SIGNS AND SYMPTOMS

• Intense and long thoracic pain that is perceived as an intense pressure, and that can extend (to be radiated) to arms and shoulders especially left, back, and even the teeth and the jaw.

• The pain is described as an enormous handle that twists the heart. It is similar to that of the angina pectoris, but more long, and he does not answer to the nitroglycerine under the language.
• The pain sometimes is perceived of different form, or is not still any fixed boss, especially in elders and in diabetics, in whom it can be perceived as a pain prolonged in the top part of the abdomen that one attributes to indigestion.

• Make difficult to breathe.
• I annoy. It is the only symptom in 10 %.
• Others: Morning sickness, vomiting, faint can happen and sudoración.
• Precedents of unstable angina: frequent attacks of ANGINA PECTORIS not tied to physical activity.

An infarction is an area of textile that has died for lack of oxygen.

The myocardium, or muscle of the heart, can suffer an infarction when an advanced cardiovascular disease exists.

The crown of blood glasses that take oxygen and nutrients to the proper cardiac muscle ("coronary" glasses) can develop ateroma badges (to see arteriosclerosis), what compromises in major or minor grade the flow of oxygen and nutrients to the proper heart, with effects that change from an angina pectoris (when the interruption of the blood flow to the heart is temporary) to a myocardium infarction (when it is permanent and irreversible).

The presence in a given arteriosclerosis glass does that in the above mentioned glass tightenings exist and that in them a thrombus develops more easily: a clot of thrombocytes, proteins of the coagulation and cellular garbage that the glass ends up by stopping up. An embolism is a thrombus that has traveled round the blood up to coming to a small glass where it is nailed like a sucker. Thrombosis and embolism are, then, equivalent terms.

A myocardium infarction is a medical urgency for definition. If I created Vd. who can be suffering it or is with someone who can have it, look immediately for medical attention. The delays are a serious error that receives thousands of lives from itself every year.

DIAGNOSIS

1. ECG. If a person suffers symptoms compatible with an infarction, an ECG will be done to him immediately, even in the ambulance that moves him. In fact, it will be joined to an ECG monitor during all the time that is in the Hospital, at least if one joins the room devoted to the serious patients of the heart or coronary unit.
2. Analysis. They include the determination of some enzymes that they increase in the blood when the cardiac muscle is damaged.
3. Studies isotópicos and/or cateterismo cardiac (coronariografía). They appear when the sharp phase has already happened.

PROGNOSIS AND COMPLICATIONS

If the infarction area is small and does not compromise to the bio-electrical system that controls the beats of the heart, the probabilities of surviving an infarction are high. Nevertheless, one of the three persons who suffer an infarction dies before being able to receive medical attention (sudden death). A very few years ago, the statistics were even worse (a precocious death for every two infarctions). The progress of these expectations is tied to the advances in resuscitation cardiopulmonar (RCP), in special diagnostic tests, and in urgent attention, including 'medicalizadas' ambulances and coronary units.

Due to the frequency of sudden death, the resuscitation skills cardiopulmonar must be applied as soon as possible to any person who is suffering a heart attack. Most of those who are alive 2 hours after an attack will survive.

Nevertheless, some possible complications exist:

Cardiac arrhythmia

There exists a bio-electrical system that controls the beats of the heart. If it is damaged in the infarction, there can appear very serious arrhythmias, like the called ventricular fibrillation, in which the ventricles contract of rapid form, descoordinada and ineffective like a "bag of worms", and to blood pumping effects, the heart for.

In other persons, slow arrhythmias can appear, that is to say, the beat is too slow so that the heart works normally. This can need the temporary or definitive implantation of an artificial pacemaker.

Heart failure

When the infarction area is extensive, the rest of the heart can be insufficient to realize the pumping work.

Death

In one of the four persons who suffer sudden death, symptoms previous to cardiopatía did not exist. With much, the most frequent cause of sudden death for infarction is the ventricular fibrillation.

TREATMENT

1. To ask for help and to look for immediate medical attention. Not to try to lead one himself up to a Hospital.
2. Oxygen. It can be the first measurement in the Hospital or the proper ambulance.
3. Analgesics (medicines for the pain). If the thoracic pain persists and is unbearable, there is administered morphine or similar medicines to relieve it.
4. Trombolíticos. There are medicines to dissolve the clot that prevents the blood from flowing. There put themselves substances as the estreptoquinasa or a "activator of the plasminógeno tisular", well in the vein, or straight in the clot by means of a catheter (a long and flexible tubito).
5. Nitrates. The derivatives of the nitroglycerine actanú diminishing the work of the heart and therefore his needs for oxygen. In the angina pectoris they take in pills under the language or also in spray. Also they can take in pills of long action or put themselves in patches of slow liberation on the skin. In the sharp phase of a heart attack, they are used usually by venous route.
6. Betabloqueantes. They act blocking many effects of the adrenaline in the body, in particular the stimulant effect on the heart. The result is that the heart beats more slowly and with less force, and therefore he needs less oxygen. Also they diminish the arterial tension.
7. Digitalis. The medicines derived from the digitalis, like the digoxina, act stimulating to the heart so that it pumps more blood. This is of interest especially if the heart attack produces heart failure.
8. The calcium - antagonist or bloqueantes of the channels of the calcium they prevent the entry of calcium in the cells of the myocardium. This diminishes the tendency of the coronary arteries to become closer and also it diminishes the work of the heart and therefore his needs for oxygen. Also they diminish the arterial tension. They are not used usually in the sharp phase of a heart attack, although yes immediately later.

• Cardiovascular disease. General information
• Basic tests of Diagnosis
• Test of Effort. Tolerance to the Exercise
• Study Isotópico
• Cardiac Cateterismo. Coronariografía
• Angina pectoris
• Infarction of Myocardium: the day later. Recovery
• The Coronary Unit
• Does the Infarction prepare the Aspirin?
• Coronary Angioplastia
• By Pass (derivation) of the Coronary ones

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