Myocardial infarction is when the coronary arteries that supply blood to the heart are blocked by a blood clot. If you have severe chest pain, you should call an ambulance and go to the emergency room of a hospital immediately. The treatment is to use “thrombolytic” drugs, or to do some emergency measures (emergency coronary stenting) to restore blood flow, which is the faster the better, do not have time to delay! Otherwise the myocardium will have irreversible necrosis! What is a myocardial infarction A myocardial infarction is a condition in which part of the heart muscle is left without a supply of blood, which, without immediate treatment, can lead to damage to the heart and affect its function. A myocardial infarction is sometimes called a heart attack or a coronary embolism. The heart’s muscle fibers are different from normal muscle fibers in that they work long hours to pump blood to every part of the body. Like other muscle fibers, the heart muscle fibers are in great need of a blood supply, and the coronary arteries are responsible for supplying blood to every part of the heart muscle. The coronary arteries branch off from the aorta and split into left and right branches. If we have a myocardial infarction, it means that a branch of the coronary artery is blocked, so part of the heart muscle is deprived of blood flow and nutrients and oxygen supply, and is at risk of necrosis unless the blocked blood vessel is quickly reopened. If the main trunk of the coronary artery is blocked, then the scope of the impact will be even larger, a large area of the heart muscle is affected, if only a small branch of the trunk is blocked, then a small area of the heart muscle is affected. If a person survives a myocardial infarction, the necrotic part of the myocardium is replaced by fibrous tissue, which fibrose after a few weeks. The most common cause of myocardial infarction is embolism, which is formed by a blood clot that may block a major or minor branch. Clots do not usually form in normal blood vessels, and in any case, if there is atherosclerosis in the walls of the vessel, a thrombus is more likely to be present. Atherosclerosis is fat-like plaque, like a water pipe that has dirt spots over time. Atherosclerotic plaques form over time over a number of years, and can occur in many places in the coronary arteries, where the outer shell of the plaque will be hard, with a soft, fatty core inside. If the outer shell of the plaque bursts, the soft fat core will be exposed, which will prompt the blood to form a blood clot through the clotting mechanism, thus atherosclerotic plaque is the most fundamental cause of myocardial infarction. Treatment with thrombolytic drugs or coronary artery dilatation can dissolve the clot or restore coronary blood flow to minimize the damage to the heart muscle and reduce the extent of the injury. There are other causes of coronary artery blockage that can lead to myocardial infarction, such as coronary arteritis, cardiac puncture wounds, blood clots outside of the coronary arteries that get into the coronary arteries, cocaine abuse that leads to coronary artery spasm, complications from cardiac surgeries, and other rare cardiac disorders, to name just a few. Dr. Zhang Yongjiang, Deputy Chief Physician, pointed out that patients with coronary artery disease must learn some basic knowledge about heart disease to effectively prevent acute myocardial infarction. Who gets myocardial infarction? Myocardial infarction with age, the rate of occurrence will continue to increase, more than 50 years of age is more likely to occur, and sometimes young people also have, men’s rate of occurrence is higher than women, the incidence rate is three times that of women. People with angina are particularly vulnerable to myocardial infarction. Sudden onset of chest pain, new onset of angina and recent worsening of stable angina are often precursors to acute myocardial infarction. There are also people who have no angina symptoms at all and go straight to myocardial infarction. The most important symptom of myocardial infarction is severe chest pain, Chinese medicine describes myocardial infarction: “true heart pain, hands and feet green to the joints, heart pain is very much, once the hair died, the death of the night.” The pain can extend to the jaw, to the left arm, and finally to both arms; some patients sweat, feel nausea, dizziness; the pain is somewhat similar to angina pectoris, but the degree of pain is much greater, and the pain of angina pectoris is sometimes relieved in a few minutes, but the pain of myocardial infarction is at least 15 minutes, and sometimes to several hours. In small myocardial infarctions, the pain is sometimes not noticeable or not even felt, and when it is mild, it can be mistaken for a burning sensation in the esophagus when acid reflux occurs. A massive myocardial infarction can lead to sudden death. What should I do if I suspect I am having a myocardial infarction? You should call an ambulance immediately, and if you have aspirin on hand, take one down first. Many people have severe chest pain but not myocardial infarction, e.g., severe gastroesophageal reflux, gallstones, but the most important way to identify whether it is a myocardial infarction is to do an electrocardiogram. There are pathologic Q waves with elevated ST segment bowing, but there are still exceptions, some people have a normal ECG but still have a myocardial infarction. The diagnosis of myocardial infarction is confirmed by a blood test for troponin, which is found in the myocardium and is released into the bloodstream when the myocardium is damaged, and can be detected by a blood test. The extent of myocardial damage can be estimated by an electrocardiogram (ECG) coupled with the concentration of troponin in the blood. Another indicator that can be measured in a blood test is creatinine kinase, which is also released from the myocardium during a myocardial infarction. Four medications commonly taken for myocardial infarction Once you have had a myocardial infarction, you will need to take medication for the rest of your life. The following four medications are commonly used: 1. Aspirin: reduces platelet aggregation and thus reduces the formation of blood clots. If you are unable to take aspirin, your physician will replace it with other antiplatelet agents, such as clopidogrel. 2. Beta-blockers, which can lower the heart rate and reduce the chance of recurrence of myocardial infarction. 3, ACE inhibitor (angiotensin converting enzyme inhibitor), this drug has many functions, one of which is the protective effect of the heart. 4, Statin lipid-lowering drugs, can lower cholesterol, prevent atherosclerotic plaque formation, anti-inflammatory response, stabilize plaque, lower the threshold of ventricular fibrillation, reduce mortality, for a very important drug. 5, nitrate drugs, dilate coronary artery, improve myocardial ischemia. Myocardial infarction in addition to atherosclerosis, there are some risk factors can be prevented and treated: smoking, hypertension, high cholesterol, lack of exercise, poor diet, obesity, alcoholism and diabetes. Attention to these items can reduce the incidence of myocardial infarction.