Medications

No significant association found for ADHD meds, CVD risk

There seems to be no statistically significant association between attention-deficit/hyperactivity disorder (ADHD) medications and cardiovascular disease (CVD) risk, according to a systematic review and meta-analysis published ...

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.

Diseases, Conditions, Syndromes

Ventilator-free days comparable with lower, higher SpO₂ target

The number of ventilator-free days does not differ for critically ill adults receiving mechanical ventilation with a lower, intermediate, or higher target for oxygen saturation, according to a study published online Oct. ...

Gerontology & Geriatrics

The pros and cons of hormone therapy for aging transgender women

An estimated 71% of transgender women use or intend to use gender-affirming hormone therapy (GAHT). Although sample sizes are comparatively small, there are studies that demonstrate psychological advantages of GAHT, whereas ...

Cardiology

Long-term outcomes of PCI, CABG compared for multivessel CAD

For patients with multivessel coronary artery disease, the rates of major adverse cardiac events and safety events do not differ for those receiving percutaneous coronary intervention (PCI) with everolimus-eluting stent or ...

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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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