Heart attack (myocardial infarction) is a damage to the heart muscle due to decreased or ceased blood supply.
Myocardial infarction is a result of the necrosis of the heart muscle due to prolonged ischemia (decreased oxygen supply to the myocardium).
Depending on the size of the vessel and the damaged area vary the severity of the condition and the presence of possible complications – pulmonary edema, acute heart failure, heart blocks or atrial fibrillation.
The most common symptom of the heart attack is the intense chest pain. A person may describe it as a sensation of tightness, pressure, aching, burning, or squeezing. He/she may hold the clenched fist over the chest, trying to describe the pain. This is called the Levine’s sign, which is typical for ischemic cardiac pain.
Usually the pain irradiates to the left arm and shoulder, the lower jaw, less commonly – to the neck, right arm, back, and upper abdomen.
In case of myocardial infarction the pain lasts more than 30 minutes and typically doesn’t relieve after the administration of nitroglycerin.
Sometimes heart attack may be painless. This form of the myocardial infarction is typical for those who suffer from diabetes mellitus. Individuals with a high pain threshold or various neuropathies (as in diabetes mellitus) may also not complain of pain.
- Malaise, weakness;
- Epigastric pain may be present. A person experiences the feeling of fullness and gas, indigestion, nausea and vomiting.
- Confusion, lightheadedness and syncope
Decreased blood supply to the brain results in confusion, loss of consciousness etc.
Intense pain causes the fear of death and anxiety.
- Shortness of breath
Dyspnoe occurs as the result of an ineffective heart function and pulmonary congestion. Another possible reason of the shortness of breath is an inadequate oxygen supply to the tissues.
Pulmonary edema is characterized by coughing and wheezing. Crepitations may be heard over the lung bases.
- Profuse sweating
Increased cathecholamines production results in profuse sweating.
- Tachycardia, arrhythmia, heart blocks
Fast heart rate, or abnormal rhythm may be detected. Ventricular fibrillation may occur and cause sudden death.
- Low blood pressure
Decreased blood pressure is typical for myocardial infarction due to the inability of the heart to pump blood effectively.
When the heart function decreases drastically the condition called cardiogenic shock develops.
Cardiogenic shock is characterized by the following symptoms:
- Hypotension (low blood pressure);
- Oliguria (decreased urine production) due to low blood pressure;
- Cyanosis (bluish skin color) due to poor oxygen supply to the tissues;
- Confusion, altered mental state;
- Weak pulse;
- Pulmonary edema characterized by the shortness of breath, tachypnoe, cough with foamy sputum, rales, crackles and crepitations in the lungs;
- Distended jugular veins;
|I||No signs of heart failure|
|II||Crackles, crepitations in the lungs|
|III||Acute pulmonary edema|