Cardiology

SCAI stages of cardiogenic shock stratify mortality risk

A new shock classification scheme released by the Society for Cardiovascular Angiography and Interventions (SCAI) and endorsed by the American College of Cardiology (ACC), American Heart Association, the Society of Critical ...

Medical research

Deaths halved among infarct patients attending Heart School

Patients who attend 'Heart School,' as almost every patient in Sweden is invited to do after a first heart attack, live longer than non-participating patients. This is shown in a new study, by researchers at Uppsala University, ...

Cardiology

Antibody 'road block' enables fine-tuning for cardiac recovery

More than one million Americans per year experience myocardial infarction, commonly known as a heart attack, as well as the healing and rebuilding phase that begins shortly thereafter—a complicated process which involves ...

Cardiology

Combo antithrombotic therapy increases bleeding risk

(HealthDay)—Patients with chronic coronary artery disease or peripheral artery disease treated with the combination of rivaroxaban and aspirin face a greater risk for bleeding versus patients treated with aspirin alone, ...

Medications

Linagliptin noninferior for CV risk in early type 2 diabetes

(HealthDay)—Linagliptin is noninferior to glimepiride for adults with relatively early type 2 diabetes and elevated cardiovascular risk, according to a study published online Sept. 19 in the Journal of the American Medical ...

Cardiology

Diabetes and heart attack is a particularly risky combination

After a heart attack, patients with diabetes are at greater risk of heart failure and subsequent death than those without diabetes, according to late breaking results from the FAST-MI registry presented today at ESC Congress ...

Cardiology

Women with heart attack do present with typical symptoms

(HealthDay)—Typical symptoms of myocardial infarction are more common and have greater predictive value in women than in men, according to a study published in the Sept. 3 issue of the Journal of the American Heart Association.

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Myocardial infarction (MI) or acute myocardial infarction (AMI), commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die. This is most commonly due to occlusion (blockage) of a coronary artery following the rupture of a vulnerable atherosclerotic plaque, which is an unstable collection of lipids (cholesterol and fatty acids) and white blood cells (especially macrophages) in the wall of an artery. The resulting ischemia (restriction in blood supply) and ensuing oxygen shortage, if left untreated for a sufficient period of time, can cause damage or death (infarction) of heart muscle tissue (myocardium).

Classical symptoms of acute myocardial infarction include sudden chest pain (typically radiating to the left arm or left side of the neck), shortness of breath, nausea, vomiting, palpitations, sweating, and anxiety (often described as a sense of impending doom). Women may experience fewer typical symptoms than men, most commonly shortness of breath, weakness, a feeling of indigestion, and fatigue. Approximately one-quarter of all myocardial infarctions are "silent", that is without chest pain or other symptoms.

Among the diagnostic tests available to detect heart muscle damage are an electrocardiogram (ECG), echocardiography, cardiac MRI and various blood tests. The most often used blood markers are the creatine kinase-MB (CK-MB) fraction and the troponin levels. Immediate treatment for suspected acute myocardial infarction includes oxygen, aspirin, and sublingual nitroglycerin.

Most cases of STEMI (ST elevation MI) are treated with thrombolysis or percutaneous coronary intervention (PCI). NSTEMI (non-ST elevation MI) should be managed with medication, although PCI is often performed during hospital admission. In people who have multiple blockages and who are relatively stable, or in a few emergency cases, bypass surgery may be an option, especially in diabetics.

Heart attacks are the leading cause of death for both men and women worldwide. Important risk factors are previous cardiovascular disease, older age, tobacco smoking, high blood levels of certain lipids (triglycerides, low-density lipoprotein) and low levels of high density lipoprotein (HDL), diabetes, high blood pressure, obesity, chronic kidney disease, heart failure, excessive alcohol consumption, the abuse of certain drugs (such as cocaine and methamphetamine), and chronic high stress levels.

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