Myocardial Infarction (Heart Attack)
By Roland Larrabee, M.D.
Myocardial infarction (MI) is a heart attack. It occurs when there is a sudden, complete blockage of blood flow to a part of the heart. Myocardial infarction may occur at any time and often occurs without warning.
As we grow older, our coronary arteries may become narrowed by the buildup of cholesterol plaque. When the arteries narrow, less blood can go through them, and less oxygen gets to the heart muscle. The process of narrowing is called atherosclerosis. The narrower the artery becomes, the more likely it is that a blood clot may form and block the artery completely, causing a heart attack.
A heart attack may occur when the heart muscle needs more oxygen than the blood vessels can provide. This might happen, for example, during hard exercise such as shoveling snow, or with a sudden increase in blood pressure.
Risk factors for heart disease include:
- cigarette smoking
- a family history of heart attack
- diabetes
- overweight
- high blood pressure
- high blood cholesterol, and
- a lifestyle that does not include much physical activity.
You are more likely to have a heart attack as you get older.
Lack of blood and oxygen during a heart attack damages the heart muscle. Part of the heart muscle usually dies. However, if only a small amount of heart muscle dies, your odds of surviving and living normally afterward are good. Early treatment of heart attacks is the best way to improve your odds.
When you are having an MI, you may feel pressure or pain in the middle of your chest. It may extend into your shoulder and arm or into your abdomen or jaw. The discomfort may be severe or may be fairly mild. (Some people think they have indigestion and do not get medical help as soon as they should.)
If you think someone is having a heart attack, call 911 and get emergency care immediately. Other typical symptoms that often occur with the chest pain are:
- shortness of breath
- sweating
- nausea or vomiting
- weakness or lightheadedness, and
- paleness.
Women may have different heart attack symptoms than men. Women may have symptoms such as a burning sensation in the upper abdomen, lightheadedness, an upset stomach, or sudden weakness or unexplained tiredness.
Heart attacks require immediate hospital treatment. Medicines that dissolve the coronary artery blood clot are quickly given through a vein and by mouth. Your heart rhythm is monitored and possibly dangerous rhythms are treated promptly. You may stay in the hospital 2 to 6 days. The exact treatment you receive depends on how you feel, how much heart muscle is damaged, and how much the arteries in your heart are blocked or narrowed.
To take care of yourself properly, one can do the following:
- Eat healthy food that is low in fat and sodium.
- Lose weight if you need to, and maintain the lower weight.
- Exercise regularly, according to your healthcare provider's instructions.
- If you smoke, quit.
- Keep your cholesterol at a normal level.
- Keep your blood pressure under control.
- Follow your healthcare provider's instructions for medicine and follow-up appointments.
- Talk with your healthcare provider about any questions or fears you may have.
- Carry your medication with you and know how to take it properly. A list of the names and doses and instructions for taking each medicine can be helpful to have.
If you think you are having a heart attack, call 911. Immediate emergency care improves your chances of survival and of avoiding damage to your heart.
Dr. Larrabee is Associate Director of Family and Community Medicine at the Walter L. Aument Family Health Center, 317 S. Chestnut St., Quarryville.
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