Tuesday, 8 May 2012
Damage or death of heart muscle caused by a blockage of an artery that supplies 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 fat and calcium in the artery (atherosclerosis). Conditions such as high blood pressure, high cholesterol, smoking, family history of heart attacks and diabetes can all increase the chances of having this disease. If untreated, death can occur, and at times very rapidly. Other complications include heart failure and stroke.
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.
Treatment is aimed at improving the blood flow to the heart, treating life threatening arrhythmias, and maximizing the heart function. Coronary (heart) artery blockages are reduced by the following: clot busting medication (alteplase t-PA), 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 (amiodorone), cardioversion or a pacemaker. Medications for blood pressure and cholesterol (statins) are also frequently used.
A coronary angiogram can definitively identify the coronary artery blockage. A high resolution chest CT scan can also demonstrate the blockages. CT scans can also rule out other diseases that can clinically mimic a heart attack. An echocardiogram can demonstrate a poorly functioning heart.