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A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops in one of the coronary arteries of the heart, causing infarction (tissue death) to the heart muscle. [1] The most common symptom is retrosternal chest pain or discomfort that classically radiates to the left shoulder, arm, or jaw. [1]
The so-called "classical 3-point MACE" is defined as a composite of nonfatal stroke, nonfatal myocardial infarction, and cardiovascular death. [4] [5] Another study similarly defined MACE as a composite of nonfatal stroke, nonfatal acute coronary syndrome, and death from vascular causes. [6]
This allowed clinicians to examine the management of myocardial infarction within their hospitals against targets specified by the National Service Framework (NSF) for coronary heart disease. The audit project produces annual reports on "How the NHS manages heart attacks" to show the performance of hospitals, ambulance services and cardiac ...
Information card published by the National Heart, Lung, and Blood Institute urging people with symptoms of angina to call the emergency medical services.. Because of the relationship between the duration of myocardial ischemia and the extent of damage to heart muscle, public health services encourage people experiencing possible acute coronary syndrome symptoms or those around them to ...
The European Society of Cardiology (ESC), [21] and National Institute for Health and Care Excellence (NICE) [23] guidelines recommend that if the patient has a CHA 2 DS 2-VASc score of 2 and above, oral anticoagulation therapy (OAC) with a vitamin K antagonist (VKA, e.g. warfarin with target INR of 2-3) or one of the direct oral anticoagulant ...
Myocardial ischemia arises from the dysfunction of coronary macrovascular or microvascular components, leading to a compromised supply of oxygen and nutrients to the myocardium. The underlying pathophysiological mechanisms encompass a range of factors, including atherosclerosis in epicardial coronary arteries, vasospasm in large or small ...
The related medication eplerenone was shown in the EPHESUS trial [31] to have a similar effect, and it is specifically labelled for use in decompensated heart failure complicating acute myocardial infarction. While the antagonism of aldosterone will decrease the effects of sodium and water retention, it is thought that the main mechanism of ...
[13] [14] In the UK, NICE guidance recommends myocardial perfusion scans following myocardial infarction or reperfusion interventions. [15] The power of prognosis from a myocardial perfusion scan is excellent and has been well tested, and this is "perhaps the area of nuclear cardiology where the evidence is most strong". [13] [16]