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Recent News and Articles on the Keywords: myocardial infarction + heart attack + heart  Related to the article below (Last Update: 7/1/2008)


Insider Medicine
Angina Strikes 1 in 5 Heart Attack Survivors
Forbes, NY - Jun 23, 2008
Recognition of these relationships will be important in monitoring at-risk patients after acute myocardial infarction (heart attack)," wrote Dr. Thomas M. ...
CV Therapeutics Announces Archives of Internal Medicine ... Biloxi Sun Herald
One in Every Five Survivors Has Angina a Year After MI MedPage Today
Angina Symptoms May Linger Up to One Year Following MI Insider Medicine
ABC7Chicago.com - Reuters
all 34 news articles »  CVTX
One Year After Heart Attack, Chest Pain Remains For Many
Medical News Today, UK - Jun 25, 2008
In both inpatient and outpatient settings, a primary goal of care after myocardial infarction (MI), commonly known as heart attack, is to the episodic chest ...

Enews 2.0
Low Vitamin D Levels May Boost Men's Heart Attack Risk
U.S. News & World Report, DC - Jun 9, 2008
"After additional adjustment for family history of myocardial infarction, body-mass index, alcohol consumption, physical activity, history of diabetes ...
Sunshine vitamin may help prevent heart attack Food Consumer
Vitamin D Deficiency Related To Heart Attack And Disease Risk Best Syndication
Low Vitamin D Levels in Men Linked to Heart Attack Risk MedPage Today
Medical News Today - eFluxMedia
all 78 news articles »
Prevalence of Chest Pain Common Among Heart Attack Survivors
MedIndia, India - Jun 28, 2008
... of those patients who are at the greatest risk for angina [chest pain] after myocardial infarction [heart attack] can occur,? the authors write. ...
Increase in heart attack patients receiving angioplasty
Nursing Times, UK - Jun 27, 2008
The number of patients in England receiving primary angioplasty instead of thrombolysis, following myocardial infarction, has increased significantly over ...

dBTechno
From a Prominent Death, Some Painful Truths
New York Times, United States - Jun 24, 2008
It was a typical heart attack, or myocardial infarction, an event that occurs 1.2 million times a year in the United States, killing 456000 people. ...
Heart disease kills one person every second in USA alone Pravda
all 33 news articles »
One-year post-heart attack angina studied
United Press International - Jun 26, 2008
Recognition of these relationships will be important in monitoring at-risk patients after acute myocardial infarction," the authors concluded. ...

Chatter Shmatter
Better Understanding How Tim Russert Died, How to Avoid It Causing ...
SeniorJournal.com, TX - Jun 17, 2008
A heart attack, known in medicine as an (acute) myocardial infarction (AMI or MI), occurs when the blood supply to part of the heart is interrupted. ...
AssociatedPress
Russert's death raises anxiety over heart disease MinnPost.com
Tim Russert Dies of Coronary Thrombosis - What Is It? HULIQ (press release)
TheHeart.Org - RedOrbit
all 776 news articles »
More lives saved if ambos give heart victims anti-clot drugs
The Australian, Australia - Jun 24, 2008
... as tenecteplase by paramedics trained with ECG (electrocardiogram) skills to diagnose the type of heart attack called ST-elevated myocardial infarction. ...
Queensland ambulance officers save lives with clot busting drug ... News-Medical.net
all 17 news articles »
Hypovitaminosis D Linked to Increased Risk of Heart Attack in Men
Medi News Direct, India - Jun 21, 2008
Low levels of vitamin D may be a risk factor for myocardial infarction (MI) in men, according to a study published in the June 2008 issue of the Archives of ...
Source: Google News

AHA/ACC Guidelines for Preventing Heart Attack and Death in Patients With Atherosclerotic … -
SC Smith, SN Blair, RO Bonow, LM Brass, MD … - Circulation, 2001 - Am Heart Assoc
... Preventing heart attack and death in patients with coronary disease. ... Effects of
long-term anticoagulant therapy in subgroups after acute myocardial infarction. ...

Effect of propranolol after acute myocardial infarction in patients with congestive heart failure -
K Chadda, S Goldstein, R Byington, JD Curb - Circulation, 1986 - Am Heart Assoc
... in the Beta Blocker Heart Attack Trial in which postmyocardial infarction patients
between ... Survivors of acute myocardial infarction with compensated or mild ...

… at High Risk for Acute Myocardial Infarction: Recommendations from the National Heart Attack Alert … -
K Dracup, AA Alonzo, JM Atkins, NM Bennett, A … - Annals of Internal Medicine, 1997 - annals.highwire.org
... 10. Emergency department: rapid identification and treatment of patients with acute
myocardial infarction. National Heart Attack Alert Program Coordinating ...

… and case fatality rates of acute myocardial infarction (1975-1984): the Worcester Heart Attack -
RJ Goldberg, JM Gore, JS Alpert, JE Dalen - Am Heart J, 1988 - ncbi.nlm.nih.gov
Click here to read Incidence and case fatality rates of acute myocardial
infarction (1975-1984): the Worcester Heart Attack Study. ...

… on the incidence and prognosis of initial acute myocardial infarction: the Worcester Heart Attack -
RJ Goldberg, JM Gore, JH Gurwitz, JS Alpert, P … - Am Heart J, 1989 - ncbi.nlm.nih.gov
Am Heart J. 1989 Mar;117(3):543-9. The impact of age on the incidence and prognosis
of initial acute myocardial infarction: the Worcester Heart Attack Study. ...

… and survival rates of acute myocardial infarction (1975 through 1981). The Worcester Heart Attack -
RJ Goldberg, JM Gore, JS Alpert, JE Dalen - JAMA: The Journal of the American Medical Association, 1986 - jama.waldenu.edu
... ABSTRACT | FULL TEXT. Do-Not-Resuscitate Orders in Patients Hospitalized With Acute
Myocardial Infarction: The Worcester Heart Attack Study Jackson et al. ...

Essential hypertension: renin and aldosterone, heart attack and stroke.
HR Brunner, JH Laragh, L Baer, MA Newton, FT … - N Engl J Med, 1972 - ncbi.nlm.nih.gov
Essential hypertension: renin and aldosterone, heart attack and stroke. ...
Hypertension/metabolism*; Male; Middle Aged; Myocardial Infarction/blood; Myocardial ...

… delay to hospital arrival in patients with acute myocardial infarction: the Worcester Heart Attack -
J Yarzebski, RJ Goldberg, JM Gore, JS Alpert - Am Heart J, 1994 - ncbi.nlm.nih.gov
Temporal trends and factors associated with extent of delay to hospital arrival
in patients with acute myocardial infarction: the Worcester Heart Attack Study. ...

… of acute myocardial infarction complicated by complete heart block (the Worcester Heart Attack -
RJ Goldberg, JC Zevallos, J Yarzebski, JS Alpert, … - Am J Cardiol, 1992 - ncbi.nlm.nih.gov
Am J Cardiol. 1992 May 1;69(14):1135-41. Prognosis of acute myocardial infarction
complicated by complete heart block (the Worcester Heart Attack Study). ...

… for the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). ALLHAT … -
BR Davis, JA Cutler, DJ Gordon, CD Furberg, JT … - Am J Hypertens, 1996 - ncbi.nlm.nih.gov
... Lowering Treatment to Prevent Heart Attack Trial (ALLHAT ... incidence of fatal coronary
heart disease (CHD) and nonfatal myocardial infarction differs between ...

Source: Google Scholar
 
Heart Attack (Myocardial Infarction)

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.

Heart Attack Symptoms

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
During the early hours of a heart attack, heart murmurs and other abnormal heart sounds may be heard through a stethoscope.

Causes of Heart Attacks and Risk Factors

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.

Diagnosis of Heart Attacks

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

Treatment of Heart Attacks (Myocardial Infarction)

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

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.

Symptoms of Congestive 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

Causes of Congestive Heart Failure and Risk Factors

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

Diagnosis of Congestive Heart Failure

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.

Treatment of Congestive Heart Failure

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
Options include:
  • 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
Congestive heart failure that develops or gets worse quickly needs to be treated on an emergency basis in a hospital. If there is severe swelling in the lungs, oxygen will be given through a face mask. Diuretics can be injected, and drugs (such as nitroglycerin) can be given to improve comfort. In some cases it may be necessary to use a mechanical ventilator to assist in breathing. Certain hormones similar to adrenaline can be given on a short-term basis to help the heart muscle work more effectively.
 
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