Hjartaáfall

Hjartaáfall is the Icelandic term for a heart attack, a medical emergency caused by a sudden interruption of blood flow to part of the heart muscle, most often due to blockage in a coronary artery. The resulting ischemia can damage or destroy heart tissue if blood flow is not restored promptly. Myocardial infarction can involve large or small areas of the heart and may affect the heart’s pumping ability.

Pathophysiology commonly involves rupture of a vulnerable atherosclerotic plaque, followed by thrombosis that narrows or stops blood flow. Prolonged loss of oxygen leads to necrosis of heart muscle. There are two main types: ST-elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI), differentiated by findings on an electrocardiogram and cardiac biomarkers.

Symptoms typically include chest pain or pressure, discomfort in the arm, neck, jaw, back, or stomach, shortness of breath, cold sweat, nausea, or lightheadedness. Symptoms can vary, especially in women, older adults, or individuals with diabetes, and some people may have atypical presentations or silent events.

Diagnosis relies on clinical assessment, ECG, and blood tests for cardiac troponins. Imaging such as echocardiography or coronary angiography may be used to assess heart function and identify blockages. Immediate management prioritizes emergency medical care: call for urgent help, chewable aspirin if not contraindicated, and nitroglycerin for chest pain (if approved). Oxygen is given if needed, and reperfusion therapy is essential within hours when indicated—primary percutaneous coronary intervention (PCI) or thrombolysis when PCI is not available. Long-term treatment includes antiplatelet therapy, statins, beta-blockers, ACE inhibitors, lifestyle changes, cardiac rehabilitation, and risk factor management.

Prognosis depends on the speed of treatment and the extent of heart damage. Preventive measures focus on controlling blood pressure, cholesterol, diabetes, smoking cessation, healthy diet, and regular physical activity.