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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]
Test Sensitivity and specificity Approximate peak Description Troponin test: The most sensitive and specific test for myocardial damage. Because it has increased specificity compared with CK-MB, troponin is composed of 3 proteins- Troponin C, Cardic troponin I, and Cardiac troponin T. Troponin I especially has a high affinity for myocardial injury.
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 ...
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 ...
[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]