Myocardial Infarction

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Myocardial Infarction

• Heart Attack

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Outline

• What is an MI (or) Heart Attack
• What are the causes?
• Patho-physiology (disease process)
• What are the signs symptoms?
• Management of diagnosis treatment
• (How is it diagnosed how is it treated?)

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What is a MI / Heart Attack?

• A heart attack (a.k.a. Myocardial Infarction) is
  the death of heart muscle from a sudden blockage
  of a coronary artery.
• Blockage of a coronary artery deprives the heart
  muscle of blood oxygen, causing injury to the
  heart muscle.

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Etiology (cause)

• Risk factors for developing heart attacks are
• Atherosclerosis
• Angina
• HBC (High Blood Cholesterol) A high level of
  cholesterol in the blood
• HBP (High Blood Pressure/Hypertension)
• Tobacco Use (Smoking)
• Diabetes
• Family History of Heart Disease

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Etiology (contd)
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Patho-physiology (disease process )

• Atherosclerosis
• Which is a gradual
• process of plaques or
• collections of
• cholesterol are
• deposited in the artery
• walls.

Cross Section of Artery With Atherosclerosis
Artery Wall
Endothelium (Inner artery wall lining)
Fatty Deposits of plaque
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Patho-physiology (contd)

• Angina
• This is chest pain
• that occurs when the
• blood oxygen supply
• to the heart muscle
• cannot keep up with the
• needs of the heart
• muscle.

endothelium
Artery wall
plaque
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Signs Symptoms

• Common symptoms of atherosclerosis angina are
• Pressure, heaviness, squeezing or aching across
  the chest.
• Pain may travel to the neck, jaw, arms, back,
  even teeth, and may be accompanied by shortness
  of breath, nausea, or cold sweat.

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Signs Symptoms (contd)

• Angina can also occur during rest. Angina at rest
  more commonly indicates that a coronary artery
  has been narrowed to a critical degree. The heart
  is NOT receiving enough oxygen even at rest.

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Management (Diagnosis)

• Severe chest pain is usually a sign that a MI or
  heart attack is occurring, and tests can be
  performed that will confirm the MI.
• When symptoms of a heart attack do not include
  chest pain, the heart attack may not be suspected
  and appropriate tests may not be performed.
• The initial step in diagnosing a heart attack is
  to be suspicious that one has occurred.

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FYI

• About 160,440 people die each year from a heart
  attack.

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Management (Diagnosis)
(contd)
Upside down ST Segment
Post Myocardial Infarction
Post Myocardial Infarction

• (Pic 1) The patient clearly has risk factors for
  coronary artery disease, symptoms suggestive of
  angina and an abnormal ECG.
• (Pic 2) ECG as it appears while patient is
  having a MI. During heart attack, notice the
  atrial ventricular spikes.
• (Pic 3) The patient has had a MI.

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Management (Diagnosis)
(contd)

• There are different ways to diagnose a heart
  attack.
• Electrocardiogram (ECG/EKG)
• Blood Tests
• The most important factor in diagnosing a heart
  attack is prompt medical attn

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Management (Treatment)

• But, what is an Electrocardiogram (ECG/EKG)?
• It is a recording of the electrical activity of
  the heart.
• It can identify the areas of heart muscle that
  are deprived of oxygen /or areas of muscle that
  have died.
• It can also give a secure diagnosis of a heart
  attack, it can be made quickly in the ER so
  treatment can be started immediately.

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Management (Treatment)
(contd)

• How is a heart attack treated?
• Anti-platelet medications to prevent formation of
  blood clots in the arteries.
• Anti-coagulants to prevent growth of blood clots
  in the arteries.
• Clot- dissolving medications to open blocked
  arteries.
• Medications to prevent abnormal heart rhythms.
• Supplemental oxygen to increase the supply of
  oxygen to the heart muscle.

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Conclusion

• So as we have discussed learned what an MI is,
  how its diagnosed treated, what will you do to
  prevent one or at the least lower your chances of
  having one?
• We can all do our own part in answering that
  question for ourselves.
• Thank You