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Heart attack


Alternative Names:

Myocardial infarction; MI; Acute MI; ST-elevation myocardial infarction; Non-ST-elevation myocardial infarction

Signs and tests:

A doctor or nurse will perform a physical exam and listen to your chest using a stethoscope.

  • The doctor may hear abnormal sounds in your lungs (called crackles), a heart murmur, or other abnormal sounds.
  • You may have a fast or uneven pulse.
  • Your blood pressure may be normal, high, or low.

You will have an electrocardiogram (ECG) to look for heart damage. A troponin blood test can show if you have heart tissue damage. This test can confirm that you are having a heart attack.

Coronary angiography may be done right away or when you are more stable.
  • This test uses a special dye and x-rays to see how blood flows through your heart.
  • It can help your doctor decide which treatments you need next.

Other tests to look at your heart that may be done while you are in the hospital:

Support Groups:

See: Heart disease - resources

Expectations (prognosis):

After a heart attack, your chance of having another one is higher than if you never had a heart attack.

How well you do after a heart attack depends on the damage to your heart muscle and heart valves, and where that damage is located.

If your heart can no longer pump blood out to your body as well as it used to, you may develop heart failure. Abnormal heart rhythms can occur, and they can be life threatening.

Usually a person who has had a heart attack can slowly go back to normal activities, including sexual activity. Discuss your activity level with your health care provider.

References:

Anderson JL. ST segment elevation acute myocardial infarction and complications of myocardial infarction. In: Goldman L, Schafer AI, eds. Cecil Medicine. Philadelphia, Pa: Saunders Elsevier; 2011:chap 73.

Antman EM. ST-segment elevation myocardial infarction: pathology, pathophysiology, and clinical features. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsever; 2011:chap 54.

Cannon CP, Braunwald E. Unstable angina and non-ST elevation myocardial infarction. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsever; 2011:chap 56.

Kushner FG, Hand M, Smith SC Jr, King SB 3rd, Anderson JL, Antman EM, et al. 2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients WithST-Elevation Myocardial Infarction (updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention(updating the 2005 Guideline and 2007 Focused Update): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2009 Dec 1;120(22):2271-306. Epub 2009 Nov 18.

Wright RS, Anderson JL, Adams CD, et al. 2011 ACCF/AHA Focused Update of the Guidelines for the Management of Patients with Unstable Angina/Non-ST-Elevation Myocardial Infarction (Updating the 2007 Guideline). A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the American College of Emergency Physicians, Society for Cardiovascular Angiograpy and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2011;57:1920-1959.


Review Date: 6/22/2012
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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