Cardiology

Plaque in arteries may not all be the same

A specific type of immune cell is more commonly found in arterial plaque from patients suffering from a recent stroke or mini-stroke, according to preliminary research presented at the American Heart Association's Vascular ...

Medications

Bladder drug linked to atherosclerosis in mice

A drug used in the treatment of overactive bladder can accelerate atherosclerosis in mice, researchers at Karolinska Institutet in Sweden report in a study published in the Proceedings of the National Academy of Sciences ...

Genetics

Genomic collision may explain why many kidney transplants fail

A genomic collision could explain why many kidney transplants fail, even when donors and recipients are thought to be well-matched, according to a new study from researchers at Columbia University Vagelos College of Physicians ...

Cancer

Why Hodgkin's lymphoma cells grow uncontrollably

Although classical Hodgkin's lymphoma is generally easily treatable today, many aspects of the disease still remain a mystery. A team at the Max Delbrück Center led by Professor Claus Scheidereit has now identified an important ...

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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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