Ischemic myocardial necrosis
usually resulting from abrupt reduction in coronary flow to a segment of
myocardium. Myocardial infarction clinical condition is characterized
by precordial pain similar to, but usually more intense and prolonged
than, Angina pectoris and Left ventricular dysfunction.
Etiology
Atherosclerosis
of the coronary arteries is the common denominator in most patients
with myocardial infarction. Angiographic studies reveal that segmental
abnormalities of myocardial infarction contractility representing old
infarction correlate reasonably well with artery supplying disease.
Abnormalities in platelet aggregation in the patient with pre-existing
coronary disease may contribute to variable changes in coronary
perfusion. However, infarction can occur in the absence of coronary
occlusion artery disease or occlusion, and if adequate collaterals are
present, coronary occlusion can develop without subsequent infarction.
Myocardial infarction may occur in the absence of coronary artery
disease because of coronary artery spasm or because of coronary
embolization complicating endocarditis, left atrial thrombosis, or
rheumatic heart disease. Myocardial Infarction is predominantly a
disease of the left ventricle but the damaged area may extend into the
right ventricle or the atria.
The first symptoms of acute myocardial infarction is the development of deep, substernal, visceral pain described as aching or pressure. The myocardial pain is similar to angina pectoris but usually more severe and relieved little, or only temporarily. In severe episodes the patient becomes apprehensive and may develop a sense of impending doom. Symptoms of left ventricular failure, pulmonary edema, shock or significant arrhythmia may develops and dominate the clinical picture.
The first symptoms of acute myocardial infarction is the development of deep, substernal, visceral pain described as aching or pressure. The myocardial pain is similar to angina pectoris but usually more severe and relieved little, or only temporarily. In severe episodes the patient becomes apprehensive and may develop a sense of impending doom. Symptoms of left ventricular failure, pulmonary edema, shock or significant arrhythmia may develops and dominate the clinical picture.
Treatment
Myocardial
infarction treatment usually designed to relieve the patient's
distress, reduce cardiac work, prevent myocardial possible
complications, and furthermore treatment complications.
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