Heart attack


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patient education on heart attack

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Heart attack

  1. 1. Heart attack : Myocardial Infarction Dato’Dr.G.Selvaraju DIMP; JSD; AMP; MBBS; ,MRCP(UK); AM (Mal); FIAMIS Consultant Physician in Internal Medicine & Gastroenterologist Clinical Specialist Geriatric Medicine
  2. 2. What is Heart attack? Heart attack -- a sudden interruption in the heart's blood supply. This happens when there is a blockage in the coronary arteries, the vessels that carry blood to the heart muscle. When blood flow is blocked, heart muscle can be damaged very quickly and die. Prompt emergency treatments have reduced the number of deaths from heart attacks in recent years 1/15/2014 Dato'Dr G.Selvaraju 2
  3. 3. Heart attack symptoms A heart attack is an emergency even when symptoms are mild. Warning signs include: -Pain or pressure in the chest -Discomfort spreading to the back, jaw, throat, or arm -Nausea, indigestion, or heartburn -Weakness, anxiety, or shortness of breath -Rapid or irregular heartbeats 1/15/2014 Dato'Dr G.Selvaraju 3
  4. 4. Heart attack symptoms in women Women don't always feel chest pain with a heart attack. Women are more likely than men to have heartburn, loss of appetite, tiredness or weakness, coughing, and heart flutters. These symptoms should not be ignored. The longer you postpone treatment, the more damage the heart may sustain. 1/15/2014 Dato'Dr G.Selvaraju 4
  5. 5. What happens in a Heart attack ? In more than 90% of the patients with acute MI an acute thrombus often associated with plaque rupture occludes the artery (previously partially obstructed by an atherosclerotic plaque) that supplies the damaged area 1/15/2014 Dato'Dr G.Selvaraju 5
  6. 6. Coronary Arteries 1/15/2014 Dato'Dr G.Selvaraju 6
  7. 7. Coronary Atherosclerosis 1/15/2014 Dato'Dr G.Selvaraju 7
  8. 8. Coronary Artery Disease 1/15/2014 Dato'Dr G.Selvaraju 8
  9. 9. Signs of Coronary Artery Disease A precursor to a heart attack, coronary artery disease or CAD occurs when sticky plaque builds up inside the coronary arteries. This narrows the arteries, making it more difficult for blood to flow through. Many people don't know they have CAD until a heart attack strikes. But there are warning signs, such as recurring chest pain caused by the restricted blood flow. This pain is known as angina. 1/15/2014 Dato'Dr G.Selvaraju 9
  10. 10. Inside a heart attack The plaque deposited in your arteries is hard on the outside and soft and mushy on the inside. Sometimes the hard outer shell cracks. When this happens, a blood clot forms around the plaque. If the clot completely blocks the artery, it cuts off the blood supply to a portion of the heart. Without immediate treatment, that part of the heart muscle 1/15/2014 could be damaged or destroyed. G.Selvaraju Dato'Dr 10
  11. 11. Don’t wait to be sure …. The best time to treat a heart attack is as soon as symptoms begin. Waiting to be sure can result in permanent heart damage or even death. If you think you may be having a heart attack, call for an ambulance. And don't try driving yourself to the hospital. 1/15/2014 Dato'Dr G.Selvaraju 11
  12. 12. Tests for Coronary Heart Disease 1/15/2014 Dato'Dr G.Selvaraju 12
  13. 13. Test to detect Coronary block 1/15/2014 Dato'Dr G.Selvaraju 13
  14. 14. What is CT Angiogram? • A computerized tomography (CT) coronary angiogram is an imaging test to look at the arteries that supply your heart muscle with blood. • Unlike a traditional coronary angiogram, CT angiograms don't use a catheter threaded through your blood vessels to your heart. Instead, a coronary CT angiogram relies on a powerful X-ray machine to produce images of your heart and heart vessels. • CT angiograms don't require the recovery time needed with traditional angiograms. • Coronary CT angiograms are becoming a common option for people with a variety of heart conditions. • CT angiograms will expose you to a small amount of radiation 1/15/2014 Dato'Dr G.Selvaraju 14
  15. 15. Who should get CT Coronary Angiogram? • In patients at high risk for developing coronary disease (cigarette smokers, those with genetic risk, high cholesterol levels, hypertension, or diabetes), • who have unclear results with treadmill or other testing, or who have symptoms suspicious of coronary disease, • CT angiography is an excellent next step in the diagnosis. If the CT scan is normal or only mildly abnormal, it makes the likelihood of a severe blockage of the coronary arteries extraordinarily small. • Conversely, if the CT scan is significantly abnormal, cardiac catheterization and angiography are then indicated, to see if angioplasty, stenting, or coronary bypass surgery may be indicated. • In people who have had bypass surgery, CT angiography is very effective at evaluating the patency of the bypass grafts. • In people who have had coronary stents , it is sometimes difficult to image the inside of the stent to see if it is narrowed. 1/15/2014 Dato'Dr G.Selvaraju 15
  16. 16. How is it done? • This procedure use intravenous dye which contains iodine and CT scanning to image the coronary arteries. While the use of catheters is not necessary (thus the term "noninvasive" test applies to this procedure), there are still some risks involved 1/15/2014 Dato'Dr G.Selvaraju 16
  17. 17. What are the risks? • In people allergic to iodine, pre-treatment with medications is necessary to prevent allergic reactions to the dye. • In people with abnormal kidney function and/or diabetes, the dye may worsen kidney function. • Finally, there is radiation exposure which is similar to, if not greater than, that received with a conventional coronary angiogram. • Nonetheless, this is generally a very safe test for most people, but should only be undergone when ordered by a physician familiar with the patient and their underlying medical condition. • Special care is needed for people with history of Bronchial Asthma 1/15/2014 Dato'Dr G.Selvaraju 17
  18. 18. To see positive as positive is easy; To see negative as positive is Coronary CT Angiogram 1/15/2014 Dato'Dr G.Selvaraju 18
  19. 19. Normal Heart 1/15/2014 Angiogram Dato'Dr G.Selvaraju External appearance 19
  20. 20. CT images -1 1/15/2014 Dato'Dr G.Selvaraju 20
  21. 21. CT images -2 1/15/2014 Dato'Dr G.Selvaraju 21
  22. 22. CT images -3 1/15/2014 Dato'Dr G.Selvaraju 22
  23. 23. CT images -4 1/15/2014 Dato'Dr G.Selvaraju 23
  24. 24. Risk Factors – age & sex Men have a higher risk of having a heart attack than women, and at an earlier age. But it's important to note that heart disease is the No. 1 killer of women, too. People with a family history of heart ailments also have a higher risk of heart trouble. 1/15/2014 Dato'Dr G.Selvaraju 24
  25. 25. Risk Factors –high BP & cholesterol High cholesterol and high blood pressure are major risk factors for heart disease. Being overweight, obese, or physically inactive all increase your risk. So does diabetes, especially if your glucose levels are not well controlled. Discuss your risks with your doctor and develop a strategy for managing them. There are many steps you can take to protect your heart. 1/15/2014 Dato'Dr G.Selvaraju 25
  26. 26. Risk Factors – Smoking If you smoke, your risk of heart disease is 2 to 4 times greater than a non-smoker's. And if you smoke around loved ones, you're increasing their risk with second hand smoke.. But it's never too late to quit. Within 24 hours of quitting, your heart attack risk begins to fall. 1/15/2014 Dato'Dr G.Selvaraju 26
  27. 27. Major Reversible Risk Factors • Abnormal serum lipid levels – High LDL ; low HDL • • • • • HTN Cigarette smoking including passive smoking DM ( Tri) Obesity ( Tri) Physical inactivity 1/15/2014 Dato'Dr G.Selvaraju 27
  28. 28. Prevention of heart diseases – the ABCs • • • • • • • • • Attitude Blood Pressure control Cholesterol control Diabetes control : Self Care Exercise Food : healthy food Games : for body & mind Healthy Life style & Quit smoking 1/15/2014 Dato'Dr G.Selvaraju 28
  29. 29. Heart disease prevention- Fitness The key to preventing heart disease is a healthy lifestyle. This includes a nutritious diet, at least 30 minutes of exercise most days of the week, not smoking, and controlling high blood pressure, cholesterol, and diabetes. If you drink alcohol, do so in moderation -- no more than one drink a day for women, two drinks a day for men. Ask your friends and family for help in making these changes. They'll benefit, too. 1/15/2014 Dato'Dr G.Selvaraju 29
  30. 30. Heart disease prevention – diet What you eat makes a difference. Be sure you get plenty of whole grains, vegetables, legumes, and fruits to help keep your heart healthy. Plant oils, walnuts, other nuts, and seeds can also help improve cholesterol levels. And don't forget to eat fish at least a couple of times each week for a good source of heart-healthy protein. 1/15/2014 Dato'Dr G.Selvaraju 30
  31. 31. 1/15/2014 Dato'Dr G.Selvaraju 31