Development of sudden chest pain is the most common symptom of heart attack. The pain may radiate down the left arm or neck in majority of the cases. The chest pain may be mild or severe. The characteristics of chest pain can be explained as follows:

• Feeling of tight band that surrounds the chest.
• Experiencing symptoms mimicking bad indigestion.
• Feeling of some kind of heavy object on chest.
• The pain often lasts for about 20 minutes. In addition to chest pain, individuals can also suffer from anxiety, shortness of breath, palpitations, sweating, cough and fainting.
• It is always better to seek medical intervention at the earliest when an individual experiences any of these symptoms. Early intervention can help prevent onset of debilitating conditions.
• In many cases, individuals may not experience any symptoms at all; or would just complain of dull or vague symptoms such as fatigue and shortness of breath. Such individuals are known to have developed silent heart attacks [6].

• Pain

  Development of sudden chest pain is the most common symptom of heart attack. The pain may radiate down the left arm or neck in majority of the cases. The chest pain may be mild or severe. [symptoma.com]

  Also, women are less likely to experience the classic symptoms of chest pain; rather, they may feel a sense of fullness in their chest or pain in their arm, neck, back or jaw. [webmd.com]

  […] without chest pain/discomfort. [dx.doi.org]

• Congestive Heart Failure

  Fifty of the patients had died in cardiogenic shock, the remainder from refractory congestive heart failure. [heart.bmj.com]

  […] disease chest pains congestive heart failure coronary coronary infarction coronary thrombosis myocardial infarction tachycardia heart disease noun disease of the heart angina cardiac infarction congenital heart disease congestive heart failure coronary [thesaurus.com]

  However, the role of aldosterone antagonists in patients with ejection fraction greater than 40% or without congestive heart failure is not well known. [doi.org]

  The reduced left ventricular ejection fraction may lead to congestive heart failure and predispose to ventricular arrhythmias. [brown.edu]

  Abstract Hypoxemia after myocardial infarction (MI) is usually explained by common culprits, including congestive heart failure, pre-existing lung disease, and pulmonary infection. [ncbi.nlm.nih.gov]

• Fatigue

  If unexplained fatigue is present, clinicians should assess it in depth and explore the degree of fatigue, because some women previously described it as so severe that they could not make a bed without resting. [dx.doi.org]

  She denied any chest pain, shortness of breath, fatigue, lightheadedness, palpitations, nausea or diaphoresis. Her initial laboratory Troponin I resulted 35.9 ng/mL. [ncbi.nlm.nih.gov]

  Women often have more subtle symptoms, including fatigue and nausea. Call emergency medical services immediately (in the United States, dial 911). [jamanetwork.com]

• Coronary Atherosclerosis

  Coronary atherosclerosis, composite, microscopic. Coronary atherosclerosis, intimal plaque, microscopic. Coronary atherosclerosis, complicated by calcification, microscopic. Coronary atherosclerosis, occlusive, microscopic. [library.med.utah.edu]

  The severity of coronary atherosclerosis was independent of the presence of angina prior to MI. Our results indicated that the incidence of asymptomatic MI in diabetics is not as high as previously believed. [doi.org]

  Coronary atherosclerosis (or coronary artery disease ) refers to the atherosclerosis that causes hardening and narrowing of the coronary arteries. [medicinenet.com]

  Pathogenesis: Commonest cause (at least 90%) is due to coronary atherosclerosis with occluding thrombus. [histopathology-india.net]

• Fever

  We report the case of 56 year old male, who presented with high grade fever and leukocytosis. On detailed evaluation, he was found to have a myocardial abscess with underlying LVA. © Journal of the Association of Physicians of India 2011. [ncbi.nlm.nih.gov]

  DIAGNOSIS: 1.Clinical features: Pain Indigestion Apprehension Shock Low grade fever 2.Serum cardiac markers: Creatinine phosphokinase (CK) Lactic dehydrogenase (LDH) Cardiac specific troponins (cTn) 13. 3.ECG changes:  ST segment elevation  [slideshare.net]

  Clinical stability was defined as a lack of fever, improved signs and symptoms associated with CAP, and improved leukocyte count [ 17 ]. [doi.org]

• Dyspnea

  About 25% of patients seen by the physician in the ambulatory setting present with dyspnea. [web.archive.org]

  Instead, their most common symptoms are weakness, fatigue and dyspnea. [cvpharmacology.com]

  PATIENT CONCERNS: A 51-year-old man was admitted to our hospital with exertional dyspnea that he had experienced for half a year. Woven coronary artery was found in coronary angiography. [ncbi.nlm.nih.gov]

• Rales

  This patient had a clear history of carbon monoxide poisoning, acute respiratory distress, bilateral lung dry and moist rale, chest X-ray showed bilateral pulmonary edema, Electrocardiograph indicated general depression of the ST segment of the leads [ncbi.nlm.nih.gov]

  Exceptions appeared for the two big RALES and EMPHASIS-HF trials [ 11 ][ 33 ], where interestingly enough, patients in the placebo groups had slightly higher rate of gynecomastia (RALES and EMPHASIS-HF) and of renal function degradation (EMPHASIS-HF). [doi.org]

  In most persons who experience an acute myocardial infarction, the circulation remains adequate, and only by subtle evidence such as rales (abnormal respiratory sounds) in the lungs or a gallop rhythm of the heartbeat may the evidence of some minor degree [britannica.com]

  There may be signs of congestive heart failure, including pulmonary rales, peripheral oedema, elevated jugular venous pressure. [patient.info]

• Respiratory Distress

  This patient had a clear history of carbon monoxide poisoning, acute respiratory distress, bilateral lung dry and moist rale, chest X-ray showed bilateral pulmonary edema, Electrocardiograph indicated general depression of the ST segment of the leads [ncbi.nlm.nih.gov]

  Favorites PDF Get Content & Permissions Open SDC Correspondence Veno-venous extracorporeal membrane oxygenation for patient with a history of open cholecystectomy and acute respiratory distress syndrome caused by coinfection of avian influenza A (H7N9 [cmj.org]

  Trevisanuto D, Zaninotto M, Altinier S, Plebani M, Zanardo V (2000) High serum cardiac troponin T concentrations in preterm infants with respiratory distress syndrome. Acta Paediatr 89(9):1134–1136 CrossRef PubMed Google Scholar 80. [doi.org]

  distress syndrome; COPD = chronic obstructive pulmonary disease. [web.archive.org]

• Tachypnea

  Neonates Older children Feeding problems Fatigue Lack of interest in surroundings Lack of appetite Irritability Paleness Diarrhoea Dyspnoea Sweating Tachypnea Vomiting Tachycardia Pallor Hypotension Tachypnea Weak pulse Dyspnea Rhythm irregularity Sudden [intechopen.com]

  Heart rate may reveal tachycardia, atrial fibrillation or ventricular arrhythmia Unequal pulses if the patient has an aortic dissection Blood pressure is usually high, but hypotension if the patient is in shock Tachypnea and fever are not uncommon. [ncbi.nlm.nih.gov]

• Dyspnea at Rest

  The person will have dyspnea (shortness of breath) on exertion and in severe cases, dyspnea at rest. Increasing breathlessness on lying flat, called orthopnea, occurs. [en.wikipedia.org]

• Nausea

  OTHER SIGNS may include breaking out in a cold sweat, nausea or lightheadedness. [heart.org]

  She denied any chest pain, shortness of breath, fatigue, lightheadedness, palpitations, nausea or diaphoresis. Her initial laboratory Troponin I resulted 35.9 ng/mL. [ncbi.nlm.nih.gov]

  Women often have more subtle symptoms, including fatigue and nausea. Call emergency medical services immediately (in the United States, dial 911). [jamanetwork.com]

• Vomiting

  A 58 year old lady was admitted to our unit with acute onset epigastric pain and vomiting for 4 h duration. Following admission she complained of retrosternal tightening type of a chest pain. She had elevated serum amylase and cardiac troponin. [ncbi.nlm.nih.gov]

  The most common symptom is chest pain, shortness of breath, nausea, vomiting. [imedpub.com]

  Meanwhile, morphine is associated with vomiting, hypotension, and respiratory depression. The study authors also reported that morphine may inhibit and delay oral antiplatelet drug absorption. [ajpb.com]

  61 yo female with no previous medical history presenting with nausea, vomiting and epigastric pain that began approximately 4 hours after eating at a mexican restaurant. [web.archive.org]

  Skip to content learn bedside ultrasound, one week at a time 61 yo female with no previous medical history presenting with nausea, vomiting and epigastric pain that began approximately 4 hours after eating at a mexican restaurant. [ultrasoundoftheweek.com]

• Regurgitation

  KEYWORDS: acute mitral regurgitation; echocardiography; flail mitral valve; mitral valve commissures; myocardial infarction; papillary muscle rupture [ncbi.nlm.nih.gov]

  Ischaemic mitral regurgitation Ischaemic mitral regurgitation (IMR) is a functional entity that occurs in 8% to 50% of patients after myocardial infarction. [intechopen.com]

• Abdominal Pain

  View larger version (186K) Fig. 12A—49-year-old man with abdominal pain. Nongated CT of abdomen and pelvis was obtained for patient’s lower abdominal pain and showed findings consistent with diverticulitis and peridiverticular abscess (not shown). [ajronline.org]

  Chest pain, often crushing, severe, and left-sided Arm, jaw, or neck pain Fainting or light-headedness Nausea Fatigue Upper abdominal pain Loss of consciousness Cardiac arrest Men are more likely to experience chest pain during a myocardial infarction [jamanetwork.com]

  Depending on the pain localization, there are several forms of myocardial infarction, such as: Typical form – chest pain Atypical form – abdominal pain Combined form – abdominal and chest pain Painless form – there is no pain syndrome (more common for [bookinghealth.com]

  Symptoms Common heart attack signs and symptoms include: Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back Nausea, indigestion, heartburn or abdominal pain Shortness of breath [mayoclinic.org]

• Epigastric Pain

  A 58 year old lady was admitted to our unit with acute onset epigastric pain and vomiting for 4 h duration. Following admission she complained of retrosternal tightening type of a chest pain. She had elevated serum amylase and cardiac troponin. [ncbi.nlm.nih.gov]

  61 yo female with no previous medical history presenting with nausea, vomiting and epigastric pain that began approximately 4 hours after eating at a mexican restaurant. [web.archive.org]

  Skip to content learn bedside ultrasound, one week at a time 61 yo female with no previous medical history presenting with nausea, vomiting and epigastric pain that began approximately 4 hours after eating at a mexican restaurant. [ultrasoundoftheweek.com]

  […] to present with atypical symptoms such as fatigue, sleep disturbance, shortness of breath, back pain, upper abdominal or epigastric pain, and nausea with or without vomiting rather than simply present with chest pain. 16 Compounding the problem for women [journals.lww.com]

  Most evident in the palms and on the face) Sweating Tachycardia Presentation of a ‘silent MI’ (no cardiac pain / chest tightness) – usually in diabetic and/or elderly patients Syncope Pulmonary oedema Epigastric pain Vomiting Acute confusional state Stroke [almostadoctor.co.uk]

• Jaw Pain

  Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes, or goes away and comes back. Pain or discomfort in one or both arms, the back, neck, jaw or stomach. [heart.org]

  This pain may travel to the neck, jaw, arms, back, or even the teeth, and may be accompanied by shortness of breath, nausea, or a cold sweat. [medicinenet.com]

  Other symptoms include: Fatigue Breathlessness or difficulty in breathing Stomach pain Profuse sweating Nausea Lightheadedness Pain in the upper torso such as the neck or jaw Pain in the arms and back It’s essential to note that although men and women [docdoc.com.sg]

  Presentation Chest pain (central chest pain may not be the main symptom): Three quarters of patients present with characteristic central or epigastric chest pain radiating to the arms, shoulders, neck, or jaw. [patient.info]

• Chest Pain

  Development of sudden chest pain is the most common symptom of heart attack. The pain may radiate down the left arm or neck in majority of the cases. The chest pain may be mild or severe. [symptoma.com]

  […] without chest pain/discomfort. [dx.doi.org]

  All patients admitted to the emergency department with chest pain and ST elevation on electrocardiography should be asked about allergic insults. [ncbi.nlm.nih.gov]

• Tachycardia

  SEE DEFINITION OF myocardial infarction as in coronary infarction as in heart disease as in cardiac arrest as in heart attack Synonyms for myocardial infarction cardiac arrest congestive heart failure heart failure tachycardia MOST RELEVANT Roget's 21st [thesaurus.com]

  The tachycardia rate is typically between 140 and 180 beats/min and the QRS is relatively narrow, with a duration of 120 to 150 ms. [ncbi.nlm.nih.gov]

  Tachycardias[edit] In adults and children over 15, resting heart rate faster than 100 beats per minute is labelled tachycardia. Tachycardia may result in palpitation; however, tachycardia is not necessarily an arrhythmia. [en.wikipedia.org]

  The pain and anxiety associated with myocardial infarction further activates the sympathetic nervous system, which causes systemic vasoconstriction and cardiac stimulation (this explains why some patients become hypertensive and have tachycardia). [cvpharmacology.com]

• Heart Murmur

  The provider may hear abnormal sounds in your lungs (called crackles), a heart murmur, or other abnormal sounds. You may have a fast or uneven pulse. Your blood pressure may be normal, high, or low. [nlm.nih.gov]

  During the early hours of a heart attack, heart murmurs and other abnormal heart sounds may be heard through a stethoscope. People who have a heart attack may also have complications that can be long-lasting. [merckmanuals.com]

• Systolic Murmur

  On day 2, however, the patient's vital signs deteriorated to a state of shock and systolic murmur appeared at the apical region. TTE showed a left-to-right shunt in the apical septal region, and ventricular septal perforation was diagnosed. [ncbi.nlm.nih.gov]

  Diagnosis is made by detection of a new systolic ejection murmur, often associated with a precordial thrill. [brown.edu]

  Third and fourth heart sound, systolic murmur if mitral regurgitation or ventricular septal defect develops, pericardial rub. [patient.info]

  Signs Signs of impaired myocardial function 3 rd / 4 th heart sounds Pan systolic murmur Pericardial rub Pulmonary oedema – crepitations in the lungs Hypotension Quiet first heart sound Narrow pulse pressure ( difference of ) Raised JVP Signs of sympathetic [almostadoctor.co.uk]

• Pericardial Friction Rub

  Abstract Fifty-two (6·8%) of 779 patients admitted to a coronary monitoring unit with acute myocardial infarction developed a pericardial friction rub. A diagnosis of postmyocardial infarction syndrome was made in three of these. [ncbi.nlm.nih.gov]

  Pericarditis pain is distinguishable from infarct pain because of its pleuritic nature, radiation to the left trapezius ridge, and the associated low-grade fever and pericardial friction rub. [brown.edu]

  Significant physical findings, often absent, include an atrial gallop rhythm (4th heart sound) and a pericardial friction rub. [medical-dictionary.thefreedictionary.com]

  A pericardial friction rub may be audible as a to-and-fro rasping sound; it is produced through sliding contact of inflammation-roughened surfaces. [emedicine.medscape.com]

• Sweating

  OTHER SIGNS may include breaking out in a cold sweat, nausea or lightheadedness. [heart.org]

  In addition to chest pain, individuals can also suffer from anxiety, shortness of breath, palpitations, sweating, cough and fainting. [symptoma.com]

  Sympathetic activation is responsible for the diaphoresis (sweating) experienced by the patient. [cvpharmacology.com]

• Increased Sweating

  CLINICAL MANIFESTATIONS: • Chest pain / chest discomfort • Dyspnea • Fatigue • Other symptoms include: Increased sweating Weakness Nausea Vomiting Light-headedness Palpitation • Anxiety, sleeplessness, hypertension or hypotension, arrhythmia. • Chest [slideshare.net]

• Cold, Clammy Skin

  Other symptoms include heart palpitations; dizziness; indigestion; nausea; sweating; cold, clammy skin; and shortness of breath. [diversalertnetwork.org]

• Upper Back Pain

  However, women are more likely than men to have: shortness of breath jaw pain upper back pain lightheadedness nausea vomiting In fact, some women who have had a heart attack report that their symptoms felt like the symptoms of the flu. [healthline.com]

• Shoulder Pain

  The most common symptoms expected and experienced were chest pain, chest discomfort, loss of strength, fatigue, and radiating pain or shoulder pain. [doi.org]

  Those who have more vague or less typical "heart" symptoms have reported the following: Upper back or shoulder pain Jaw pain or pain spreading to the jaw Pressure or pain in the center of the chest Light headedness Pain that spreads to the arm Unusual [my.clevelandclinic.org]

  […] observation units, or coronary care units; age and sex; index test: pain radiating to left arm and/or shoulder; to right arm and/or shoulder; to both arms and/or shoulders; to neck; to back; epigastric, oppressive pain; nausea and/or vomiting; sweating [bjgp.org]

• Panic Attacks and Disorders

  (eg, somatoform disorders, panic attack, anxiety disorders) are noncardiac causes of chest pain that can mimic ACS. 57 3.2.2. [doi.org]

• Dizziness

  A 73-year-old woman complained of dizziness and fatigue with shortness of breath after carbon monoxide intoxication. [ncbi.nlm.nih.gov]

  “Instead they may experience shortness of breath, pressure or pain in the lower chest or upper abdomen, dizziness, lightheadedness or fainting, upper back pressure or extreme fatigue.” [heart.org]

  Märkus: Symptoms of heart attack include discomfort or pain in the chest, shoulder, arm, back, neck, or jaw, shortness of breath, dizziness or light-headedness, heartburn, nausea, excessive sweating, and extreme fatigue. [M-W] [termin.eki.ee]

  Other symptoms include heart palpitations; dizziness; indigestion; nausea; sweating; cold, clammy skin; and shortness of breath. [diversalertnetwork.org]

  Other signs of a heart attack include shortness of breath, dizziness, faintness, or nausea. The pain of a severe heart attack has been likened to a giant fist enclosing and squeezing the heart. [webmd.com]

• Confusion

  This anomaly, because it is rare, can be a source of confusion to clinicians, especially when acute coronary syndrome is present. The possible presence of this anomaly should, therefore, be kept in mind in daily practice. [ncbi.nlm.nih.gov]

  Such imprecision on the part of the doctor can lead to confusion among the family members of the victim. [verywellhealth.com]

  But if you don’t have the telltale sign of sudden chest pain that everyone is taught to recognize, it can be confusing. This is called a silent heart attack. It means you don’t even know you’re having one. [pennmedicine.org]

  Many women think the signs of a heart attack are unmistakable — the image of the elephant comes to mind — but in fact they can be subtler and sometimes confusing. [heart.org]

• Altered Mental Status

  The man was bitten on the left index finger and subsequently developed localized edema followed by hypotension, chest pain, and altered mental status. His initial electrocardiogram revealed ST-segment elevation in the inferior and lateral leads. [ncbi.nlm.nih.gov]

  In addition, some patients may have an altered mental status caused by medications or impaired cerebral perfusion. [emedicine.medscape.com]

  Therefore, patients with altered mental status were not eligible to participate in the trial. [doi.org]

• Agitation

  Hyperthermic complications Excessive cocaine use can result in hallucinations, agitation, and hyperthermia, and management is urgent. [doi.org]

  […] medically determined that the person is no longer alcohol or drug dependent, (xiv) no established medical evidence of an intractable psychoneurotic disorder having particular regard for sustained hostile, aggressive, paranoid, or suicidal tendencies and agitated [gov.ns.ca]

A preliminary physical examination to determine the heart sounds, blood pressure and pulse rate will be quickly carried out. Following this, an electrocardiogram will be done to evaluate the extent of heart damage. A blood test will be conducted which would determine heart tissue damage. This test would also confirm heart attack.

Coronary angiogram would either be done immediately or after stabilizing the condition of the patient. In this test, a specialized dye is inserted which allows to evaluate areas of blockage. In addition, other tests such as nuclear stress test and exercise stress test would also be conducted [7].

• Wide QRS Complex

  If the QRS complex is wide (longer than 120 ms) it suggests disruption of the heart's conduction system, such as in LBBB, RBBB, or ventricular rhythms such as ventricular tachycardia. [en.wikipedia.org]

• Lateral Q Wave

  Typical picture of changes ST elevation – then later, T inversion –, then later, Q wave appears Other patterns of ECG change: ST- depression Reciprocal change – sometimes seen in STEMI. [almostadoctor.co.uk]

• Inferior Q Wave

  Q waves - not Old Inferior Wall Myocardial Infarction (MI) ECG Old Inferior Wall Myocardial Infarction (MI) ECG (Example 1) Old Inferior Wall Myocardial Infarction (MI) ECG (Example 2) References: 1. [healio.com]

• ST Elevation

  KEYWORDS: Cardiac arrest; ST elevation myocardial infarction; cardiac catheterization lab; hypothermia; morbidity; mortality. [ncbi.nlm.nih.gov]

  Myocardial infarction; MI; Acute MI; ST - elevation myocardial infarction; Non-ST - elevation myocardial infarction; NSTEMI; CAD - heart attack; Coronary artery disease - heart attack Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline [nlm.nih.gov]

• ST Elevation in Anterior Leads

  The left anterior descending (LAD) artery supplies the anterior wall of the heart, and therefore causes ST elevations in anterior leads (V1 and V2). [en.wikipedia.org]

• Sinus Arrhythmia

  This is mediated by the sympathetic nervous system on the sinus node and called sinus tachycardia. [en.wikipedia.org]

• Ventricular Bigeminy

  […] arrhythmia[edit] Premature ventricular contractions (PVCs), sometimes called ventricular extra beats (VEBs) Premature ventricular beats occurring after every normal beat are termed ventricular bigeminy PVCs that occur at intervals of 2 normal beats to [en.wikipedia.org]

• Complete Left Bundle Branch Block

  The exclusion criteria included an inability to provide informed consent, dementia, complete left bundle-branch block, cardiogenic shock, and a higher-than-normal risk of bleeding 8-10. [dx.doi.org]

  Imaging modalities can be added to stress testing in patients whose electrocardiographic response to exercise is inadequate to confidently assess for ischemia (e.g., complete left bundle branch block, paced rhythm, accessory pathway, left ventricular [web.archive.org]

  branch block Complete right bundle branch block (RBBB) Left bundle Complete left bundle branch block (LBBB) Incomplete left bundle branch block Left anterior fascicular block (LAFB) Left posterior fascicular block (LPFB) Bifascicular block (LAFB plus [en.wikipedia.org]

• Left Anterior Fascicular Block

  […] branch block Complete right bundle branch block (RBBB) Left bundle Complete left bundle branch block (LBBB) Incomplete left bundle branch block Left anterior fascicular block (LAFB) Left posterior fascicular block (LPFB) Bifascicular block (LAFB plus [en.wikipedia.org]

• T Wave Inversion

  Electrocardiography showed a sinus rhythm with Q-wave formation in the inferior wall leads (II, III, aVF), T-wave inversion in the same leads, and borderline QT prolongation (QTc of 490 ms). [ncbi.nlm.nih.gov]

  The classic electrocardiogram findings: ST segment elevation, followed by T wave inversion and Q waves, are associated with transmural infarction. ST segment depression and T wave inversion are associated with subendocardial infarction. [histopathology-india.net]

  Am J Cardiol. 1967; 20: 494–508 Abstract | Full Text PDF | PubMed | Scopus (161) | Google ScholarSee all References while patients with only T-wave inversion were found to have a benign in-hospital course.8x8Lown, B, Vassaux, C, Hood, WB et al. [journal.chestnet.org]

  wave inversion  appearance of wide deep Q waves. 14. [slideshare.net]

  Poor R wave progression (R wave height < 3mm in V3). Abnormal Q waves and T-wave inversion in I and aVL. The pattern indicates prior infarction of the anteroseptal and lateral walls. [lifeinthefastlane.com]

• Ischemic Changes

  MSIMI was defined by the aforementioned ischemic changes during 1 or more of the 3 mental stress tasks. [ncbi.nlm.nih.gov]

  Furthermore, the electrocardiograms were independently reviewed by a physician for the presence of ischemic changes. Chest pain in the absence of electrocardiographic changes was considered non-ischemic. [dx.doi.org]

  Patients with ischemic discomfort may or may not have ST-segment or T-wave changes denoted on the electrocardiogram (ECG). ST elevations seen on the ECG reflect active and ongoing transmural myocardial injury. [emedicine.com]

• Electrocardiogram Change

  A case was diagnosed as AMI if two out of the three criteria (clinical symptoms, electrocardiogram changes and raised enzyme levels) were positive. [dx.doi.org]

  AMI was defined as: (1) a typical increase and gradual decrease of biochemical markers of myocardial necrosis and at least 1 of the following: ischemic symptoms, development of pathologic Q waves on electrocardiogram, electrocardiogram changes indicative [doi.org]

Heart attacks require emergency treatment. Once the patient arrives he is immediately admitted to the intensive care unit and is constantly monitored through heart monitor and is put on an external oxygen supply [8]. He is given medications such as nitroglycerin and morphine intravenously for reducing chest pain [9].

In addition, aspirin would also be given to prevent blood from clotting. In case, the individuals is having arrhythmias he would be given medications to bring the heart rate back to normal. Once the patient’s vital signs are stabilized he is prepared for angioplasty which is employed to open blocked blood vessels [10].

In case of greater degree of blockages, a bypass surgery may be recommended. In many cases, individuals are given drugs to breaks the clots. These drugs work best when given within 3 hours of chest pain. Such a type of method is known as thrombolytic therapy.

Prognosis of myocardial infarction greatly depends on the extent of damage the infarct has caused to the heart muscles as well as the left ventricular function. The prognosis of the condition is not very favorable in most of the cases. It has been reported that acute myocardial infarction causes mortality in 30% cases. In addition to this, about 5 to 10% individual who survive the condition, eventually die within the first year of suffering an attack. To add to this, about 50% of patients need to be hospitalized again within a year of suffering from myocardial infarction. Individuals with diabetes or hypertension are known to have a poor prognosis [5].

Development of blockage in the coronary arteries that prevents the blood and oxygen from reaching the heart causes myocardial infarction. Occurrence of atherosclerosis is known to be major causative factor for development of most of the acute coronary syndromes. It has been reported that 90% cases of myocardial infarction occurs due to atherosclerotic coronary artery. Individuals with chronic disorders such as hypertension, diabetes and obesity are an increased risk of developing myocardial infarctions. Those in habit of smoking or living a sedentary lifestyle are also highly susceptible to heart attack [2].

It has been estimated that about 1.5 million individuals suffer from myocardial infarctions each year in the US. Cardiovascular disease is the leading cause of mortality in the US causing 500,000 to 700,000 deaths each year. Worldwide, about 12 million deaths occur each year due to cardiovascular diseases. Male are more prone to contract myocardial infarctions than women [3].

Buildup of plaque in the coronary arteries causes the arteries to block preventing the oxygen rich blood to reach the heart. The plaque is essentially made up of cholesterol and other cells. When plaque slowly and gradually builds up in the arteries, it causes them to narrow so much so that they gradually get blocked.

A heart attack can also occur when the plaque tears, causing the blood platelets along with other substances to form a clot. The clot is formed at the site which prevents the blood and oxygen to reach the heart causing an attack. Lack of oxygen supply, gradually reduces the muscular contractions and systolic wall motion in the affected area [4].

Adopting certain lifestyle changes can help prevent onset of myocardial infarction. Exercising regularly and eating diet low in cholesterol and sodium will help in preventing the onset of chronic degenerative disorders and plaque formation. Individuals should also quit smoking in order to decrease their chances of developing heart attacks.

Individuals with acute myocardial infarction suffer from sudden onset of chest pain which is felt behind the sternum and in many cases the pain travels down the left arm. However, there are times when individuals experience absolutely no or some vague symptoms. This is known as silent myocardial infarctions. Heart attack requires immediate medical intervention to prevent development of irreversible damages [1].

Definition

Myocardial infarction is characterized by necrosis of heart cells due to blockage of the coronary arteries that supply blood and oxygen to the heart. It is a common occurrence affecting about 1.5 million individuals in US.

Cause

Heart attack occurs primarily due to plaque tear or narrowing of the arteries due to gradual deposition of the plaque in them. Formation of plaque in the coronary arteries cause it to block as a result of which blood and oxygen no longer reach the heart muscles.
Symptoms

Symptoms of myocardial infarction consist of sudden onset of chest pain that is characterized by feeling of tightness in the chest. The pain can even radiate along the left arm and neck. In addition, other symptoms include lightheadedness, nausea, cough, sweating and shortness of breath.

Diagnosis

A quick preliminary examination of the vital signs is made following blood tests to reveal extent of damage to the heart. In addition, electrocardiogram is also carried out to determine heart damage.

Treatment

Treatment begins with intravenous administration of nitroglycerine and morphine to decrease the chest pain. Medications to correct the blood clot are also given. Following this, angioplasty or bypass surgery is done depending on the extent of blockages.

1. Siddiqui MA, Tandon N, Mosley L, Sheridan FM, Hanley HG.Interventional therapy for acute myocardial infarction. J La State Med Soc. Jun 2001;153(6):292-9.
2. McCord J, Jneid H, Hollander JE, et al. Management of cocaine-associated chest pain and myocardial infarction: a scientific statement from the American Heart Association Acute Cardiac Care Committee of the Council on Clinical Cardiology. Circulation 2008; 117:1897.
3. Rosamond WD, Chambless LE, Folsom AR, et al. Trends in the incidence of myocardial infarction and in mortality due to coronary heart disease, 1987 to 1994. N Engl J Med 1998; 339:861.
4. Busko M. High-risk plaque predicts ACS in ER patients with chest pain. Heartwire [serial online]. July 18, 2014;Accessed July 21, 2014.
5. Yan AT, Tan M, Fitchett D, et al. One-year outcome of patients after acute coronary syndromes (from the Canadian Acute Coronary Syndromes Registry). Am J Cardiol 2004; 94:25.
6. Bahit MC, Cannon CP, Antman EM, et al. Direct comparison of characteristics, treatment, and outcomes of patients enrolled versus patients not enrolled in a clinical trial at centers participating in the TIMI 9 Trial and TIMI 9 Registry. Am Heart J 2003; 145:109.
7. Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am CollCardiol. Aug 14 2007;50(7):e1-e157. 
8. Cabello JB, Burls A, Emparanza JI, et al. Oxygen therapy for acute myocardial infarction. Cochrane Database Syst Rev 2013; 8:CD007160.
9. Meine TJ, Roe MT, Chen AY, et al. Association of intravenous morphine use and outcomes in acute coronary syndromes: results from the CRUSADE Quality Improvement Initiative. Am Heart J 2005; 149:1043.
10. Cantor WJ, Fitchett D, Borgundvaag B, Ducas J, Heffernan M, et al. Routine early angioplasty after fibrinolysis for acute myocardial infarction. N Engl J Med. Jun 25 2009;360(26):2705-18