Hartinfarct

Hartinfarct, or myocardial infarction (MI), is irreversible death of heart muscle due to prolonged ischemia from reduced coronary blood flow. It most often results from rupture or erosion of an atherosclerotic plaque with subsequent thrombosis, causing obstruction of blood supply to part of the heart. MIs are categorized as STEMI or NSTEMI, and are commonly transmural affecting the left ventricle.

Clinical features usually include sudden onset chest discomfort described as pressure or squeezing, often radiating to the arm, neck, or jaw, with shortness of breath, sweating, nausea, or lightheadedness. Some patients, especially women, older adults, or those with diabetes, may present with atypical symptoms.

Diagnosis relies on clinical presentation, ECG findings, and cardiac biomarkers. STEMI shows persistent ST-elevation; NSTEMI may show ST depression or T-wave changes. Elevated troponin confirms myocardial injury.

Treatment aims to restore blood flow promptly and support the heart. Immediate steps include aspirin and nitroglycerin as appropriate, with oxygen if needed. Reperfusion therapy is primary PCI when available within 90 minutes of first medical contact; thrombolysis is an alternative if PCI cannot be readily performed. Adjuncts include anticoagulants, antiplatelet agents, beta-blockers, statins, and ACE inhibitors or ARBs.

Prognosis depends on infarct size and rapid treatment; complications may include arrhythmias, heart failure, cardiogenic shock, and mechanical rupture. Secondary prevention focuses on risk factor modification, lipid control, antiplatelet therapy, and lifestyle changes.