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Recent News and Articles on the Keywords: heart + attack + myocardial  Related to the article below (Last Update: 8/5/2008)

Kanawha leads new approach that reduces heart attack deaths Charleston Gazette, WV - They've dramatically decreased the time between when someone suffers a specific type of heart attack - called a Segment-elevation myocardial infarction, ... NHS Choices Statins after heart attack NHS Choices, UK - The study was a retrospective cohort study that followed up people in the UK who had survived a myocardial infarction (heart attack) between January 01 2002 ... When Am I Most Likely to Have a Heart Attack? TIME - Jul 22, 2008 A group from Harvard estimated this risk, and evaluated that on average the extra risk of having a myocardial infarction, or heart attack, between 6 am and ... Critics at odds with AAP on how to cut kids' heart disease risk American Medical News (subscription) - Aug 3, 2008 As data accumulate indicating that vascular disease starts decades before it becomes apparent in the form of a heart attack or stroke, physicians who treat ... Kidney Patients Less Likely to Get Heart Attack Meds Atlanta Journal Constitution,  USA - Jul 21, 2008 The researchers analyzed data on medication use after a heart attack, or myocardial infarction, in approximately 21500 patients, 17 percent of whom had ... Instinct Guides ER Docs Treating Heart Patients MedHeadlines, IL - Jul 27, 2008 No MI: No Myocardial Infarction. Patient came to the hospital with symptoms of heart attack but troponin levels were normal EMI: Evolving Myocardial ... Novel Approach May Protect Against Heart Attack Injury MarketWatch - Jul 10, 2008 The size of the myocardial infarction--an area of dead tissue caused by obstructed blood flow, as occurs after a heart attack--was reduced by more than half ... NHS Choices Pregnant women in heart attack risk The Press Association - Jul 7, 2008 ... the chances of acute myocardial infarction (AMI). This condition is rare in women of child-bearing age but can increase a woman's risk of heart attack ... Researchers Say Pregnancy Can Lead To Acute Myocardial Infarction AHN Expectant mums at risk of AMI Nursing in Practice Heart attack in pregnancy NHS Choices Telegraph.co.uk all 36 news articles » Exercise Could Be The Heart's Fountain Of Youth Science Daily (press release) - Jul 23, 2008 But if it can increase glucose uptake, the heart is better protected against ischemia (low oxygen) and heart attack. Based on heart glucose metabolism, ... MedPage Today Ratio Beats Cholesterol-Based Measures of Heart Attack Risk MedPage Today, NJ - Jul 17, 2008 ... myocardial infarction than any cholesterol-based marker, and should become the global standard for assessing heart attack risk, researchers here said. ...

A heart attack or myocardial infarction is a medical emergency in which the supply of blood to the heart is suddenly and severely reduced or cut off, causing the muscle to die from lack of oxygen. More than 1.1 million people experience a heart attack (myocardial infarction) each year, and for many of them, the heart attack is their first symptom of coronary artery disease. A heart attack may be severe enough to cause death or it may be silent. As many as one out of every five people have only mild symptoms or none at all, and the heart attack may only be discovered by routine electrocardiography done some time later.

Not everyone has the same heart attack symptoms when having a myocardial infarction. Common ones include:

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• About two out of every three people who have heart attacks have chest pain, shortness of breath or feel tired a few days or weeks before the attack
• A person who has angina (temporary chest pain) may find that it happens more often after less and less physical activity. A change in the pattern of angina should be taken seriously.
• During a heart attack, a person may feel pain in the middle of the chest that can spread to the back, jaw or arms. The pain may also be felt in all of these places and not the chest. Sometime the pain is felt in the stomach area, where it may be taken for indigestion. The pain is like that of angina but usually more severe, longer lasting and does not get better by resting or taking a nitroglycerin pill.
• About one out of every three people who have heart attacks do not feel any chest pain. These people are more likely to be women, non-Caucasian, older than 75, someone with heart failure or diabetes and someone who has had a stroke.
• Faintness
• Sudden sweating
• Nausea
• Shortness of breath, especially in older people
• Heavy pounding of the heart
• Abnormal heart rhythms (arrhythmias), which occur in more than 90% of the people who have had a heart attack
• Loss of consciousness, which sometimes is the first symptom of a heart attack
• Feelings of restlessness, sweatiness, anxiety and a sense of impending doom
• Bluishness of the lips, hands or feet
• Older people may have symptoms that resemble a stroke and may become disoriented
• Older people, especially women, often take longer than younger people to admit they are ill or to seek medical help

A heart attack (myocardial infarction) is usually caused by a blood clot that blocks an artery of the heart. The artery has often already been narrowed by fatty deposits on its walls. These deposits can tear or break open, reducing the flow of blood and releasing substances that make the platelets of the blood sticky and more likely to form clots. Sometimes a clot forms inside the heart itself, then breaks away and gets stuck in an artery that feeds the heart. A spasm in one of these arteries can cause the blood flow to stop.

Because a heart attack (myocardial infarction) can be life threatening, men older than 35 or women older than 50 who have chest pain should be examined to see if they area having a heart attack. However, similar pain can be caused by pneumonia, a blood clot in the lung (pulmonary embolism), pericarditis, a rib fracture, spasm of the esophagus, indigestion or chest muscle tenderness after injury or exertion. A heart attack can be confirmed within a few hours of its occurrence by:

• Electrocardiography (ECG)
• Blood tests to measure levels of serum markers. The presence of these markers shows that there has been damage to or death of the heart muscle. These markers are normally found in the heart muscle, but they are released into the blood when the heart muscle is damaged.
• Echocardiography can be performed if the above tests do not give enough information
• Radionuclide imaging can also be done

Half the deaths from a heart attack occur in the first three or four hours after symptoms begin. It is crucial that symptoms of a heart attack be treated as a medical emergency. A person with these symptoms should be taken to the emergency department of a hospital in an ambulance with trained personnel.

The sooner that treatment of a heart attack begins, the better. Chewing an aspirin tablet after an ambulance has been called can help reduce the size of the blood clot. A beta-blocker may be given to slow the heart rate so the heart is not working as hard and to reduce the damage to the heart muscle. Often a person who is having a heart attack is given oxygen, which also helps heart tissue damage to be less.

People who may be having a heart attack are usually admitted to a hospital that has a cardiac care unit. People who may be having a heart attack are usually admitted to a hospital that has a cardiac care unit. Heart rhythm, blood pressure and the amount of oxygen in the blood are closely monitored so that heart damage can be assessed. Nurses in these units are specially trained to care for people with heart problems and to handle cardiac emergencies.

Drugs may be used to dissolve blood clots in the artery so that heart tissue can be saved. To be effective, these drugs must be given intravenously within six hours of the start of the symptoms of a heart attack. After six hours, most damage is permanent. (People who have bleeding conditions or severe high blood pressure and those who have had recent surgery or a stroke cannot be given these drugs.)

Instead of drug therapy, angioplasty or coronary artery bypass surgery may be performed immediately after a heart attack to clear the arteries. This approach is preferred for people who cannot take thrombolytic drugs and for those who are very ill after having a massive heart attack.

Because most people who have had a heart attack (myocardial infarction) are anxious and uncomfortable, morphine is often given to calm them and reduce the work load on the heart. Nitroglycerin, which opens up the arteries of the heart and relieves pain, may also be given. Angiotensin-converting enzyme (ACE) inhibitors can reduce heart enlargement and increase the chance of survival for many people. Therefore, these drugs are usually given in the first few days after a heart attack and prescribed indefinitely.

A person who has just had a heart attack needs rest and as little emotional distress or excitement as possible. If there are no complications, most people can safely leave the hospital within five to seven days. If abnormal heart rhythms develop, the heart can no longer pump adequately or there are complications, a person recovering from a heart attack will need to stay longer in the hospital.

Most people who survive for a few days after a heart attack (myocardial infarction) can expect a full recovery. One out of every 10 people who have heart attacks, however, die within a year - usually within the first three or four months. Typically, these people continue to have chest pain, abnormal heart rhythms or heart failure. Older people and smaller people tend to not do as well after a heart attack as younger people and larger people. This may be one reason why women tend to fare less well than men after a heart attack - they tend to be both older and smaller, as well as have other disorders. They also tend to wait longer after a heart attack before going to the hospital.

After a heart attack (myocardial infarction), a doctor may require additional tests or treatment, including:

• Wearing a Holter monitor for continuous monitoring of the heart's electrical activity
• An exercise stress test
• Drug therapy, including taking a daily aspirin, beta-blockers or ACE inhibitors
  

Congestive heart failure occurs when the heart muscle fails to pump as much blood as the body needs. The faulty pumping means the body doesn't get the oxygen it needs, blood backs up in the veins and lungs and other changes occur that make the heart even weaker.

Congestive heart failure is usually caused by a problem with the lower left chamber of the heart. Normally, it pumps out more than 50% of the blood that fills it during each heartbeat. In most heart failure patients, it pumps out less than 40% of the blood that fills it during each heartbeat. As a result, a large portion of blood remains in the chamber, and there is less room for blood coming from the lungs during the next heartbeat. Blood may back up inside the heart and lungs. The heart's lower right chamber may also not be working well, causing blood to back up in the body.

When the heart does not pump normally, the patient's hormone and nervous systems try to step in. To make up for not getting enough blood, the body may raise the blood pressure, hold on to salt and water and make the heart beat faster. The muscular walls of the heart may get bigger and thicker. At first, all these reactions may help. In time, however, the heart is no longer able to keep up. The symptoms then get worse.

Many people with severe heart disease in time develop congestive heart failure. When and how it develops depends on the type of underlying heart disease.

Today heart disease is identified earlier and treated more effectively. This extends the lives of millions of individuals. Although patients with heart disease are living longer, they now have a greater chance of developing heart failure.

Congestive heart failure can affect persons of any age, even young children, especially if they are born with a heart defect. It most often affects older persons who may already have hearts weakened by age-related conditions or disease.

In the early stages of congestive heart failure, a person may have no symptoms. When symptoms do develop, they may include:

• A dry, hacking cough, especially when lying down
• Confusion, sleepiness and disorientation may occur in older people
• Dizziness, fainting, fatigue or weakness
• Fluid buildup, especially in the legs, ankles and feet
• Increased urination at night
• Nausea, abdominal swelling, tenderness or pain (may result from the buildup of fluid in the body and the backup of blood in the liver)
• Weight gain (due to fluid buildup)
• Weight loss as nausea causes a loss of appetite and as the body fails to absorb food well
• Rapid breathing, bluish skin and feelings of restlessness, anxiety and suffocation
• Shortness of breath and lung congestion as the blood backs up in the lungs
• Tiring easily
• Wheezing and spasms of the airways similar to asthma

Congestive heart failure is generally the result of another disease, such as:

• A blood clot in an artery of the lungs
• Amyloidosis
• An over- or underactive thyroid gland, which can speed up or slow down the pumping of the heart, causing it not to completely fill or empty as it should
• Anemia
• Certain lung disorders
• Certain parasites that get into the heart muscle in tropical countries
• Constrictive pericarditis
• Coronary artery disease
• Disorders of the heart's electrical conduction system
• Heart valve disorders
• Kidney failure, which causes fluid to build up in the blood stream, making it harder for the heart to work
• Myocarditis
• Untreated or inadequately treated high blood pressure

A doctor will diagnose congestive heart failure using:

• An electrocardiogram and chest X-ray
  
• An echocardiogram, which is the best way to diagnose heart failure
  
• Cardiac blood pool scans are often used when echocardiography results are less likely to be accurate due to a person's weight, breast size or the presence of severe lung disease
  
• Thallium scans use a radioactive tracer to show the blood flow through the coronary artery
• Cardiac catheterization with angiography. A special substance is injected into the blood vessel that reveals the inside of the artery.
  

Treating conditions, such as high blood pressure, thyroid disorders and coronary artery disease, as early as possible can help prevent heart failure. Treatment depends on the cause of the heart failure, how severe the symptoms are and how well the body is able to make up for the heart's not being able to pump enough blood. While heart failure cannot be cured or made to go away, it is possible to make physical activity more comfortable, improve the quality of the life and prolong life.

Congestive heart failure treatments focus on:

• Treating the underlying disorder that may be causing heart failure
• Controlling the elements that can make heart failure worse
• Treating the heart failure itself

• Drugs. In most cases, patients with heart failure have the disease for the rest of their lives and require specific drugs. A combination of drugs may be used, including ACE inhibitors, diuretics, beta-blockers and digoxin. These do not cure heart failure. They can relieve symptoms, improve heart function, slow the progress of the disease and reduce the risk of complications, hospitalization and premature death.
  
• Biventricular pacing, which is a promising new procedure to improve the output of blood from the heart. This is a type of pacemaker that coordinates the pumping of the lower left and right chambers. Less blood leaks through the mitral valve, and the muscles of the left lower chamber can pump better.
• Surgery to open blocked blood vessels in the heart can restore normal blood flow. Surgery to correct certain types of heart valve disease may also improve symptoms of heart failure.
  
• Ventricular assist devices (VAD) are machines that help a failing heart pump blood through the body. VADs have been used in patients as young as seven years old and as old as 70.
• The Cardiac Mechanical Assist Device Program at Cedars-Sinai Heart Center provides complete state-of-the-art mechanical support for patients with end-stage heart failure
  
• Heart transplant
• In most heart failure patients, treatment is also needed to correct or control related health problems (such as high blood pressure or coronary artery disease) and any other heart failure triggers (such as fever, anemia or infection)
  
• Lifestyle changes, such as losing weight, starting an exercise program approved by your doctor or in a supervised cardiovascular rehabilitation program, reducing the amount of salt and fat in the diet, quitting smoking and avoiding alcohol