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In patients with symptoms typical of myocardial ischemia an electrocardiogram must be immediately obtained - e.g., within 10 minutes from first contact with medical or paramedical personnel, including prehospital setting; the electrocardiographic findings will guide the subsequent management.
Myocardial infarction (MI) refers to tissue death of the heart muscle caused by ischemia, the lack of oxygen delivery to myocardial tissue. It is a type of acute coronary syndrome , which describes a sudden or short-term change in symptoms related to blood flow to the heart. [ 22 ]
Coronary ischemia, myocardial ischemia, [1] or cardiac ischemia, [2] is a medical term for abnormally reduced blood flow in the coronary circulation through the coronary arteries. [3] Coronary ischemia is linked to heart disease, and heart attacks. [4] Coronary arteries deliver oxygen-rich blood to the heart muscle. [5]
The TIMI risk score can identify high risk patients in ST-elevation and non-ST segment elevation MI ACS [30] [31] and has been independently validated. [32] [33] Based on a global registry of 102,341 patients, the GRACE risk scoreestimates in-hospital, 6 months, 1 year, and 3-year mortality risk after a heart attack. [34]
Ischemic cardiomyopathy is a type of cardiomyopathy caused by a narrowing of the coronary arteries which supply blood to the heart. [4] Typically, patients with ischemic cardiomyopathy have a history of acute myocardial infarction, [5] however, it may occur in patients with coronary artery disease, but without a past history of acute myocardial infarction.
Also known as 'effort angina', this refers to the classic type of angina related to myocardial ischemia.A typical presentation of stable angina is that of chest discomfort and associated symptoms precipitated by some activity (running, walking, etc.) with minimal or non-existent symptoms at rest or after administration of sublingual nitroglycerin. [11]
Symptoms include chest pain or angina, shortness of breath, and fatigue. [6]A completely blocked coronary artery will cause a heart attack. [6] Common heart attack symptoms include chest pain or angina, pain or discomfort that spreads to the shoulder, arm, back, neck jaw, teeth or the upper belly, cold sweats, fatigue, heartburn, nausea, shortness of breath, or lightheadedness.
Patients often experience myocardial ischemia symptoms, such as heaviness, tightness, pressure or squeezing in the chest area, which can also include sweating, nausea, shortness of breath (dyspnea), fatigue. [5] While there is no formal definition of microvascular angina, the general consensus is that it entails all of the following:
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