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Updated on July 27, 2009

heart attack

Heart attack
Heart attack (infark miokardial), (myocard infarct), (miokard infark) is a situation where a sudden there restrictions or termination of blood flow to the heart, which cause the heart muscle (miokardium) die because of lack of oxygen.

Infark miokardial

Heart attack usually occurs when a coronary arterial sumbatan on the cause or the limited dissolution of blood flow to a part of the heart.
If dissolution or reduction of blood flow is held more than a few minutes, the heart of the network will die.

Pumping ability of the heart after a heart attack is directly related to the area and location of damage to the network (infark).
If more than half the network were damaged heart, usually the heart can not function and possible death occur. Even though kerusakannya not knowledgeable, the heart is not capable of pumping well, so that heart failure occurs or shock.

A damaged heart can swell, and some business is the heart's ability to mengkompensasi the memompanya decreased (due to the greater heart will beat stronger).
The heart of the draw is also a picture of the damaged heart muscle itself. Heart enlargement after a heart attack to give a worse prognosis.

# The cause of heart attack are: A clot from the heart itself.
Sometimes a clot (embolus) in the form in the heart, and get caught and broken in the coronary arterial.
# Strain at which the arterial coronary blood flow interruption.
This strain may be caused by drugs (like cocaine) or because of smoking, but sometimes it is not known.

Approximately 2 out of 3 people who have experienced heart attack, a few days before the occurrence of attacks of chest pain to feel lost-relief, shortness of breath or fatigue.
Chest pain more often appear even after a mild physical activity. Unstable angina, such as this can end a heart attack.

In the mid-chest pain spreading to the back, jaw or left arm, or a more rare sweep to the right arm.
Pain can occur in places without chest pain at all.

Pain in heart attack similar to the angina pain but more intense and longer, does not decrease with the rest and nitroglliserin.
Sometimes the pain is felt in the stomach and disalahartikan as a meal, especially because after a bit of pain belch reduced or lost for a while.

The other is feeling symptoms such as fainting and heart akan pulse.
Abnormal heart rhythm (aritmia) can affect the pumping ability of the heart or can cause cardiac arrest (heart stops pumping effectively), so that awareness of a decline or death.

During attacks, patients may feel nervous, anxious and sweaty and can feel one's fate will soon arrive.
Lips, hands and feet appear kebiruan.
Of old age can experience disorientation (weak).

As many as 1 of 5 people who have experienced heart attack, have only mild symptoms or no symptoms at all
Heart attack such as this can only be identified from routine EKG examination some time later.


Complications that often happens is ruptur miokardial, blood, aritmia (heart rhythm disturbances), heart failure or shock or perikarditis.

Ruptur miokardial

Heart muscle is damaged, will be weak, so sometimes the hole because the pressure of the heart pump action.
2 the heart of the split often during or after a heart attack is heart muscle wall, and muscles that control the opening and closing one of the heart valve (valve mitralis).
If ototnya tear, the valve can not functioning so that a sudden going to fail a heavy heart.

Heart muscle in the walls that limit both ventrikel (septum) or the muscle on the outside wall of the heart can also rip. Split septum can be repaired sometimes through surgery, but the hole in the wall outside is almost always cause death.

Heart muscle is damaged because of heart attack will not berkontraksi well despite not having hole. The damaged muscle is replaced by scar network fibrosa rigid and can not be berkontraksi. Sometimes this section will fill up at the time should berkontraksi.
To reduce the extent of this can not work given ACE-inhibitor.

The damaged muscle can form a small projection on the wall of the heart (aneurisma). There is aneurisma could be a description of the EKG is not normal, and to strengthen the allegations of this can be done ekokardiogram.
Aneurisma akan not have split, but it can cause heart rhythm is not regular and can cause reduced heart pumping ability.
Aneurisma through which blood will flow more slowly, because the clot can form in the spaces in the heart.


At approximately 20-60% who had experienced heart attack, blood clot form in the heart. At 5% of patients, the clot can be broken, in the arterial flow and blood vessel involved in a smaller in the body, causing blood to flow tersumbatnya part of the brain (causing stroke) or to other organs.
To find the clot in the heart or predisposisi to know the factors that are owned by people, conducted ekokardiogram.

To help prevent blood clot formation is often given antikoagulan (such as heparin and warfarain).
This medicine is usually taken for 3-6 months after the heart attack.

If a man over 35 years old or a woman over 50 years complained chest pain, usually considered the possibility of a heart attack.
Diagnosis heart attack can be conducted with the following checks:

    1. EKG
       Occurs when a suspected heart attack, the EKG is an early diagnostic pemeriksan the most important.
       Some deviation can be seen on the EKG, depending on the size and location of heart damage.
    2. Examination of blood
       Blood examination is done to determine the degree a particular enzyme.
       Enzyme CK-MB in normal circumstances is found in heart muscle and released into the blood when heart damage occurs. Increasing the degree akan this enzyme appear within 6 hours after the heart attack and settled for 36-48 hours. Enzyme level is usually checked at the entrance of the hospital and every 6-8 hours during the next 24 hours.
    3. Ekokardiogram
       Ekokardiogram akan reflect the reduced movement of part of the wall ventrikel left (space the heart to pump blood throughout the body), which is an indication of damage due to heart attack.
    4. Radionuclide imaging.
       Delineation with radionuklida can show reduced blood flow to a part of the heart muscle, which is an indication of scar network (network off) due to heart attack.

Heart attack is an emergency.
Half the deaths due to heart attack occur within 3-4 hours after the first symptoms. The aid is given quickly, the more likely people can tertolong.

A person suspected of having heart attacks are usually treated in heart care unit, and to assess the damage to the heart, be strict monitoring of heart rhythm, blood pressure and the amount of oxygen in the blood.

Start treatment

Usually immediately given a tablet of aspirin must be chewed.
Giving this drug will reduce the formation of blood clot in the coronary arterial.

Beta-blocker given to slow heart rate and heart that does not work too heavy pumping blood throughout the body.
Oxygen is often given through sungkup face or a small hose that is inserted into the nostril. With the delivery of oxygen, the oxygen pressure in the blood will be increased so that more oxygen to the heart and the heart may be damaged.

If a stoppage in the coronary arterial can be overcome, then the heart of the network can be saved.
In arterial blood clot can often dilarutkan with trombolitik therapy, namely by giving streptokinase, urikinase and aktivator plasminogen network. To be effective, this drug is given intravena within 6 hours after the symptoms of heart attack, because if it is more than 6 hours, some damage is akan settle.

Early treatment to improve blood flow in the 60-80% sufferer and can minimize the damage to the heart of the network.
Aspirin (to prevent the formation of platelet clot) or heparin (stop bleeding) can increase the effectiveness of therapy trombolitik.

Trombolitik therapy can cause bleeding, so are not usually given to patients who:
- The alimentary tract bleeding
- Have high blood pressure is heavy
- New suffering stroke
- New undergo surgery.
Elderly people who do not have the conditions mentioned above, can undergo therapy trombolitik secure.

Some hospitals use angioplasti or coronary arterial bypass surgery immediately after the heart attack.
Nitroglycerin can overcome the pain by reducing the burden of heart, and is usually given initially in intravena.

If the drug is used to increase coronary arterial blood flow was not successfully reduce the symptoms of heart attack, morphine injections are usually given.
Morphine is also a sedative, and reduce the burden of heart.

Advanced Medicine

Someone who has a new heart attack, tirah have to lie in a quiet room for several days, due to excitement, physical activity and emotional stress can aggravate heart work.
Softener and laxative feces can be used to prevent constipation.

Fear and depression often occur after a heart attack. Worries can be a heavy burden the heart, so that given tranquilizer.
ACE-inhibitor routinely given to reduce heart enlargement, which often occur after a heart attack.


Most patients who survive for several days after a heart attack may experience total healing, but about 10% died within 1 year.
Death occurred within the first 3-4 months, especially in patients who have angina again, aritmia ventrikuler and heart failure.


Rehabilitation of heart is an important part in the process of healing.
Fixed lie in bed more than 2-3 days will cause interruption and physical activity sometimes cause depression and a sense of dependency.

On the third or fourth day after the heart attack, the patient gradually trained to sit, to passive activities, walk to the bathroom and doing activities that do not cause stress (eg, reading).
After 3-6 weeks, the patient should slowly increase activity.
If there is no shortness of breath and chest pain, normal activities can be carried out again after about 6 weeks.

# Wherever possible to reduce the factors that cause coronary arterial disease, especially that can be changed by people with: Stop smoking
# Reduce weight
# Controlling blood pressure
# Lowered blood cholesterol level with diet or with medication
# Doing exercise regularly.

Heart Attack


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