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Q.1) What does Myocardial infarction mean?
Ans :  Loss of blood supply to some parts of the heart muscle due to a blockage in coronary artery is commonly known as heart attack or myocardial infarction.
 
Q.2) Whom does it affect the most?
Ans:  It usually occurs above the age of 40 years and the incidence increases with increasing age. It is more common in males till the age of 60 years. After 60 years of age equal incidence is observed in both sexes.
 
Q.3) How does Myocardial infarction progress?
Ans: With the death of  the part of a heart muscle following a blockage in its blood supply. In silent Infarction the person does not experience chest pain. 
 
Complications
A. Early complications
  • Arrthymias and conduction block:
  • Cardiogenic shock
  • Heart failure
  • Papillary muscle dysfunction and rupture
  • Embolism
  • Post-infarction Angina
  • Cardiac rupture

B. Late complications

  • Ventricular aneurysm
  • Post-myocardial infarction syndrome
  • Shoulder-hand syndrome-Limitation of shoulder joint,
 
Q.4) What are the causes of Myocardial infarction?
Ans: Usual causes are:
  • Coronary atherosclerosis with superimposed thrombosis.
  • Coronary artery spasm
  • Non-Atherosclerotic coronary artery disease
  • Coronary artery emboli
  • Congenital coronary artery anomalies
  • Severe aortic stenosis.
Risk Factors
  • Family history
  • Smoking : Risk is highest among young people and it can be reduced by quitting smoking.
  • Hypertension
  • Diabetes mellitus.
  • Sedentary lifestyle
  • Obesity
  • Mental stress
 
Q.5)What are the symptoms of Myocardial infarction?
Ans:  It usually develops suddenly and may include:
  • Severe, heavy, crushing pain in the center of the chest that may spread up to the neck and into the arms, especially the left arm.
  • Pallor (paleness)
  • Sweating.
  • Shortness of breath.
  • Nausea, sometimes, vomiting.
  • Anxiety,
  • Restlessness.
  
Q.6)What investigations are done?
Ans: The tests conducted are
  • ECG: Electrocardiogram
  • Echocardiogram
  • Cardiac enzymes : Serum Creatine phosphokinase (CK) 
     Lactate   Dehydrogenase levels (LDH), SGOT
  • Lipid profile
  • Radionuclide imaging
  
Q.7) What are the treatment measures?
Ans: MI is a medical emergency. Hence immediate hospitalisation is advised. Drugs generally used are as follows:
  • Anti-coagulants.
  • Calcium channel blockers
  • Nitrates
  • Beta-blockers
  • Thrombolytic Agents
  • Oxygen
  • Analgesics
  • Sedation: Benzodiazepines.

Surgical interventions like Coronary Angioplasty, if required.

 
Q.8) What is the prognosis?
Ans: Prognosis depends on
  • Mortality increases with age.
  • Higher mortality in females because it occurs at older age in women.
  • Previous infarction or hypertension or diabetes has adverse effect.
  • Unfavourable features are 
       shock, 
       cardiac failure,
       cardiac arrhythmias, 
       systemic and pulmonary emboli.
 
Q.9) How can Myocardial infarction be prevented?
Ans: Myocardial infarction can be prevented by changing the lifestyle
  • Stop smoking. 
  • Eat a healthy diet 
  • Weight maintenance 
  • Alcohol: only moderate amounts.
  • Regular exercise
  • Avoid stressful situations. 
 

 

 

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