Acute Myocardial Infarction: Diagnosis, Treatment, and What You Need to Know

Acute myocardial infarction, commonly known as a heart attack, occurs when there is a sudden blockage in the coronary arteries, leading to the death of heart muscle cells. One of the most common symptoms is intense chest pain lasting more than 30 minutes, often radiating to other areas such as the left arm, jaw, or back. This pain is usually accompanied by excessive sweating, shortness of breath, and a feeling of impending doom.

How Is Acute Myocardial Infarction Diagnosed?

Emergency diagnosis typically begins with an electrocardiogram (ECG), which can detect specific changes in heart activity. A hallmark sign of acute MI is ST-segment elevation with a characteristic upward convexity. In some cases, pathological Q waves may also appear on the ECG tracing.

However, even if the initial ECG appears normal, healthcare providers should not rule out the possibility of a heart attack. In such situations, blood tests measuring cardiac biomarkers become crucial. Among these, cardiac troponin is considered the gold standard due to its high sensitivity and specificity. A rapid and significant rise in troponin levels strongly indicates myocardial injury.

The Role of Coronary Angiography

While ECG and blood tests are essential for early diagnosis, the most definitive diagnostic tool is coronary angiography. This procedure provides a detailed view of the coronary arteries, helping doctors identify the location and severity of blockages. Importantly, it also allows for immediate intervention, such as percutaneous coronary intervention (PCI), to restore blood flow.

Treatment Options for Acute Myocardial Infarction

The cornerstone of acute MI treatment is prompt reperfusion therapy to reopen the blocked artery and preserve heart function. The preferred method is emergency PCI, especially when performed within the first few hours of symptom onset. However, if PCI is not immediately available, fibrinolytic (clot-busting) therapy can be a life-saving alternative.

Long-Term Management and Secondary Prevention

Following the acute phase, patients require comprehensive secondary prevention strategies to reduce the risk of future cardiac events. This includes lifestyle modifications, regular monitoring, and medication such as antiplatelet drugs, beta-blockers, statins, and ACE inhibitors. Cardiac rehabilitation programs also play a vital role in recovery and long-term heart health.