HEART ATTACK

Heart attack occurs when perfusion to myocardium is insufficient to meet metabolic needs of tissue, leading irreversible tissue damage.

Cause:

Occlusion of a major Coronary Artery

Coronary Artery Disease (CAD):

Occlusion of a major coronary artery, usually due to atherosclerosis, leads to in adequate oxygen supply to area of myocardium which in result cell death.

Complications:

1. Problems will be related to size and location of artery involved,
2. Whether or not blockage is complete,
3. Depending on severity, patients can develop pain(angina) or myocardial infarction (MI).

Symptoms:

1. Chest Heaviness
2. Pressure (lasting more than 20 minutes)
3. Sweating
4. Pain radiating to left arm to heart

Levine Sign: Clenched Fist often radiates to left arm can associated with Nausea.

Severity of Ischemia and Infarction depends on rate at which occlusion or Stenosis has occurred or whether Collateral Channels have chance to develop.

Symptoms In Men:

• Chest Pain
• Cold Sweats

Symptoms In Women:

• Abdominal pain/crams
• Achiness in jaw or back
• Nausea
• Shortness of breath
• Fatigue/ Lethargic

Surgical Interventions:

Percutaneous Coronary Intervention/Angioplasty:

Technique in which a long fine tube (catheter) is inserted into Femoral Artery in thigh and passed through external and common Iliac Arteries and into Abdominal Aorta, It continues moved upward through Thoracic Aorta to origin of Coronary Arteries.

Coronary Arteries may approached through Radial or Brachial Arteries (present in forearm, arm and in axillary region), A fine wire passed into Coronary Artery and cross the Stenosis,

A fine Balloon is then passed over wire and may be inflated at level of obstructions which result in widening of artery to set the flow of blood.

Suction:

Extraction of Coronary Thrombus and Rotary Ablation of Plaque.

Coronary Artery Bypass Graft (CABG) :

Great Saphenous Vein in lower limb harvested and used as graft.

It divided into several pieces and each piece used to bypass blocked sections of Coronary Arteries, Internal Thoracic and Radial Arteries can also be used.