Table of contentsIntroductionBodyConclusionIntroductionThe World Health Organization (WHO) has announced that cardiovascular diseases are the leading cause of death in developed countries. This is a general term used to refer to conditions affecting the heart and blood vessels. Although it is a largely preventable and predictable disease, it and stroke claimed the lives of 15.2 million people in 2016 alone. Coronary heart disease is a spectrum of interrelated diseases: stable angina, unstable angina, diffuse coronary insufficiency and myocardial infarction. In this essay, I will describe myocardial infarction (MI), how it develops, what parts of the body it affects, how a case of MI presents, i.e. its clinical features and finally, what are the risk factors and incidence rates between different groups of people. . I will also add a note on the differential diagnosis of MI and the altered effect of diabetes mellitus on patients with MI while simultaneously explaining the fatigue experienced by patients. But before discussing these points, I will mention the basic anatomy and physiology of the heart and coronary vessels to understand the subject better. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get the original essay BodyThe heart is a muscular organ located in the center of the chest, below the sternum, tilted slightly to the left. It is the central element of the cardiovascular system. It is about the size of a closed fist, although it differs in shape. The heart rests on the diaphragm, a skeletal muscle that separates the thoracic and abdominal cavities. It is easiest to visualize the heart as a cone lying on its side. It pumps all of the body's blood to the lungs first, where oxygen from the alveoli diffuses to the red blood cells, and then to the entire body, including the heart itself. It carries this blood through a closed system of blood vessels, the first and most important being the aorta. Two coronary arteries, the left and right coronary arteries, branch off from the ascending aorta and supply oxygenated blood to the heart muscles, i.e. the myocardium. The left coronary artery divides into two main branches, the anterior interventricular branch (left anterior descending branch: LAD) and the circumflex branch. While the two main branches of the right coronary artery are the right marginal branch and the posterior descending artery. These arteries surround the heart in a way that resembles a crown, hence the name “coronary” arteries. Clinically, doctors use alternative names for the coronary vessels. The short left coronary artery is called the left main stem vessel. One of its main branches, the anterior descending artery, is called the left anterior descending (LAD) artery. Similarly, clinicians call the terminal branch of the right coronary artery, the posterior descending artery, the posterior descending artery (PDA). Now that we have reviewed the basic anatomy of the heart and its simplified vascular system, we can move on to our own topic, our topic being the presentation of myocardial infarction, a heart disease. Coronary artery disease is one of the leading causes of heart disease. As mentioned, the coronary arteries supply the myocardium with oxygenated blood. Therefore, for the heart to function properly and properly, we need the blood from these arteries to reach the muscles without blockage or obstruction. Atherosclerosis is a disease of the arteries wherethey are blocked by fatty deposits called plaques, also called atheroma. This causes stenosis, a narrowing of the arteries, which decreases blood perfusion to target tissues. This is a major, life-threatening condition, especially when the narrowed artery leads to a sensitive organ like the heart or brain. Although initially this disease rarely has any symptoms, if left untreated, can progress to other life-threatening illnesses such as coronary heart disease, which is a spectrum of diseases ranging from angina to Unstable angina induced by ischemia, then myocardial infarction due to almost complete obstruction of the coronary arteries. Infarction (MI), or heart attack, is one of the most common causes of heart failure. A typical MI usually occurs when an atherosclerotic plaque ruptures and forms a blood clot that blocks a coronary vessel. Myocytes that received blood from the blocked vessel have several outcomes. Collateral channels can completely alleviate the effect of stenosis. Sometimes collaterals can supply enough blood during inactivity, but fail to keep up during exercise. This usually leads to angina, also called angina, which is pressure, squeezing, tightness, or pain in the chest. When cardiac ischemia or reduced blood flow to the heart occurs, the coronary arteries become narrowed. Myocardial ischemia is caused by a combination of fixed vessel narrowing and endothelial obstruction. This leads to an imbalance between cardiac output and demand. There may even be nonatherosclerotic causes of ischemia, such as low perfusion due to low blood pressure, decreased blood oxygen in anemia and lung disease, and significantly increased cardiac oxygen demand, such as in acute tachycardia and acute hypertension. . Obstruction of the venous and arterial sides can lead to necrosis of myocardial tissue. We call this a heart attack. There are three crucial factors that determine the severity of ischemia, decreased perfusion of a tissue, and whether it will lead to myocardial infarction. The speed of onset is a major factor: if the obstruction is rapid, the effects are much more serious than if it is gradual. Another factor is the extent of the obstruction. The higher the occlusion percentage, the more serious the effects. The last factor is the time it takes for the arteries to form collateral channels, so the age of the person is a good determinant of the intensity of the effects of ischemia, that is to say that the more the The older the patient, the more time they have had to form collateral channels, therefore the higher the probability of suffering less damage. When part of the heart muscles die, they are replaced by fibrous tissue, sometimes called scar tissue. This fibrous part is rigid and does not work in harmony with the myocardium, so it reduces cardiac contractility. The heart is a resistant organ. Even if he takes a lot of damage, he can still survive. Moving on to the risk factors for MI and its prevalence in certain groups, epidemiologists divide them into three groups of factors: major static risk factors, major modifiable risk factors, and contributory risk factors. Age is a major factor. The majority of people who die from a heart attack are aged 65 or older. Gender is also an important static factor, since men are more likely to suffer a heart attack than women. Women without hormonal imbalance suffer from MI after reaching menopause, which is on average 51years. The last non-modifiable factor is genetic: children of patients with MI are more likely to suffer from it. There is also a pattern of inheritance across races: for example, African Americans have higher blood pressure and are more likely to suffer from heart disease than Caucasians. Now let's move on to the main modifiable factors, one of them being smoking. The risk of smokers developing coronary heart disease is much higher than that of non-smokers. Smoking also interacts with other risk factors and worsens the effects of both. Cigarette smoke will affect anyone who inhales it, including non-smokers. Hyperlipidemia, another modifiable factor, is the amount of fat in the blood. Higher than normal cholesterol and triglyceride levels increase the risk of coronary heart disease. Another factor from the same category is high blood pressure. High blood pressure increases the work the heart has to do, making it thicker and stiffer. This causes the heart to function abnormally. A sedentary lifestyle also increases the risk of MI because when the body's activity levels are high, blood cholesterol levels drop and can even lower blood pressure. Another factor is diabetes. Diabetes poses a major risk for developing heart disease, even when blood sugar levels are under control. The risk is even greater if blood sugar levels are not controlled. Obese and overweight people should work to make lifestyle changes to lose weight, including exercising and/or eating better. Contributing factors include stress, alcohol, nutrition and diet, all of which are secondary and minor influences. When talking about the manifestation of heart attacks in patients, the most symbolic presentation is the clenched fist in the center of the chest, signifying the intense, crushing retrosternal pain they feel. The most cardinal symptom of MI is chest pain accompanied by fatigue, but shortness of breath, vomiting, and collapse or syncope are common features. The pain occurs in the same place as angina, but it is usually more intense and lasts longer; Patients often describe it as chest constriction. Typical cases of MI present with chest discomfort and a general feeling of illness before the heart attack. Chest pain experienced during MI is dull, nonlocalized, and vague, meaning the patient cannot identify the exact origin of the pain. It is typical for the pain to be located in the center of the chest, however, this pain may radiate to the upper arm and left shoulder, lower neck, jaws and rarely to the lower arm and back. In some cases, it may appear only in the irradiated areas and not in the chest itself. Heart pain is usually caused by exertion, exercise, stress and heavy meals. The pain is usually relieved by rest after a few minutes of intense discomfort. Unlike cardiac pain, pleural or pericardial pain is described as a sharp sensation made worse by breathing, coughing, or movement. Pain associated with a specific movement (bending, stretching, and rotating) is likely musculoskeletal in origin. The MI usually takes a few minutes to develop. Likewise, angina gradually accumulates in proportion to the intensity of the effort. Pain that occurs after, rather than during, exercise is more likely to originate from the musculoskeletal system or a psychological abnormality. In addition to symptoms and signs, constitutional effectsaccompany heart attacks of significant magnitude. Fever is one of these effects, along with the release of enzymes from necrotic tissue into the bloodstream, which can help with diagnosis. A small infarction simultaneously triggers short- and long-term compensatory mechanisms. Short-term events help maintain production until long-term pathways have had time to fully activate. There are local and central short-term reflexes. Disruption of blood flow to myocytes results in increased levels of interstitial metabolites (e.g., adenosine, potassium cation, carbon dioxide, lactate). Any resistance in the immediate vicinity expands reflexively through local vascular control mechanisms. Collaterals are normally contracted, but they also participate in the vasodilator response due to increased metabolite levels. Blood flow through collaterals may allow peripheral areas of a focal infarct to survive the initial ischemic event. Myocyte death impairs myocardial contractility, reducing left ventricular stroke volume and cardiac output. As a result, mean arterial pressure (MAP) decreases. If the infarct is small, these pathways may be sufficient to restore MAP. Some patients with MI feel tired all the time. Fatigue is a condition characterized by diminished work capacity and reduced productivity, usually accompanied by feelings of lethargy and fatigue. Chronic fatigue is more or less associated with having had a myocardial infarction or heart disease in general. Studies on this topic divide fatigue into smaller components such as general fatigue, mental fatigue, reduced motivation, and reduced activity. Fatigue is also part of an adaptive spectrum with fatigue and exhaustion as the starting and ending points respectively, with each state being a response to stimulants. To identify the underlying causes of post-myocardial infarction fatigue, we need to look at it from multiple angles. It could have physiological causes due to disease, increased cardiac enzymes, damaged heart muscle, impaired electrical and neuronal transmissions, and a compromised immune system. As diabetes is a major modifiable risk factor for MI, we should also talk about the presentation of diabetes in patients. to further expand our diagnostic capabilities. Diabetes mellitus (derived from the Greek word diabetes, meaning to cross, and the Latin word mellitus, meaning sweet or honeyed) is a disease in which the human body does not have the resources to store and use glucose, a sugar-producing monosaccharide. energy. cells. This causes blood sugar levels to skyrocket. Insulin is the hormone responsible for storing glucose as glycogen, the stored form of glucose. Glycogen is a multibranched polymer of glucose that accumulates in response to insulin and is degraded in the presence of glucagon. The glucagon antagonist hormone is insulin. Insulin facilitates the entry of glucose into cells, because glucose cannot enter cells on its own without special transporters. Specialized cells called beta islet cells in the pancreas produce insulin. Any problem with these cells will cause an inappropriate amount of insulin to circulate in the bloodstream. There are two types of diabetes; type 1 and type 2. Type 1, also known as insulin-dependent diabetes, occurs when an autoimmune reaction in which the patient's immune system attacks the insulin-secreting cells of the pancreas, destroying them. This causes.