MYOCARDIAL INFARCTION - MI (Heart Attack)
What precisely is an infarcted myocardium? . ‘Myocardium’ refers to the muscle of the heart while ‘infarction’ stems from the Latin word, “infarcire” translating to “to plug up or cram”. In familiar terms, it means Heart Attack.
It is a common form of synesthesia to coin heart attacks with words such as pain, life-threatening and that pertaining to the heart. While you aren’t far off, this hardly covers the full scope of it. So let’s pick-apart this morbid topic so we can pick-up on some of its quintessential points that culminate in making it the menace we know.
Pathogenesis
Our heart, like every other organ, requires a constant, adequate supply of blood in order to survive, blood which is supplied via ‘coronary arteries’. As one can imagine, if these arteries fail to deliver the
required volume of blood on time, the heart muscle will run the risk of becoming ischemic, meaning, facing an oxygen shortage due to a restriction in blood supply. An intermittent chest pain termed ‘Angina pectoris’ is experienced by transient , reversible oxygen inadequacies and if not tended to, will eventually cause the heart muscle to necrose or die, alas an ‘infarcted myocardium’.
The major underlying cause of a myocardial infarction is atherosclerosis; a process of progressive thickening and hardening of the walls of medium-sized and large arteries as a result of fat deposits on their inner lining. I.e such thickening potentiates the formation of blood clots that can completely occlude the arteries carrying blood to your heart muscle subsequently causing its death.
Risk factors to develop and MI
1. Dyslipidemia
One major Risk factor for atherosclerosis include high levels of "bad" cholesterol. While avoiding foods with high cholesterol maybe beneficial for some, it can be agreed that the most effective dietary approach to cutting blood cholesterol is choosing foods that contain unsaturated or good fat over those that contain saturated, trans or bad fat. You can arm your pantry with Black or green tea packing a powerful punch of antioxidants, bountiful beans, citrus fruits, wholesome whole grains like
barley or oatmeal rich in soluble fiber that reduce the absorption of cholesterol , nuts like almonds,
fish like salmon and a bottle of olive oil in place of animal oils! Another arm of curbing ones bad
cholesterol level is having a healthy weight and avoiding physical inactivity.
2. Hypertension, Diabetes and other risk factors
Having high blood pressure (hypertension) also increases the risk by damaging the blood vessels and increasing its ability to make atherosclerotic plaques. Smoking, being a diabetic and having a family history of atherosclerotic disease are a few other steps that could be taken in the wrong direction inevitably taking you to a life threatening destination.
Heart attacks can occur virtually at any age, the frequency rises progressively with age and increasing risk factors for atherosclerosis. Men are at greater risk although this gap narrows with age. Women are generally protected against heart attacks in their reproductive years while this becomes the commonest cause for death in older women, after their menopause.
The classic myocardial infarction is heralded by severe, crushing substernal chest pain that can travel to the neck, jaw, upper-mid abdomen, or left arm. Unlike in angina pectoris the pain lasts several minutes to hours and will not be relieved by taking a nitroglycerin or rest for that matter. However some patients may present with atypical symptoms and may even be entirely asymptomatic. Such ‘silent’ infarcts are seen in those with diabetes mellitus and elderly patients.
In the unfortunate event of having a pain that one suspects to be a heart attack an ECG report and a laboratory evaluation of enzymes such as cardiac specific troponins are needed in order to be diagnosed. Myocardial ischemia kills your muscle within 1 to 2 minutes and may cause death in 30 to 40 minutes, even if one does survive he or she will be left with life disabling complications such as arrhythmias and progressive heart failure. Therefore as the wise saying goes “ there is no greater wealth than good health! “ so its never too late to put down your deep fried delicacies and make time in your daily routines for some exercise, because in reality what you’re making time for isn’t exercise but it is for a longer and healthier life!
By
Rtr. Shanya Mudannayake
RACFOM