a coronary artery, atherosclerosis, embolus, and thrombus.

2- Shock or haemorrhage lead to the sudden reduction in blood supply to the heart muscle.

Signs and symptoms:

1- Pain is the chief symptoms ( pain is usually pericardial, sub sternal. it might be radiated to the left shoulder, arm, jaw or throat. pain is very severe and of the long duration. pain is like crushing or heaviness sensation. this pain is usually not related to exertion, rest or nitroglycerin does not relieve pain.

2- Signs and symptoms may follow or accompany the pain (sweating, decreased blood pressure, increased heart rate and pallor wet skin ).

3- Nausea and vomiting.

4- Fear, restlessness and apprehension.

5- Sings and symptoms of Lt. sided heart failure may appear.

6- Death might occur within a few hours.

Diagnostic tests:

- Physical examination.

- ECG changes within 2- 12 hours.

- Cardiac enzymes will be elevated (CPK, LDH and CK-MB ).

- Troponin test will be elevated.

Management:

Bed rest, physical activities are increasing gradually { avoid sudden efforts}.

Sedation and pain relief: morphine and pethidine IV.

Antiemetic to decrease nausea and vomiting.

Oxygen therapy.

Thrombolytic drugs.

Urgent cardiac catheterization if possible .

Complications of MI:

1- Arrhythmias: Abnormal heartbeat patterns, most common and fetal are ventricular tachycardia, ventricular fibrillation and a systole.

2- Cardiogenic shock.

3- Congestive heart failure.

4- Venous thrombosis.

5- Pulmonary embolism.

6- Atrial embolism.

7- a Ventricular aneurysm and ventricular modification.


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