Description
Damage or death of heart muscle caused by a blockage of an artery (coronary artery) that supplies blood to a part of the heart. Symptoms can vary widely and can be atypical in the elderly, diabetics and women. The most common cause of the blockage is buildup of fat and calcium in the arteries that supply blood to the heart muscle (atherosclerosis). Conditions such as high blood pressure, high cholesterol, smoking, family history of heart attacks and diabetes can all increase the chances of having a heart attack. Rapid treatment reduces, but does not eliminate, the risk of death. Longer term consequences of having had a heart attack include heart failure and stroke.
Symptoms
Chest pain (typically described as squeezing, crushing, or band like), some people may have little or no chest pain (elderly, diabetics, or women). Other symptoms include: jaw pain, arm pain, back pain, abdominal pain, shortness of breath, sweating, nausea, vomiting, apprehension, fainting, dizziness.
Tests
Common tests used for diagnosis and treatment
Workup:
A history and physical exam will be performed. An EKG can provide strong evidence of a heart attack. A coronary angiogram can definitively identify the coronary artery blockage. A high resolution chest CT scan may also demonstrate the blockage. CT scans can also rule out other diseases that can clinically mimic a heart attack. An echocardiogram can demonstrate a poorly functioning heart.
Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), Coronary angiogram, Echocardiogram (ECHO), Electrocardiogram (EKG), Troponin, X-ray
Specialists:
Cardiothoracic Surgery, Cardiology
Workup:
A history and physical exam will be performed. An EKG can provide strong evidence of a heart attack. A coronary angiogram can definitively identify the coronary artery blockage. A high resolution chest CT scan may also demonstrate the blockage. CT scans can also rule out other diseases that can clinically mimic a heart attack. An echocardiogram can demonstrate a poorly functioning heart.
Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), Coronary angiogram, Echocardiogram (ECHO), Electrocardiogram (EKG), Troponin, X-ray
Specialists:
Cardiothoracic Surgery, Cardiology
Treatment
Treatment is aimed at improving the blood flow to the heart, treating life threatening arrhythmias, and maximizing the heart function. During a heart attack, clot busting medications (alteplase/t-PA) often are used to break apart the blood clot that has stopped blood flow to one part of the heart. In people with angina (and sometimes in people having heart attacks), coronary (heart) artery blockages are reduced by the following: balloon angioplasty, stent placement, surgical bypass, blood thinners and/or anti-platelet medications (aspirin, abciximab/ReoPro, eptifibatide/Integrilin, clopidogrel/Plavix). When arrhythmias are present they are treated with medications (amiodarone), cardioversion or a pacemaker. Medications for blood pressure and cholesterol (statins) are also frequently used.