Cardiology

Price of alirocumab would have to be cut to be cost-effective

(HealthDay)—For patients with a recent acute coronary syndrome receiving a statin, the price of alirocumab would have to be reduced to be cost-effective, according to a study published online Jan. 1 in the Annals of Internal ...

Cardiology

A sobering conclusion: Adult hearts contain no stem cells

A detailed cell-by-cell map of all dividing cells in the adult murine heart before and after myocardial infarction was created using advanced molecular and genetic technologies in a combined research effort led by Hans Clevers ...

Cardiology

Antibodies linked to heart attacks

Levels of antiphospholipid antibodies, which are associated with rheumatic diseases, are also elevated in myocardial infarction without any autoimmune co-morbidity, a study from Karolinska Institutet in Sweden published in ...

Cardiology

Presence of antiphospholipid antibodies tied to first-time MI

(HealthDay)—There is a strong and independent association between the presence of antiphospholipid antibodies (aPLs) and first-time myocardial infarction (MI), according to a research letter published recently in the Annals ...

Cardiology

Lower mortality seen for cardiac care at top-ranked hospitals

(HealthDay)—Compared with nonranked hospitals, top-ranked hospitals have lower 30-day mortality but similar or higher readmission rates for cardiovascular conditions, according to a study published online Nov. 28 in JAMA ...

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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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