Heart Attack (Myocardial Infarction)


Heart attack Myocardial infarction or MI is the medical term of heart attack. A heart attack happens when the oxygen-rich blood does not flow to a section of the heart muscle due to sudden blockage of a coronary artery by a blood clot. If the blood flow is not restored quickly, that section of the heart muscle begins to die and this causes heart attack.

Arteries that carries oxygen rich blood to the heart muscle are the coronary arteries. Blockage of a coronary artery causes the heart muscle to starve for blood and oxygen, thus causing injury to the heart muscle. This injury of the heart muscle leads to chest pain and chest pressure sensation. If within 20 to 40 minutes the blood flow is not restored to the heart muscle then irreversible death of the heart muscle can occur.

What causes heart attack?

Coronary heart disease (CHD) also known as coronary artery disease (CAD) is the main cause of Heart Attack. A condition in which a waxy substance called plaque is formed inside the coronary arteries is known as CAD or CHD. Coronary arteries are blood vessels that carries oxygen rich blood to our heart.

The gradual process by which plaques get deposited in the walls of the arteries is known as atherosclerosis. The build-up of plaque takes many years. Deposition of cholesterol plaques leads to hardening of the arterial walls and narrowing of the inner channel of the artery. Therefore arteries that are narrowed due to atherosclerosis cannot deliver sufficient blood to maintain normal function of the body parts they supply.

The deposition of the plaques inside the coronary arteries causes reduction of blood supply to the heart muscle. This problem is known as coronary atherosclerosis or coronary heart diseases (CHD). CAD or CHD include heart attacks, sudden unexpected death, abnormal heart rhythms, chest pain (angina), and heart failure due to weakening of the heart muscle.

However, an area of plaque can rupture or break open inside of an artery. This leads to the formation of a blood clot on the plaque's surface. Sometimes when the clot becomes large enough it can mostly or completely block blood flow through a coronary artery.

The portion of heart muscle fed by the artery starts to die, if the blockage isn't treated quickly. Healthy heart tissue is replaced by scar tissue. This heart damage may not be obvious, or it can cause long-lasting or severe heart problems like heart failure. It is a in which the heart can't pump enough blood to fulfil the body's needs

Heart attack

What are the symptoms of heart attack?

The most common symptom of a heart attack are chest pain or pressure, but there are other symptoms experiences by the heart attack victims like>
  • Pain, fullness, or squeezing sensation of the chest
  • Sometimes toothache, headache or jaw pain
  • Breathing shortness
  • Nausea, vomiting, or general epigastric discomfort in the upper middle abdomen
  • Sweating
  • Heartburn, indigestion
  • Arm pain mostly left arm but can be either arm.
  • Upper back pain
  • Without any symptoms. However one fourth of the heart attack are without any symptoms. Silent heart attacks are mostly common among patients with diabetes mellitus.

It is important to note that heart attacks with no symptoms or only mild symptoms can be as serious and life-threatening as heart attacks that cause severe chest pain. One cannot ignore the importance of seeking prompt medical attention in the presence of symptoms that suggest a heart attack. Early diagnosis and treatment can save lives, while delays in getting medical assistance can be fatal.

Complications of a heart attack

The most common complications of heart attack is Heart Failure. The ability of the heart to pump blood to the rest of the body decreases when a large amount of heart muscle dies. This can result in heart failure. The body retains fluid, and organs, like, the kidneys, begin to fail.

How is a heart attack treated?

Heart attack can be prevented by:
  • Antiplatelet medications are used to prevent the formation of blood clots in the arteries
  • Anticoagulant medications are used to prevent the growth of blood clots in the arteries
  • Coronary angiography a test done to see the insides of the coronary arteries using dye and special x rays. Followed by coronary angioplasty with or without stenting to open blocked coronary arteries.
  • Clot-dissolving medications to open blocked arteries are used
  • Supplemental oxygen is used to increase the supply of oxygen to the heart's muscle
  • Medications are used to reduce the need for oxygen by the heart's muscle
  • Medications are used to prevent abnormal heart rhythms
  • Cardiac surgery

The first and the most important goal of the treatment is to open the blocked artery quickly and restore blood flow to the heart muscle. This process is known as reperfusion. Damage to heart muscle ceases, and pain begins to decrease once the artery opens. Early reperfusion preserves the pumping function of the heart, by minimizing the extent of heart muscle damage. Within the first 4 to 6 hours of a heart attack if reperfusion is established optimal benefit is obtained.

But if there is a delay in establishing reperfusion, it can result in more widespread damage to heart muscle and a greater reduction in the ability of the heart to pump blood. This can result in heart failure, decreased ability to exercise, and abnormal heart rhythms. Thus the most important determinant for the future quality of life and longevity is the amount of healthy heart muscle remaining after a heart attack.

Heart attack in women

Women has a lower risk of having CAD before menopause. The risk of CAD in women rises after menopause.

The risk factors for developing CAD in women are the same as in men are:
  • increase in blood cholesterol,
  • high blood pressure,
  • smoking cigarettes, Even "light" smoking increases the risk of CAD
  • diabetes mellitus,
  • If there is a family history of coronary heart disease at a young age.

How a heart attack is diagnosed?

Heart attack can be diagnosed by its severe symptoms like chest pain and test should be done promptly that will confirm the heart attack. A problem occurs, when the symptoms of a heart attack do not include chest pain. Therefore, in such cases the initial step would be to suspicious that one has occurred so that the appropriate tests can be done.

Electrocardiogram. A recording of the electrical activity of the heart is an electrocardiogram (ECG). With a heart attack abnormalities in the electrical activity of the heart usually occurs and the areas of heart muscle that are deprived of oxygen and/or areas of muscle that have died can be identified.

Blood tests. Proteins in the form of Cardiac enzymes are released into the blood by dying heart muscles. These cardiac enzymes are creatine phosphokinase (CPK), the MB fraction of CPK), special sub-fractions of CPK (specifically, and troponin, and their levels in the blood can be measured. Several hours after the onset of a heart attack these cardiac enzymes typically are elevated in the blood.

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