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Heart attack    See images

Overview | Symptoms | Treatment | Prevention

Alternative names:

Myocardial infarction; MI; Acute MI

Symptoms

• Chest pain below the sternum (breastbone)
• Back pain
• Abdominal pain
• Painthat radiates:
  • to the chest, arms, shoulder (See shoulder pain)
  • to the neck, teeth and jaw (See toothaches, face pain)
  • to the back
• Pain that is prolonged, typically greater than 20 minutes
• Pain similar to angina, but not relieved by rest or nitroglycerin
• Any prolonged chest pain, back pain, or abdominal pain
• Pain that may be described as:
  • "bad indigestion"
  • intense, severe, subtle, or absent
  • squeezing or heavy pressure
  • a tight band on the chest
  • "an elephant sitting on my chest"
• Sudden shortness of breath that may or may not be accompanied by pain
• Cough
• Light-headedness - dizzy
• Fainting
• Nausea
• Vomiting
• Sweating, which may be profuse (diaphoresis)
• Dry mouth
• Feeling of "impending doom"
• Anxiety

Additional symptoms that may be associated with heart attack:

• Seizures
• Fatigue
• Breathing, absent temporarily
• Breathing difficulty when lying down
• Low blood pressure
• Unusual or strange behavior

Note: The victim commonly denies that he or she may be having a heart attack. The person may have no symptoms (i.e., having a "silent attack")

Signs and Tests

Examination often reveals a rapid pulse. Blood pressure may be normal, high, or low. Listening to the chest with a stethoscope (auscultation) may show crackles in the lungs, heart murmur, or other abnormal sounds.

Heart attack and the extent of heart damage may also show on the following tests:

• An electrocardiogram (ECG), single or repeated over 2 to 3 days
• Coronary angiography
• Nuclear ventriculography (MUGA or RNV)
• Echocardiography
• Treadmill

The by-products of heart damage and factors indicating high risk for heart attack may show on the following tests:

• CPK
• CPK isoenzymes
• Troponin
• LDH
• LDH isoenzymes

This disease may also alter the results of the following tests:

• Aldolase
• Apolipoprotein B100
• Apolipoprotein CII
• AST
• BUN
• Chem-20
• Cholesterol test
• Heart MRI
• Lipids - serum
• Myoglobin - serum
• Myoglobin - urine

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