Myocardial Infarction

Myocardial Infarction

Myocardial Infarction
Myocardial infarction (MI) is ischemic necrosis of the heart muscle caused by an acute disruption of its blood supply. It is one of the most dangerous cardiovascular diseases and remains one of the leading causes of death worldwide.
According to statistics, most cases occur in individuals aged 45–65. Men tend to develop the disease at a younger age than women. In recent years, due to preventive measures in developed countries, the incidence of infarction has somewhat decreased, but it remains a major global health problem.

Etiology and Risk Factors

The main cause of myocardial infarction is atherosclerotic damage to the coronary arteries. After rupture of an atherosclerotic plaque, a thrombus forms, blocking the artery and leading to myocardial ischemia.

The main risk factors are:

• High blood pressure.
• High cholesterol or lipid disorders.
• Diabetes mellitus.
• Smoking.
• Overweight and physical inactivity.
• Age, especially over 50.
• Stress and unhealthy lifestyle.

Clinical Picture

1. The main symptom of MI is a compressive, burning, or pressing chest pain lasting more than 20 minutes.
2. The pain may radiate to the left arm, neck, lower jaw, or back.
3. It is often accompanied by cold sweats, weakness, shortness of breath, and nausea.
4. In elderly patients and those with diabetes, pain may be mild or absent.

Classification

Myocardial infarction is classified according to several principles.
1. Based on ECG findings:
• ST-segment elevation MI (STEMI).
• Non-ST-segment elevation MI (NSTEMI).
2. Based on localization:
• Anterior wall infarction.
• Posterior wall infarction.
• Lateral, inferior, or extensive infarction.
3. Based on stages:
• Early stage — first 24 hours.
• Acute stage — up to 7 days.
• Subacute stage — up to 4 weeks.
• Chronic stage — formation of myocardial scar.

Diagnosis

1. Diagnosis is based on three main criteria:
• Typical clinical symptoms.
• ECG changes — ST-segment elevation or depression, Q-wave formation.
• Elevated biochemical markers of myocardial injury (Troponin I/T, CK-MB).
2. Echocardiography helps detect areas of segmental hypokinesia or akinesia.

Complications

The complications of acute myocardial infarction are divided into early and late stages.
Early Complications (from the first hours to the first days)
1. Arrhythmias:
• Ventricular tachycardia or fibrillation.
• Atrioventricular block.
• Sinus bradycardia or tachycardia.
2. Heart failure:
• Acute left ventricular failure.
• Pulmonary edema.
3. Cardiogenic shock.
4. Myocardial rupture (often on the 3rd–5th day):
• Free wall rupture leading to cardiac tamponade.
• Ventricular septal rupture.
• Papillary muscle rupture leading to acute mitral insufficiency.
5. Early fibrinous pericarditis.
Late Complications (weeks to months)
1. Myocardial aneurysm, acute or chronic.
2. Impaired ejection of blood from the heart.
3. Thrombosis in the aneurysmal cavity.
4. Thromboembolic complications — cerebral stroke or pulmonary embolism.
5. Late pericarditis (Dressler’s syndrome) of autoimmune origin.
6. Chronic heart failure.
7. Recurrent infarction or ischemic attacks.

Treatment

The main goal of treatment is to restore coronary blood flow as quickly as possible to prevent myocardial damage. Coronary angiography is considered the “gold standard” because it identifies the occlusion site and allows restoration of circulation. Thrombolysis is most effective during the first hours after onset, while percutaneous coronary intervention (PCI, stenting) is the preferred method. If PCI is not possible, coronary artery bypass grafting (CABG) is performed.
Additional medications are used, including morphine for pain relief, antiplatelet therapy with aspirin and P2Y12 inhibitors, heparin for anticoagulation, as well as beta-blockers and ACE inhibitors to reduce cardiac workload. This comprehensive approach lowers the risk of complications and improves recovery outcomes.

Prevention

Secondary prevention is essential after myocardial infarction to reduce the risk of recurrence and complications. Patients should remain under regular cardiologist supervision, with strict control of blood pressure, glucose, and lipid levels. Cardiac rehabilitation exercises play an important role in restoring cardiac function. Prescribed medications must be taken consistently and according to medical recommendations.
Myocardial infarction is a severe but controllable disease if diagnosed and treated in time. Early detection and appropriate therapy can save lives and prevent complications. Prevention begins with every individual — through a healthy lifestyle and regular medical check-ups.
What is an AMH test?
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An AMH test measures the level of anti-müllerian hormone in your blood. This hormone is produced by the small follicles in your ovaries and reflects the number of eggs you have — your ovarian reserve. Higher AMH levels usually suggest more available eggs, while lower levels indicate fewer remaining eggs or a naturally declining reserve with age. Although AMH provides valuable insight into egg quantity, it cannot predict how easily you can get pregnant, whether fertility treatment will work or when menopause will begin. Healthcare providers use AMH testing to get a clearer picture of reproductive health. It helps determine if your ovaries are aging faster than expected, estimate how well you may respond to fertility medications and prepare for treatments such as IVF, where multiple mature eggs are needed. AMH can also be useful in identifying or tracking certain ovarian tumors, including granulosa cell tumors. AMH levels rise through adolescence, peak in your mid-20s and gradually decrease as you age. Typical levels range from 1.0 to 3.0 ng/mL, while anything below 1.0 is considered low. Levels may vary slightly depending on the laboratory equipment used. What an AMH test is used for: • Evaluating ovarian reserve, reproductive aging and potential response to fertility treatments like IVF. • Helping diagnose or monitor ovarian masses, especially granulosa cell tumors. The AMH test is a simple blood test that can be performed at any point in the menstrual cycle because AMH stays relatively stable throughout the month. You don’t need to prepare beforehand. If your sample is processed by a laboratory, results typically return within a few days. While at-home AMH kits are available, a specialist should always interpret the results. Fertility is influenced by many factors, including age, ovulation patterns, sperm quality, blocked fallopian tubes, pelvic conditions and uterine abnormalities — none of which AMH can measure. What an AMH test cannot tell you: • Your ability to conceive naturally, your exact fertility potential or the age you will reach menopause. • Other major fertility factors such as sperm count, ovulatory problems, fallopian tube blockage, endometriosis or uterine fibroids. In summary, an AMH test offers valuable information about your ovarian reserve, but it is only one part of the bigger fertility picture. Understanding your results with a qualified specialist ensures you get accurate guidance and a personalized plan for pregnancy or treatment options.
What Is Bradycardia?
11 December 2025
Bradycardia means your heart beats slower than normal — fewer than 60 beats per minute. For many people, especially athletes or those who are asleep, this can be completely normal. But sometimes a low heart rate signals a problem with the heart’s electrical system and may prevent the body from getting enough oxygen-rich blood. Many people with bradycardia feel no symptoms at all. Others may experience dizziness, fainting, unusual fatigue, shortness of breath or trouble concentrating. These symptoms appear when the heart isn’t pumping enough blood to meet the body’s needs. Even if you feel well, it’s important to talk to a healthcare provider if you notice that your heart rate is consistently lower than usual. Common causes include: • Age-related changes in the heart’s electrical pathways, electrolyte imbalances, underactive thyroid, sleep apnea and infections such as Lyme disease. • Heart conditions like cardiomyopathy or previous heart attacks, as well as certain medications including beta-blockers and calcium channel blockers. To diagnose bradycardia, doctors typically start with an electrocardiogram (ECG), though additional monitoring may be needed because slow heart rate episodes can come and go. Blood tests, echocardiograms, stress tests and sleep studies help identify underlying problems. Treatment depends on the cause. Sometimes adjusting medications or treating thyroid issues, infections or other conditions is enough to correct the heart rate. In more serious cases where the heart’s electrical system isn’t functioning properly, a pacemaker may be needed. If a person is healthy and has no symptoms — as is often the case with athletes — treatment might not be necessary. Seek emergency care if: • You have a low heart rate with chest pain, severe dizziness, difficulty breathing or fainting. • Your heart rate drops below 40 beats per minute and this isn’t normal for you. Bradycardia is often treatable and sometimes temporary. With early diagnosis and proper care, most people have a good outlook.
Benefits of a house call doctor
03 December 2025
House call medicine is returning in a big way, reshaping how people receive care in today’s fast-paced world. What once seemed like a tradition of the past is now a modern solution for patients who value comfort, convenience, and meaningful connections with their healthcare providers. As lifestyles shift, populations age, and technology continues to evolve, in-home healthcare has become a practical and patient-centered alternative to traditional clinic visits. Care that comes to you The most obvious advantage of a house call doctor is simple: you don’t have to go anywhere. For individuals with limited mobility, chronic conditions, busy schedules, or post-operative needs, traveling to a clinic can be physically uncomfortable and emotionally draining. A home visit eliminates transportation challenges entirely, allowing the patient to stay in a familiar space while receiving professional care.Even for those who are otherwise healthy, having medical services brought to the doorstep adds a layer of ease that traditional appointments rarely offer. A more personal approach House call visits naturally allow for deeper, unhurried interactions. Without the rush of a clinic environment, providers can listen more closely, ask more thoughtful questions, and observe subtle details that might otherwise be missed. This extra time helps build a stronger relationship based on trust and understanding. Patients often find it easier to express concerns openly when they feel relaxed and unpressured—something that’s harder to achieve during quick, crowded office visits. Seeing the whole picture When care happens at home, providers gain a clearer understanding of a patient’s daily life. They can observe environmental factors that influence health—sleep setups, mobility challenges, fall risks, medication storage, dietary patterns, or stressors within the household. These small details often provide big insights. Better management of chronic conditions Chronic conditions such as heart disease, diabetes, COPD, and dementia often benefit greatly from consistent in-home oversight. Regular visits help keep symptoms under control, monitor progress, and adjust treatments before problems worsen. For many patients, this ongoing support means fewer complications and a stronger sense of stability. Comfort, privacy, and peace of mind Many patients feel anxious in clinical settings. Exams, bright lights, unfamiliar rooms, and long waits can create stress, especially for older adults, children, or those with anxiety. At home, the patient is surrounded by their own environment—familiar objects, comforting routines, and supportive family members. This sense of comfort encourages honest conversation and helps patients feel more in control of their care. Support for aging in place As the senior population grows, more older adults are choosing to remain at home for as long as possible. House call doctors play a crucial role in making this safe and achievable. They provide routine checkups, medication guidance, wellness monitoring, and post-operative care—all without the patient needing to travel. The future of healthcare is at home House call doctors offer a level of comfort, personalization, and meaningful connection that traditional clinics often struggle to match. As healthcare continues shifting toward patient-centered, flexible, and relationship-focused models, in-home care stands out as a powerful and modern solution. For many, it isn’t just a convenient option—it’s the best way to receive care.
What is a coagulogram?
02 December 2025
A coagulogram, or coagulation panel, is a diagnostic blood test that evaluates how effectively your blood forms clots. Clotting is a vital protective process that stops bleeding when blood vessels are injured. This mechanism relies on platelets and a series of proteins called clotting factors, which are mostly produced in the liver. Under normal circumstances, these factors remain inactive, but when bleeding begins, platelets become sticky and trigger a chain reaction that activates clotting factors and forms a stable clot. A coagulogram helps determine whether this complex system is functioning properly. It can show if blood clots too slowly, which may lead to excessive bleeding, or too quickly, which increases the risk of dangerous clots forming inside blood vessels. Such clots can travel to the lungs, brain, or heart and cause life-threatening complications. Why Is a Coagulogram Needed? Doctors may recommend this test when there is a suspicion of abnormal bleeding or clotting. People with prolonged bleeding after injuries or procedures, frequent nosebleeds, unexplained bruising, or blood in urine or stool may need this evaluation. It is also important for individuals showing signs of excessive clotting, such as leg swelling, sudden shortness of breath, or chest pain, which may indicate deep vein thrombosis or a pulmonary embolism. Many medical conditions can disrupt the balance of clotting factors, including liver disease, vitamin K deficiency, autoimmune disorders, cancer, severe infections, and nutrient deficiencies. Patients who take blood-thinning medications require regular monitoring, and a coagulogram is routinely performed before surgeries to ensure safe clotting function. What Does a Coagulogram Include? A coagulogram generally measures how long blood takes to clot and evaluates the key proteins involved in the clotting process. It typically includes tests such as PT/INR, aPTT, fibrinogen levels, and platelet count. Key Reasons to Perform a Coagulogram • To investigate unexplained bleeding or bruising and diagnose possible clotting factor deficiencies. • To assess the risk of excessive clot formation in cases of limb swelling, pain, or breathing difficulties. • To monitor patients taking anticoagulant medications such as warfarin. • To evaluate liver-related clotting factor production. • To ensure safe clotting before a surgical procedure. Main Components of a Coagulogram • PT/INR: Measures the time needed for blood to clot through the prothrombin pathway. • aPTT: Evaluates the internal clotting pathway and screens for factor deficiencies. • Fibrinogen level: Shows whether the final clot-forming protein is sufficient. • Platelet count: Determines if enough platelets are present to initiate clotting. • Specific factor assays: Identify missing or malfunctioning individual clotting factors. Conclusion A coagulogram provides essential information about how your blood clots and helps identify both bleeding risks and clot-forming disorders. By evaluating key components of the clotting system, it guides diagnosis and supports safe medical decision-making. This test is a valuable tool for maintaining overall health and preventing serious complications.

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