It would mean a lot to me if you guys can pray for my Dad. He had an MI last night due to a complete blockage in one of his arteries and is currently in the ICU. Had my mom not fought with him to take aspirin and go to the Hospital when she did, he most likely would have died sometime last night. It’s a really trying time and we could use the support.
How do doctors look at ECGs and determine a patient has had a heart attack in the past? Well there is a pattern of evolution of a myocardial infarction seen on an ECG. A sign of an old infarct is the presence of pathological Q waves.
Heart: microscopic section of a 3 day old acute myocardial infarction Unlike the previous slide, which showed the early stages of coagulation necrosis, this slide depicts a heavy neutrophilic infiltrate with destruction of the cardiac fibers. The neutrophils came into the area of the infarct from the periphery, so this should not be confused with liquefactive necrosis. Macrophages will eventually replace the neutrophils and then collagen tissue will be deposited in the area of infarction.
According to a study conducted by Alfred A. Bartolucci, Ph.D. and colleagues from the University of Alabama at Birmingham, aspirin is effective as a preventive medication regiment against “nonfatal myocardial infarction and decreasing total cardiovascular events,” but not against “risk of stroke, CV mortality, and all-cause mortality.”
This topic is particularly alarming to me since both my parents are on a prophylactic (aka preventive) aspirin regime as a way to prevent the onset of stroke. It scares me that the results of this study conclude that aspirin does not effectively reduce the onset of stroke. I am interested in reading the actual study (the link is provided in the article cited above) and deciphering just how the researchers conducted the study. Something that I’m glad I gained from the UCI Program in Nursing Science is the ability to investigate, question, and develop a curiosity for solid evidence.
How does a stroke work? In a nutshell, a stroke is when your brain lacks the oxygen and energy it needs to function and thus begins shutting down. There are two ways this can happen: clogged brain vessels and bleeding brain vessels.
Another name for stroke caused by clogged brain vessels is ischemic stroke. The word “ischemia” comes from the Greek word "iskhein“, meaning ”to restrict". With a clogged blood vessel, the blood is restricted from moving anywhere–particularly, your brain. The majority of all strokes are ischemic.
Another name for stroke caused by bleeding brain vessels is hemorrhagic stroke. That means that a brain vessel popped and thus bled all over the inside of the brain. When there is too much volume in the brain from all the bleeding, more pressure builds up inside the brain and limits normal brain cell activity. It’s similar to how the organs in an obese person are compressed in the abdomen and thus limited in function when there is too much fat buildup in the belly.
ECG Quiz on LearnTheHeart.com - more than 200 ECG tracings with detailed answers. Beginner and expert.
To master ECG interpretation takes time and effort, however the LearnTheHeart.com ECG tutorial is designed to be concise and focused on only what you need to know, yet very thorough. Start by reading through the ECG basics and the different parts of the ECG. Once completed, be sure to read through all of the ECG criteria and review pages to learn how to diagnose specific conditions and rhythms such as myocardial infarctions and chamber hypertrophies. Then go through the 100+ practice ECG quizzes below that have detailed explanations and link to the pertinent explanation pages. Then there are ECG cases which test your ECG interpretation skills in the setting of clinical scenarios. Once completed, a thorough understanding of ECG interpretation will be attained. Keep your skills up by signing up for our ECG Blog.
The ECG quizzes on LearnTheHeart.com are organized as below:
From basic 12-lead ECG tracings to the most bizarre expert level tracings, this ECG test is excellent for all levels of ECG interpretation skills. Nearly 200 tracings are currently included each with detailed explanations and links to relevant topic reviews for each ECG.
Atrial fibrillation, atrial flutter, atrial tachycardia, varying SVTs and junctional rhythms. Every derivation of atrial arrhythmias is included with detailed explanations and links to pertinent reviews.
Rhythms originating in the ventricles such as ventricular tachycardia (monomorphic and polymorphic), ventricular fibrillation and premature ventricular contractions. Some SVT with aberrancy ECG tracings are included to help enhance the discussion of how to diagnose ventricular tachycardia. Detailed explanation are included with links to the relevant topic reviews.
Anterior MI ECGs, inferior MI ECGs, posterior MI ECGs and other ischemic ECG changes. All ECGs have detailed explanations and links to relevant topic reviews. Test yourself on these ECG tracings regularly since quick diagnosis is important.
Unusual ECG findings such as hyperkalemia, other electrolyte disturbances and rare findings. These include hypothermia and rare electrophysiologic conditions. Detailed explanations are provided with links to topic reviews.
These ECG tests are quite extensive, but it is important to complete all of the tracings to attain a full ECG education. Review then once every few months to keep these ECG principles fresh in your mind. Join the LearnTheHeart.com ECG Blog for regular postings of ECG Cases.
Today I had an appointment with my primary care provider (PCP). As I waited to be seen, I saw an issue of WebMD magazine beckoning me to grab it from the shelf. Of the several articles I read (it was a long wait, I might add), a particular one stood out to me–the differences in heart attack symptoms between men and women.
“What is a heart attack, and how is it caused?”
Heart attack, also known as myocardial infarction (MI), occurs when a blood vessel (or vessels), which usually delivers oxygen, energy, and nutrients to the heart, is blocked or occluded by deposits known as plaque.
Plaque can consist of fat, cholesterol, protein, cells used for inflammation, and other substances. As you can see in the photo above, plaque deposits collect along the inner tissue lining of the blood vessel, thus restricting the amount of blood that can flow forward into the heart (this is what you call coronary heart disease).
If the plaque buildup is left untreated, it can eventually burst. The damage on the fibrous cap that surrounds the plaque will trigger the body’s clotting system to produce a blood clot inside the vessel, thus completely blocking the flow of blood.
When the heart is not receiving the blood (thus the oxygen and energy it needs) to function, heart muscle begins to die and becomes too weak to pump blood to the body (this is what you call a heart attack). As a result, you’re losing blood flow to vital organs like the brain.
Once you have heart disease or damage to the heart vessels, you will have that damage for life. Surgery cannot completely cure someone with heart disease.
(For an in-depth photo slideshow on how heart attacks work, check this out.)
So we’re down to the most important bit: how do you recognize a heart attack?
The “typical signs” are often seen in both men and women:
- Pain/discomfort in the chest (can be described as “an elephant crushing my chest”) - Pain/discomfort that extends to the arm, jaw, shoulder, or back - Sweating, nausea, feeling light-headed - Difficulty breathing
Women, however, more often experience the following signs and symptoms that can also be indicative of heart attack:
- Indigestion or gas-like pain - Dizziness or nausea - Unexplained weakness or fatigue - Pain/discomfort between the shoulder blades - Recurring chest discomfort - Sense of impending doom
The bottom line: Do not “tough it out”, ignore symptoms, or wait to get treatment, especially if you or someone you know is experiencing the symptoms listed above. They say that “time is muscle” and that every minute counts toward saving someone from an MI.
“How can I become healthy and reduce my chances of getting a heart attack?”