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ACE inhibitor therapy should be started within 24 hours, and continued indefinitely at the highest tolerated dose. Textbook of pulmonary and critical care medicine. He hands specific books to guys in the spirit of coaches like Phil Jackson. Jeremy Noble, Ph. A Systematic Review and Meta-analysis".
Aspirin has been studied extensively in people considered at increased risk of myocardial infarction. Based on numerous studies in different groups e. There is a large crossover between the lifestyle and activity recommendations to prevent a myocardial infarction, and those that may be adopted as secondary prevention after an initial myocardial infarct. Following a heart attack, nitrates, when taken for two days, and ACE-inhibitors decrease the risk of death.
Aspirin is continued indefinitely, as well as another antiplatelet agent such as clopidogrel or ticagrelor "dual antiplatelet therapy" or DAPT for up to twelve months. Beta blocker therapy such as metoprolol or carvedilol is recommended to be started within 24 hours, provided there is no acute heart failure or heart block. However, 1 in people were prevented from a repeat heart attack, and another 1 in from having an abnormal heart rhythm.
Additionally, for 1 in 91 the medication causes a temporary decrease in the heart's ability to pump blood. ACE inhibitor therapy should be started within 24 hours, and continued indefinitely at the highest tolerated dose.
This is provided there is no evidence of worsening kidney failure , high potassium , low blood pressure, or known narrowing of the renal arteries. Statin therapy has been shown to reduce mortality and subsequent cardiac events, and should be commenced with the aim of lowering LDL cholesterol. Other medications, such as ezetimibe , may also be added with this goal in mind.
Aldosterone antagonists spironolactone or eplerenone may be used if there is evidence of left ventricular dysfunction after an MI, ideally after beginning treatment with an ACE inhibitor. A defibrillator , an electric device connected to the heart and surgically inserted under the skin, may be recommended. This is particularly if there are any ongoing signs of heart failure, with a low left ventricular ejection fraction and a New York Heart Association grade II or III after 40 days of the infarction.
The prognosis after myocardial infarction varies greatly depending on the extent and location of the affected heart muscle, and the development and management of complications.
It is unusual for babies to experience a myocardial infarction, but when they do, about half die. Complications may occur immediately following the myocardial infarction or may take time to develop.
Disturbances of heart rhythms , including atrial fibrillation , ventricular tachycardia and fibrillation and heart block can arise as a result of ischemia, cardiac scarring, and infarct location. Cardiogenic shock is the largest cause of in-hospital mortality. Heart failure may develop as a long-term consequence, with an impaired ability of heart muscle to pump, scarring, and increase in size of the existing muscle.
Risk factors for complications and death include age, hemodynamic parameters such as heart failure , cardiac arrest on admission, systolic blood pressure , or Killip class of two or greater , ST-segment deviation, diabetes, serum creatinine , peripheral vascular disease , and elevation of cardiac markers.
Myocardial infarction is a common presentation of coronary artery disease.
The World Health Organization estimated in , that Rates of death from ischemic heart disease IHD have slowed or declined in most high-income countries, although cardiovascular disease still accounted for one in three of all deaths in the USA in In contrast, IHD is becoming a more common cause of death in the developing world. For example, in India , IHD had become the leading cause of death by , accounting for 1.
Depictions of heart attacks in popular media often include collapsing or loss of consciousness which are not common symptoms; these depictions contribute to widespread misunderstanding about the symptoms of myocardial infarctions, which in turn contributes to people not getting care when they should. At common law , in general, a myocardial infarction is a disease , but may sometimes be an injury. This can create coverage issues in the administration of no-fault insurance schemes such as workers' compensation.
In general, a heart attack is not covered;  however, it may be a work-related injury if it results, for example, from unusual emotional stress or unusual exertion. In some countries or states, a person having suffered from an MI may be prevented from participating in activity that puts other people's lives at risk, for example driving a car or flying an airplane. From Wikipedia, the free encyclopedia.
For other uses, see Heart attack disambiguation. Main article: Acute coronary syndrome. Areas where pain is experienced in myocardial infarction, showing common dark red and less common light red areas on the chest and back. Play media. Further information: Myocardial infarction diagnosis. See also: Electrocardiography in myocardial infarction. Management of acute coronary syndrome. Myocardial infarction complications. September 29, Archived from the original on 24 February Retrieved 23 February American Heart Association.
December 17, Archived from the original on 19 February Retrieved 24 February How Are They Different? Jul 30, Trends in Cardiovascular Medicine. Global atlas on cardiovascular disease prevention and control PDF 1st ed. Archived PDF from the original on European Heart Journal.
Archives of Cardiovascular Diseases. Archived from the original on 18 February Major consequences of illicit drug consumption". Critical Care.
Archived from the original on 11 April Retrieved 10 April Colledge, Brian R. Walker, Stuart H. Ralston; illustrated by Robert Davidson's principles and practice of medicine 21st ed. The Most Expensive Conditions by Payer, ".
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McGraw Hill Education. Harrison's Principles of Internal Medicine. Emergency Medicine Clinics of North America. The American Journal of Medicine. Archives of Internal Medicine. Cleveland Clinic. Archived from the original on 11 July Retrieved 24 May Pathophysiology of Heart Disease: Archived from the original on Retrieved Journal of the American College of Cardiology. Nature Reviews. The Cochrane Database of Systematic Reviews.
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