Heart Attack PDF

7/25/2019 Heart Attack PDF

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HEART ATTACKDea Prista Agatha, MD


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Definition

Otherwise know as Myocardial Infarction

An MI occurs when there is a diminished blood supply to

the heart which leads to myocardial cell damage and

ischemia.

Contractile function stops in the necrotic areas of theheart.

Ischemia usually occurs due to blockage of the coronaryvessels.

This blockage is often the result of thrombus that is

super imposed on an u lcerated or unstab le

atherosclerotic plaque formation in the coronary artery


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Coronary Artery Anatomy


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Risk Factors

The presence of any risk factor is associated withdoubling the risk of an MI.

Non Modifiable Modifiable

Age SmokingGender Diabetes

Family history Hypertension

Hyperlipidemia

ObesityPhysical Inactivity


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Pathophysiology

Atherosclerosis with superimposed coronary thrombosis

Slowly growing high-grade stenoses can progress to completeocclusion but do not usually precipitate acute MI d/t collateral

circulation

During development of plaques, abrupt transition can occur,

resulting in

Platelet activation

Thrombin generation

Thrombus formation

Blood flow occlusion leads to imbalance between supply anddemand and could lead to myocardial necrosis

Less severe stenosis with lipid-laden plaques and fragile caps

more likely to rupture and causing thrombsis and MI


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PathophysiologyStable AnginaProgressive

narrowing ofcoronary lumen

Stable fibrous cap

Unstable

AnginaProgressive

narrowingAcute worsening of

coronary lumen due

to thrombus

formation

NSTEMIAcute worsening of

coronary lumen dueto thrombusformation

Sub-occlusive/

transient coronary

thrombus with

myocardial necrosis

STEMIMinimal prior

narrowing of

coronary lumenAcute rupture of

thin fibrous cap

Occlusive

thrombus formation

Acute injury

patternMyocardial

necrosis


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Signs and Symptoms

Chest pain

Nausea and vomiting

Sympa the t i c ne rvous sys tem

stimulation: cold sweat, temperature

increase

Cardiovascular changes Initially the BP and pulse may be

elevated.

Later, BP will drop due to

decreased cardiac output.

Urine output will decrease

Lung sounds will change tocrackles

Jugular veins may becomedistended and have obvious

pulsations.


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Long Term Care

Modern treatments, along with healthy lifestyle choices, can assist inrecovering from a heart attack and greatly reduce the risk of furtherheart problems and relieve or control symptoms such as angina.

The most important things you can do to reduce your risk and aidheart attack recovery are:

Aspirin, Beta Blockers and Clopidogrel will be indefinite.

Lipid lowering medication along with diet modifications.

Smoking cessation

Lifestyle modifications (physically active, achieve and maintain ahealthy body weight )

Control blood pressure

If the person affected has diabetes, they should also aim to keep

their blood glucose levels within the normal non-diabetic range.


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THANK YOU

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Heart Attack PDF