CAUSES AND PREVENTION
MYOCARDIAL INFARCTION: Myocardial infarction is a cardiovascular disease that affects
the circulatory system (blood vessels or the heart).
It is the necrosis of the myocardial muscle cells of the
heart due to the lack of blood supply due to blood clot (obstruction) or
stenosis in the coronary artery. The blood supply is blocked. It is usually an
acute phenomenon.
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Cardiovascular
diseases are the first cause of death in
developed countries - 31.2% of those that take place in Spain. The main cause
of these deaths is myocardial infarction (more than 50% of total cardiovascular
mortality).
Myocardial infarction primarily affects the left
ventricle, but the injury may extend to the right ventricle or the atria.
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The process to understand how myocardial
infarction occurs is:
/ Coronary arteries narrow for different reasons.
/ Oxygen doesn’t reach the myocardium.
/ The heart muscle cannot produce energy to move.
/ Myocardial cells die because they do not receive blood,
so they become necrotic.
https://youtu.be/_WXxET_DzE4
In general terms, we can say that there are two types of heart attacks:1. ST-segment elevation Q-wave
myocardial infarction. It occurs when a major coronary artery is affected for a
prolonged period of time. This leads to the death of a large area of the
heart.
2. Non-ST-segment elevation non-Q wave myocardial infarction (also known as NSTEMI or a non-STEMI). The lack of irrigation affects the smaller arteries of the heart. A smaller area of the heart dies and has a better prognosis.
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CAUSES
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o
The
most common cause it the formation of fatty deposits on the walls of the
blood
vessels that supply the heart knows as atherosclerosis that occurs
progressively.
o
It can
also be narrowed by the deposit of a blood clot
- Others: there may be myocardial infarctions as a result of:
o
An
infection of the coronary arteries
o
Vasculitis
o
Cocaine
use
o
Heart
trauma
As I said before, the most frequent cause is the
formation of fatty deposits on the walls of the blood vessels that supply the
heart. Myocardial infarction is the
consequence of the development of coronary arteriosclerosis (chronic and
progressive process). The arteries become obstructed by atherosclerotic
plaques. When one of these plates ruptures or breaks off, it forms a small clot
(thrombus) that completely blocks the flow of blood.
Heart attacks therefore usually occur in those patients
with risk factors (which increase
the probability of developing a disease) for the development of
arteriosclerosis, such as:
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- * The male sex
- * Unhealthy diet
- * Elevation of bad cholesterol (LDL)
- * The decrease in good cholesterol (HDL)
- * Physical inactivity
- * Overweight or obesity - especially abdominal obesity this is, from the point of view of cardiovascular health, the most dangerous type of obesity
- * Smoking
- * Harmful use of alcohol.
- * Diabetes
- * High blood pressure
Heart attacks are often caused by a combination of risk factors, most of the times, the heart attack
isn´t due to a single factor, but to several. In these cases, the
cardiovascular risk resulting from these factors is not a sum of them, but is multiplied. The combination of several risk factors in the same
individual together with abdominal obesity has been called metabolic syndrome and is
becoming a more frequent and worrying reality.
PREVENTION
It has been proved that these factors can
reduce
the risk of suffering a myocardial infarction:
- / Not
smoking
- / Have a healthy and heart-healthy diet: reduction of salt in the diet, consumption of fruit and vegetables…
- / Do regular physical activity: for example walk quickly 30 to 60 minutes a day, at least 5 days a week
- / Avoid stress
- /Not being overweight: to avoid abdominal obesity, men should keep their waist circumference below 102 cm and women below 88 cm.
- / Avoid excessive alcohol intake.
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- From the age of 40 it is recommended to go to the doctor
to know the risk factors of each one. With the measurement of blood pressure
and a blood test, it is possible to know if blood pressure, lipids and glucose
are within normal parameters
There are two types of interventions to reduce cardiovascular disease:
1. Population interventions:
/ Comprehensive tobacco control policies
/ Taxes to reduce the consumption of foods with a lot of
fat, sugar and salt
/ Strategies to reduce harmful use of alcohol
/ Construction of resources to promote physical activity:
It is necessary to create conducive environments and publicize the importance
of adopting healthy behaviors for our health.
/ Campaigns on the importance of having a healthy diet.
In Spain there is the "Spanish Heart
Foundation" whose objectives are: to promote education, prevention and
research on cardiovascular health in society. It also spreads heart-healthy
lifestyle habits.
2. Individual
interventions: preventive health interventions should focus on people
with risk factors. It is necessary that people who have diseases such as
diabetes, hypertension or hyperlipidemia, receive their pharmacological
treatment in order to reduce cardiovascular risk.
In 90% of heart attacks, an avoidable and reversible cardiovascular risk factor such as smoking, unhealthy diet and lack of exercise can be identified. According to Dr. Alfonso Varela Román: “80% of the risk of heart attack can be eliminated just by quitting smoking, with regular physical exercise and a healthy diet, rich in fruits and vegetables, which is not difficult or expensive. It is not necessary to spend money on medicines, but to make a change in life habits and become aware that it should be like this"
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