Extensive Heart Attack and Types of Myocardial Infarction: How They Differ

Myocardial infarction is the death of an area of heart muscle due to cessation of blood flow through a coronary artery. Let us examine what types of myocardial infarction exist and how they differ.

What myocardial infarction is

The heart is supplied with blood through the coronary arteries, just as a plumbing network supplies a building: shut off the riser and not just one apartment but the entire entrance is left without water. In coronary heart disease, cholesterol plaques accumulate on the artery walls and the lumen narrows. If a plaque ruptures, a thrombus forms around it that blocks blood flow. The myocardium dies without oxygen — this is infarction.

The diagnosis of myocardial infarction is made by ECG and a blood test for troponin.

What types of myocardial infarction exist

The basic division is by ECG result: ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). The first means complete blockage of the artery, the second partial. STEMI is more common in men. Types are also distinguished separately by mechanism: associated with plaque rupture, with increased oxygen demand in bleeding or arrhythmias, with coronary intervention and bypass surgery.

• STEMI — complete occlusion of the artery
• NSTEMI — partial blockage
• Infarction associated with reduced oxygen supply (bleeding, arrhythmias, spasm)
• Infarction associated with cardiac procedures

Symptoms of myocardial infarction

The symptoms of myocardial infarction resemble angina but with a more intense picture: pressure, burning, or pain in the chest that may radiate to the neck, left arm, back, or jaw, shortness of breath, nausea, abdominal pain. The set of symptoms varies: in some the pain is severe, in others mild or absent. A "silent" infarction is more often experienced by older people and patients with diabetes mellitus. Women more often than men report atypical manifestations — pain in the upper back or shoulders, dizziness, unusual fatigue.

Myocardial infarction and ischemic stroke: why the terms are confused

"Myocardial stroke" is an incorrect expression, although it occurs in conversation. Stroke is an acute impairment of blood supply to the brain, myocardial infarction is the death of heart muscle. They have one thing in common: both are based on ischemia, that is, oxygen starvation of tissue due to impaired blood flow. Therefore both conditions are called ischemic, but the organs and consequences are different.

Complications and diagnosis of myocardial infarction

Infarction can lead to heart failure — a condition in which the heart does not pump enough blood — to life-threatening rhythm disturbances or cardiac arrest. Diagnosis includes ECG, blood test for troponin, cardiac ultrasound, angiography, CT or MRI. If an attack is suspected, the person is hospitalized; management depends on the type of infarction and how quickly care is sought.

Call emergency services 103 or 112 immediately if there is squeezing or pressing chest pain radiating to the arm, neck, or jaw, severe shortness of breath, cold sweat and pallor, or the person has lost consciousness and is not responding normally. Do not drive yourself.

This material is for reference: it explains terminology but does not replace consultation with a doctor and assessment of your specific examinations.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer