Heart Attack : Diagnosis, Treatment & Prevention

DIAGNOSIS OF HEART ATTACK

According to the WHO criteria as revised in 2000, a cardiac troponin rise accompanied by either typical symptoms, pathological Q waves, ST elevation or depression or coronary intervention are diagnostic of MI

A diagnosis of myocardial infarction is created by integrating the history of the presenting illness and physical examination (e.g. : elevated jugular venous pressure and hepatojugular reflux, abnormalities of the heart sound, swelling of the legs due to peripheral edema and so on ) with electrocardiogram findings and cardiac markers (blood tests for heart muscle cell damage). A coronary angiogram allows visualization of narrowings or obstructions on the heart vessels, and therapeutic measures can follow immediately. At autopsy, a pathologist can diagnose a myocardial infarction based on anatomopathological findings.

A chest radiograph and routine blood tests may indicate complications or precipitating causes and are often performed upon arrival to an emergency department. New regional wall motion abnormalities on an echocardiogram are also suggestive of a myocardial infarction. Echo may be performed in equivocal cases by the on-call cardiologist. In stable patients whose symptoms have resolved by the time of evaluation, Technetium (99mTc) sestamibi (or known as "MIBI scan"), thallium-201 chloride or Rubidium-82 Chloride can be used in nuclear medicine (Myocardial perfusion imaging) to visualize areas of reduced blood flow in conjunction with physiologic or pharmocologic stress. Thallium may also be used to determine viability of tissue, distinguishing whether non-functional myocardium is actually dead or merely in a state of hibernation or of being stunned.

TREATMENT OF HEART ATTACK

Heart attacks require immediate treatment, so most treatments begin in the emergency room. A surgical procedure called angioplasty may be used to unblock the arteries that supply blood to the heart. During an angioplasty, the surgeon will insert a long, thin tube called a catheter through the artery to reach the blockage. He will then inflate a small balloon attached to the catheter in order to reopen the artery, allowing blood flow to resume. The surgeon may also place a small, mesh tube called a stent at the site of the blockage. The stent can prevent the artery from closing again.

The doctor may also want to perform a coronary artery bypass graft (CABG) in some cases. In this procedure, he will reroute the veins and arteries so the blood can flow around the blockage. A CABG is sometimes done immediately after a heart attack. In most cases, however, it’s performed several days after the incident so the heart has time to heal.

A number of different medications can also be used to treat a heart attack:

1. Blood thinners, such as aspirin, are often used to break up blood clots and improve blood flow through narrowed arteries.
2. Thrombolytics are often used to dissolve clots.
3. Antiplatelet drugs, such as clopidogrel, can be used to prevent new clots from forming and existing clots from growing.
4. Nitroglycerin can be used to widen the blood vessels.
5. Beta-blockers lower the blood pressure and relax the heart muscle. This can help limit the severity of damage to the heart.
6. ACE inhibitors can also be used to lower blood pressure and decrease stress on the heart.
7. Pain relievers may be used to reduce any discomfort the patient may feel.

PREVENTION OF HEART ATTACK

The prevention is better than the cure. For this disease, there is no other effective prevention than changing you lifestyle to a healthy one starting today.

Diet

1. Increase wholegrain starch intake
2. Eats lots of vegetables and fruits
3. Decrease fats consumption in diet ( trans fat and saturated fat )
4. Reduce sugar intake
5. Avoid fast foods

Physical activity

• Exercise for 75 to 150 minutes/week
• Do activity that use a lot body movement such as gardening, cleaning the house, take stairs instead of escalator and so on.

STOP SMOKING : it will lower the chance of you getting a heart attack

For alcohol consumer, drink it within the recommended limits

Basically, a healthy lifestyle is the best prevention from MI!