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, 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 of a coronary artery following the rupture of a vulnerable atherosclerotic plaque, which is an unstable collection of lipids and white blood cells in the wall of an artery. The resulting ischemia and ensuing oxygen shortage, if left untreated for a sufficient period of time, can cause damage or death .
Classical symptoms of acute myocardial infarction include sudden chest pain , shortness of breath, nausea, vomiting, palpitations, sweating, and anxiety . 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 , echocardiography, cardiac MRI and various blood tests. The most often used blood markers are the creatine kinase-MB fraction and the troponin levels. Immediate treatment for suspected acute myocardial infarction includes oxygen, aspirin, and sublingual nitroglycerin.
Most cases of STEMI are treated with thrombolysis or percutaneous coronary intervention . NSTEMI 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 and low levels of high density lipoprotein , diabetes, high blood pressure, obesity, chronic kidney disease, heart failure, excessive alcohol consumption, the abuse of certain drugs , and chronic high stress levels.
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