Description Damage or death of ...
Description
Damage or death of heart muscle cells, caused by a blockage of an artery that supplies oxygen and nutrients to the heart (coronary artery). Symptoms can vary widely and can be atypical in the elderly, diabetics and women. The most common cause of the blockage is build- up of fatty deposits called plaque in the artery (atherosclerosis). High blood pressure, high cholesterol, smoking, family history of heart attacks and diabetes increase the risk of having a heart attack. If untreated, heart failure and death can occur, and at times very rapidly.
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, difficulty breathing, sweating, nausea, vomiting, apprehension, fainting, dizziness.
Tests
Common tests used for diagnosis and treatment
Workup:
A history and physical exam will be performed. Initial testing includes an electrocardiogram (ECG) and blood test for troponin (a heart muscle protein released into the blood during a heart attack). A coronary angiogram can identify the site of coronary artery blockage. A high resolution chest CT scan can also demonstrate blockages. CT scans can also rule out other diseases that can clinically mimic a heart attack. An echocardiogram is done to see how well the heart is pumping.
Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), Coronary angiogram, Electrocardiogram (EKG), Troponin, X-ray
Other Specific Tests: Coronary angiography, echocardiogram
Do I need this test?
Don't perform stenting of non-culprit lesions during percutaneous coronary intervention (PCI) for uncomplicated hemodynamically stable ST-segment elevation myocardial infarction (STEMI). Stent placement in a noninfarct artery during primary PCI for STEMI in a hemodynamically stable patient may lead to increased mortality and complications. While potentially beneficial in patients with hemodynamic compromise, intervention beyond the culprit lesion during primary PCI has not demonstrated benefit in clinical trials to date.
Specialists:
Cardiology
Workup:
A history and physical exam will be performed. Initial testing includes an electrocardiogram (ECG) and blood test for troponin (a heart muscle protein released into the blood during a heart attack). A coronary angiogram can identify the site of coronary artery blockage. A high resolution chest CT scan can also demonstrate blockages. CT scans can also rule out other diseases that can clinically mimic a heart attack. An echocardiogram is done to see how well the heart is pumping.
Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), Coronary angiogram, Electrocardiogram (EKG), Troponin, X-ray
Other Specific Tests: Coronary angiography, echocardiogram
Do I need this test?
Don't perform stenting of non-culprit lesions during percutaneous coronary intervention (PCI) for uncomplicated hemodynamically stable ST-segment elevation myocardial infarction (STEMI). Stent placement in a noninfarct artery during primary PCI for STEMI in a hemodynamically stable patient may lead to increased mortality and complications. While potentially beneficial in patients with hemodynamic compromise, intervention beyond the culprit lesion during primary PCI has not demonstrated benefit in clinical trials to date.
Specialists:
Cardiology
Treatment
Treatment is aimed at improving the blood flow to the heart, treating life threatening arrhythmias, and maximizing the heart function. Anti-platelet drugs, such as aspirin and clopidogrel/Plavix, are given immediately. Coronary (heart) artery blockages are reduced by the following: clot busting medication (alteplase/t-PA), balloon angioplasty, stent placement, surgical bypass, and/or blood thinners. Other medications also given usually include a high dose statin to lower cholesterol, a beta blocker to slow heart rate and an angiotensin enzyme inhibitor (ACEI) that helps the heart remodel appropriately.