Short answers, pulled from the story.
The most common symptom of myocardial infarction is chest pain or discomfort that classically radiates to the left shoulder, arm, or jaw. Other symptoms include shortness of breath, nausea, cold sweats, and fatigue. Women are more likely than men to present with neck pain, arm pain, or unusual tiredness rather than chest pain.
Most myocardial infarctions are caused by the rupture of an atherosclerotic plaque in a coronary artery, which triggers blood clot formation that can block the artery within minutes. Less common causes include coronary artery spasm from cocaine use, extreme cold, or severe emotional stress, the latter known as Takotsubo or broken heart syndrome.
A STEMI, or ST elevation myocardial infarction, is identified by a characteristic rise in the ST segment on an electrocardiogram and represents a complete artery blockage requiring immediate intervention, ideally within 90 to 120 minutes. An NSTEMI, or non-ST elevation myocardial infarction, does not show that pattern and is generally managed with heparin and, in high-risk cases, PCI within 1 to 3 days. STEMIs account for roughly 25 to 40% of all myocardial infarctions.
Aspirin is the appropriate immediate treatment for a suspected myocardial infarction, cutting mortality associated with the acute event by at least 50%. For STEMI, percutaneous coronary intervention is the preferred treatment and should be performed within 90 to 120 minutes of reaching a medical provider. If PCI is not available in time, fibrinolysis using medications such as tissue plasminogen activator, reteplase, streptokinase, or tenecteplase is used to dissolve the clot.
Tobacco smoking accounts for roughly 36% of coronary artery disease cases, making it the leading modifiable risk factor. Obesity accounts for around 20%, and physical inactivity for 7 to 12% of cases. Other factors include high blood pressure, diabetes, high LDL cholesterol, a family history of ischemic heart disease, and even short-term exposure to air pollutants such as carbon monoxide and nitrogen dioxide.
Yes. Silent myocardial infarctions, with no symptoms at all, account for between 22 and 64% of all infarctions by some estimates. They are more common in older people, in those with diabetes mellitus, and in people who have received a heart transplant, where the donor heart is not fully connected to the recipient's nervous system.