Heart attack (Myocardial infarction)

1. Definition
A heart attack is an emergency medical condition that is to be handled, if too late then it
is very likely the patient immediately met his end (death). developed countries, especially in
America, heart disease is the number one cause of death in which a heart attack experienced by
more than 1.5 million people there. Similarly in Indonesia, the Ministry of Health and Heart
Disease Foundation suggests that this is now in Indonesia, heart disease ranks first as the cause
of death.
Diseases of heart attack (Heart Attack), which in medical language referred to as
myocardial infarction (MI), is the damage and even death of heart muscle (myocardium) caused
an abrupt interruption of blood supply (as the bearer of Oxygen) is stricken area as a result of
several factors, For example: Occurs when a coronary artery blockage was for some time, either
due to spasm (mengencangnya coronary arteries), due to thrombus (blood clot) or due to the
narrowing and blockage by the buildup of fatty substances (cholesterol, triglycerides) that the
longer more and more and accumulate beneath the deepest layer (endothelium) of the artery wall.
Heart attack is a condition when the damage suffered by the heart muscle (myocardium)
due to very sudden decrease in blood supply to the heart muscle. Reduced blood supply to the
heart suddenly can occur when one of the coronary artery blockage was for some time, either due
to spasm - coronary artery mengencangnya - or akibar blood pergumpalan - thrombus. Sections
of heart muscle that is usually supplied by a pulse which terblokade stop functioning properly
immediately after splasme subsides by itself, the symptoms disappeared completely and heart
muscle function completely normally again. This is often called crescendo angina or coronary
insufficiency. Conversely, if the blood supply to the heart stops altogether, the cells in question
experienced a permanent change in just a few hours only and referred to the heart muscle is
severely degraded or permanently damaged. Muscles of the dead is called infarction.

2. Causes
Heart attack rates are higher in association with intense exertion, be it psychological
stress or physical exertion, especially if the exertion is more intense than the individual usually
performs.Quantitatively, the period of intense exercise and subsequent recovery is associated
with about a 6-fold higher myocardial infarction rate (compared with other more relaxed time
frames) for people who are physically very fit. For those in poor physical condition, the rate
differential is over 35-fold higher. One observed mechanism for this phenomenon is the
increased arterial pulse pressure stretching and relaxation of arteries with each heart beat which,

as has been observed with intravascular ultrasound, increases mechanical "shear stress" on
atheromas and the likelihood of plaque rupture.
Acute severe infection, such as pneumonia, can trigger myocardial infarction. A more
controversial link is that between Chlamydophila pneumoniae infection and atherosclerosis.
While this intracellular organism has been demonstrated in atherosclerotic plaques, evidence is
inconclusive as to whether it can be considered a causative factor. Treatment with antibiotics in
patients with proven atherosclerosis has not demonstrated a decreased risk of heart attacks or
other coronary vascular diseases.
There is an association of an increased incidence of a heart attack in the morning hours,
more specifically around 9 a.m. Some investigators have noticed that the ability of platelets to
aggregate varies according to a circadian rhythm, although they have not proven causation.

3. Risk factors
risk factors for myocardial infarction:

Diabetes (with or without insulin resistance) the single most important risk factor for
ischaemic heart disease (IHD)

Tobacco smoking

Hypercholesterolemia (more accurately hyperlipoproteinemia, especially high low

density lipoprotein and low high density lipoprotein)

Low HDL

High Triglycerides

High blood pressure

Family history of ischaemic heart disease (IHD)

Obesity (defined by a body mass index of more than 30 kg/m, or alternatively by waist
circumference or waist-hip ratio).

Age: Men acquire an independent risk factor at age 45, Women acquire an independent
risk factor at age 55; in addition individuals acquire another independent risk factor if
they have a first-degree male relative (brother, father) who suffered a coronary vascular
event at or before age 55. Another independent risk factor is acquired if one has a first-

degree female relative (mother, sister) who suffered a coronary vascular event at age 65
or younger.

Hyperhomocysteinemia (high homocysteine, a toxic blood amino acid that is elevated

when intakes of vitamins B2, B6, B12 and folic acid are insufficient)

Stress (occupations with high stress index are known to have susceptibility for
atherosclerosis)

Alcohol Studies show that prolonged exposure to high quantities of alcohol can increase
the risk of heart attack

Males are more at risk than females.

4. Signs and symptoms

Chest pain, which lack muscle blood supply (called ischemic conditions) that affect
oxygen demand by muscle is reduced.
Shortness of breath, usually felt by people who have heart failure.
Tiredness or fatigue, presence of heart abnormalities can lead to heart pumping that is not
maximal.
Feelings of pounding (palpitations)
Dizziness and fainting, This could be an early symptom of heart attack patients.
Bluish discoloration of the lips, fingers and feet as a sign of inadequate blood flow
throughout the body.
Sudden cold sweat, and others such as nausea and anxiety.

5. Complications
Complications may occur immediately following the heart attack (in the acute phase), or
may need time to develop (a chronic problem). Acute complications may include heart failure if
the damaged heart is no longer able to adequately pump blood around the body; aneurysm or
rupture of the myocardium; mitral regurgitation, particularly if the infarction causes dysfunction
of the papillary muscle; and arrhythmias, such as ventricular fibrillation, ventricular tachycardia,
atrial fibrillation and heart block. Longer-term complications include heart failure, atrial
fibrillation, and the increased risk of a second myocardial infarction.

6. Disease Treatment Heart Attack

Half of the deaths from heart attack is happening in the first 3 to 4 hours after the
symptoms of the attack began. So the act of handling the early symptoms of heart attack is the
most important for the medical team.
Providing drugs such as aspirin in chewable tablets can help in case of blood clotting in
the coronary arteries, while the type of beta-blocker tablets given to slow the heart so as not to
work hard and reduce the possibility of damage to heart muscle. The next major is the provision
of Oxygen, which helps minimize damage to muscle tissue.
Patients who had a heart attack (heart disease) will certainly be hospitalized, especially in
intensive indoor heart disease, because it requires intensive monitoring and the monitor. In
addition to the provision of medicines in the hospital, measures that may be performed by a team
of health (medical) is angioplasty or coronary artery bypass surgery (surgery / problematic cuts
the artery).

7. Disease Prevention Heart Attack

Precautions include what you can do is to avoid obesity and high cholesterol, quitting
smoking is the target to be achieved, also avoiding cigarette smoke from the environment,
Reduce or stop drinking alcohol, Doing sport regularly, if a contagious disease and high blood
diabetes should be controlling the advice of your doctor regularly.