Myocardial infarction is a cardiovascular event that occurs after the obstruction or occlusion of a blood vessel in the heart. As a consequence, there is an interruption of blood flow and subsequent death and loss of a segment of the heart muscle.

Myocardial infarction is currently the leading cause of death in our country. Although it is a pathology that preferably affects the male sex, women in the postmenopausal period can also be affected.

What are the symptoms of Infarction?

The most important symptom is pain. This is of an oppressive (“crushing”) character, involving the anterior aspect of the thorax. Occasionally, the pain radiates to the left arm, neck and jaw, as well as to the upper abdomen and dorsum.

These are the main signs that may indicate the presence of a heart attack:

1. Fatigue and breathing difficulties

Dyspnea, shortness of breath,
appears before many heart attacks, particularly among women,
and may begin months before we suffer a heart attack. It is usually accompanied by great fatigue. These symptoms are difficult to associate with cardiac arrest, but if we find ourselves exhausted without an apparent cause, the smartest thing to do is to go to the emergency room.

2. Excessive sweating

Sweating more than usual, even if we are not exercising, can be a sign that our heart has a problem. Pumping blood through clogged arteries requires our heart to make a greater effort than usual, the body temperature increases due to this effort and our body sweats to try to keep it at bay.
These symptoms may appear days before a heart attack.
If we notice cold sweats that have no apparent cause, and cold and clammy skin, we should go to the doctor without thinking twice.

3. Indigestion, nausea and vomiting

Sometimes cardiac arrest is preceded by digestive problems, including nausea and vomiting.These are the most difficult symptoms to associate with cardiac arrestIf we have an iron stomach and have not eaten anything out of the ordinary, sudden indigestion may indicate that something is wrong with our heart, and we would do well to see a doctor.

4. Chest pain

Although not all heart attacks are preceded by chest pain,
this is the most frequent and easily recognizable symptom.
Chest pain is usually prolonged – lasting about 15 minutes – and is perceived as an intense pressure in the chest, which may extend to the back, arms and shoulders, especially on the left side (areas that may hurt more than the chest itself).Pain may not be continuousThe heart attack will come and go on numerous occasions, but the heart attack will come sooner or later. Not all heart attacks are preceded by chest pain of equal intensity: we may have little pain and yet cardiac arrest may be imminent. In the event of this symptom, we should immediately notify the emergency service.

Risk factors that can lead to coronary artery blockage

• Hypertension
• High cholesterol
• Tobacco
• Obesity
• Sedentary lifestyle
• Advanced age

Who is more likely to suffer a myocardial infarction?

• Being a smoker
• Male sex.
• Diabetes Mellitus
• Arterial hypertension
• Obesity
• Cholesterol disorders
• Sedentary lifestyle
• History of close relatives with coronary artery disease, particularly early onset.

How is the diagnosis of myocardial infarction made?

The diagnosis of myocardial infarction is not always simple, given that there are other conditions that manifest with chest pain, and the characteristics of this can vary from patient to patient. Clinical suspicion is given in individuals with the risk factors mentioned above who present with suggestive chest pain. It should be noted that there is a difference between infarction and angina. In the latter, the duration of symptoms is shorter and is relieved by rest or medication.

In the evaluation, a resting electrocardiogram will be performed which demonstrates suggestive findings, however, especially in small infarcts, it may also be normal. In the Emergency Department, the physician can supplement with cardiac enzymes consisting of markers that are released into the bloodstream when there is damage to the heart.

What is the treatment for myocardial infarction?

The management of myocardial infarction includes early recognition, electrocardiogram and initial care. This includes aspirin and some anticoagulant drugs whose role is to prevent the expansion of the clot that obstructs the flow of the coronary arteries. In certain cases, especially in cases of significant infarctions, it will be necessary to administer intravenous medications that dissolve the clot or to perform a coronary angiography to evaluate the condition of the coronary arteries of the heart, in order to subsequently recanalize the obstructed artery by means of angioplasty (dilation of the coronary artery).

How can I prevent heart attack and cardiovascular disease?

In the prevention of cardiovascular diseases, periodic monitoring and management of risk factors is necessary. It is important to stop smoking, regular aerobic exercise (three times a week for 20 minutes each session), regular control of cholesterol levels and blood pressure. In addition, a diet low in saturated fats and increased intake of a Mediterranean diet that includes colorful vegetables (e.g. tomatoes and peppers) may reduce the risk. Patients with two or more cardiovascular risk factors benefit from the administration of low-dose aspirin (81 to 100 mg) on a daily basis.

When is it necessary to consult?

Any adult person with symptoms of chest pain accompanied by the symptoms described above, particularly if he/she is a carrier of cardiovascular risk factors such as hypertension, smoking, diabetes, should consult an emergency service.

Dr. Licurgo Cruz
Cardiology