Diseases, Conditions, Syndromes

Shingles associated with increased risk for stroke, heart attack

A new study by investigators from Brigham and Women's Hospital, a founding member of the Mass General Brigham health care system, demonstrated that shingles, also known as herpes zoster, is associated with an almost 30% higher ...

Cardiology

Study shows blood pressure levels rose during pandemic

Adults with hypertension saw a small, but consequential, rise in their blood pressure levels during the first eight months of the COVID-19 pandemic, while the number of times they had their blood pressure measured dropped ...

Cardiology

New troponin test improves heart attack diagnostics

A new test has been developed in Turku, Finland, that helps in separating heart attack patients from those whose cardiac troponin values are elevated due to renal insufficiency.

Cardiology

Marital stress linked to worse recovery after heart attack

A stressful marriage may negatively impact heart attack recovery. Marital stress among younger adults (ages 18–55 years) was linked to worse recovery after a heart attack. That negative impact did not change substantially ...

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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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