Myocardial infarction
Myocardial infarction (MI), commonly known as a Heart Attack, occurs when blood flow to a part of the heart is blocked, leading to damage or death of heart muscle cells.
It is a serious medical emergency requiring prompt treatment to prevent complications and minimize damage to the heart.
Types –
• ST-elevation myocardial infarction (STEMI):
– Characterized by a complete blockage of a coronary artery, resulting in significant heart muscle damage.
– Identified by ST-segment elevation on an electrocardiogram (ECG).
• Non-ST-elevation myocardial infarction (NSTEMI):
– Involves a partial blockage of a coronary artery, causing less severe damage to the heart muscle.
– May not show ST-segment elevation on an ECG but is diagnosed based on other criteria.
Symptoms –
• Chest pain or discomfort:
– Often described as a pressure, squeezing, or tightness in the chest.
– May radiate to the arms, shoulders, neck, jaw, back, or abdomen.
• Shortness of breath:
– Difficulty breathing, especially with exertion or at rest.
– Can be accompanied by sweating, nausea, or lightheadedness.
• Other symptoms:
– Nausea, vomiting, or indigestion.
– Dizziness or fainting.
– Fatigue or weakness.
Causes –
• Coronary artery disease (CAD):
– Most common cause, where arteries supplying blood to the heart become narrowed or blocked due to a buildup of plaque.
• Blood clot:
– Formation of a clot within a coronary artery, obstructing blood flow to the heart.
– Often occurs on the surface of plaque in a diseased artery.
• Coronary artery spasm:
– Sudden constriction of a coronary artery, leading to decreased blood flow to the heart.
– Can occur spontaneously or be triggered by factors like stress or certain drugs.
Risk Factors –
▪︎ Modifiable risk factors:
Smoking.
High blood pressure (hypertension).
High cholesterol levels (hypercholesterolemia).
Diabetes.
Obesity or overweight.
Sedentary lifestyle.
▪︎ Non-modifiable risk factors:
Age (risk increases with age).
Family history of heart disease.
Gender (men are at higher risk than premenopausal women).
Complications –
• Arrhythmias:
– Abnormal heart rhythms, such as atrial fibrillation or ventricular tachycardia.
– Can lead to sudden cardiac arrest.
• Heart failure:
– Inability of the heart to pump enough blood to meet the body’s needs.
– Results from extensive damage to the heart muscle.
• Cardiogenic shock:
– Severe form of heart failure where the heart is unable to pump enough blood to maintain vital organ function.
• Ventricular septal defect (VSD):
– Rupture of the wall separating the heart’s chambers due to extensive damage from a heart attack.
– Leads to mixing of oxygenated and deoxygenated blood, compromising circulation.
Diagnosis –
• Electrocardiogram (ECG):
Detects abnormalities in the heart’s electrical activity, such as ST-segment elevation or depression.
• Blood tests:
Measure levels of cardiac biomarkers like troponin, which are released into the bloodstream when heart muscle cells are damaged.
• Imaging tests:
Echocardiogram, cardiac MRI, or coronary angiography may be performed to assess heart function and identify blockages in coronary arteries.
Treatment –
• Reperfusion therapy:
Goal is to restore blood flow to the affected area of the heart.
Includes medications like thrombolytics or primary percutaneous coronary intervention (PCI) to dissolve clots or mechanically open blocked arteries.
• Medications:
Aspirin, beta-blockers, ACE inhibitors, and statins are commonly prescribed to reduce blood clotting, lower blood pressure, and manage cholesterol levels.
• Lifestyle changes:
Smoking cessation, regular exercise, healthy diet, and weight management are essential for long-term management and prevention of future heart attacks.
• Cardiac rehabilitation:
Structured program involving exercise training, education, and counseling to improve cardiovascular health and reduce the risk of recurrent events.
Ayurvedic Perspective –
Myocardial infarction is a tridoshaj disease so according to Dosha dominance treatment is given which include Shodhana (Detoxification), Panchakarma, then shaman medicines to passify the vitiated Doshas ,and then the Rasayana, rejuvenating treatment as cardiac tonics, lifestyle and diet regulation & as it is Sthana of Ojas, Chetana, emotions hence, mental stress anxiety, depression should be avoided. Shirodhara, Shiropichu, Hridya vasti, Mantra Jaap, along with Yoga and exercises training are effective.
Ayurvedic Medications –
• Draksharishta : Gives strength to diseased and weakned heart. Improves the muscular system. A good tonic.
DOSAGE : To be taken with equal quantity of water in 10ml dosage after meals.
• Swarnabhrakasindura : Useful for heart disease, trembling sensation in the heart. Gives new life, vigour and vitality.
DOSAGE : 1g = 10 doses. One dose twice daily with Partharistha.
• Yogendra rasa : Gives strength to nerves, heart and brain. A great nervine tonic in Ayurveda.
DOSAGE : 1 g = 5 doses. One dose twice daily with juice of dry grapes (or) Draksharishta (or) with milk added with sugar candy.
• Poornachandrodaya : A great general tonic. Prevents heart weakness.
DOSAGE : 1g = 5 doses. To be taken twice daily with honey (or) as directed by the physician.
• Siddhamakaradhwaja : A great nervine tonic. Strengthens heart, lungs and nerves.
DOSAGE : 1g = 10 doses. To be taken twice daily with honey (or) as directed by the physician.
• Partharishta : A specific for heart disease, palpitation etc.
DOSAGE : To be taken with equal quantity of water in 10ml dosage after meals
Conclusion
Myocardial infarction is a life-threatening condition that requires immediate medical attention.
Understanding the causes, symptoms, risk factors, diagnosis, and treatment options is crucial for early recognition and effective management of heart attacks.
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