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Heart Attack
Myocardial infarction
Myocardial infarction
(MI), commonly known as a heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle.[1] The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw.[1] Often it occurs in the center or left side of the chest and lasts for more than a few minutes.[1] The discomfort may occasionally feel like heartburn.[1] Other symptoms may include shortness of breath, nausea, feeling faint, a cold sweat, or feeling tired.[1] About 30% of people have atypical symptoms.[7] Women more ofte
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Statin
Statins, also known as HMG-CoA reductase
HMG-CoA reductase
inhibitors, are a class of lipid-lowering medications. Statins have been found to reduce cardiovascular disease (CVD) and mortality in those who are at high risk of cardiovascular disease. The evidence is strong that statins are effective for treating CVD in the early stages of the disease (secondary prevention) and in those at elevated risk but without CVD (primary prevention).[1][2] Side effects of statins include muscle pain, increased risk of diabetes mellitus, and abnormalities in liver enzyme tests.[3] Additionally, they have rare but severe adverse effects, particularly muscle damage.[4] They inhibit the enzyme HMG-CoA reductase
HMG-CoA reductase
which plays a central role in the production of cholesterol
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Atherosclerosis
Atherosclerosis
Atherosclerosis
is a disease in which the inside of an artery narrows due to the build up of plaque.[7] Initially, there are generally no symptoms.[1] When severe, it can result in coronary artery disease, stroke, peripheral artery disease, or kidney problems depending on the arteries affected.[1] Symptoms, if they occur, generally do not begin until middle age.[3] The exact cause is not known.[1] Risk factors include high blood pressure, diabetes, smoking, obesity, family history, and an unhealthy diet.[3] Plaque is made up of fat, cholesterol, calcium, and other
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Coronary Angiography
A coronary catheterization is a minimally invasive procedure to access the coronary circulation and blood filled chambers of the heart using a catheter. It is performed for both diagnostic and interventional (treatment) purposes. Coronary catheterization
Coronary catheterization
is one of the several cardiology diagnostic tests and procedures. Specifically, coronary catheterization is a visually interpreted test performed to recognize occlusion, stenosis, restenosis, thrombosis or aneurysmal enlargement of the coronary artery lumens; heart chamber size; heart muscle contraction performance; and some aspects of heart valve function. Important internal heart and lung blood pressures, not measurable from outside the body, can be accurately measured during the test. The relevant problems that the test deals with most commonly occur as a result of advanced atherosclerosis – atheroma activity within the wall of the coronary arteries
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Percutaneous Coronary Intervention
Percutaneous coronary intervention (PCI) is a non-surgical procedure used to treat narrowing (stenosis) of the coronary arteries of the heart found in coronary artery disease. After accessing the blood stream through the femoral or radial artery, the procedure uses coronary catheterization to visualise the blood vessels on X-ray imaging. After this, an interventional cardiologist can perform a coronary angioplasty, using a balloon catheter in which a deflated balloon is advanced into the obstructed artery and inflated to relieve the narrowing; certain devices such as stents can be deployed to keep the blood vessel open. Various other procedures can also be performed. Primary PCI is the very urgent use of PCI in people with acute myocardial infarction (heart attack), especially where there is evidence of severe heart damage on the electrocardiogram (ST elevation MI)
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Thrombolysis
Thrombolysis is the breakdown (lysis) of blood clots formed in blood vessels, using medication. It is used in ST elevation myocardial infarction, stroke, and very large pulmonary embolisms. The main complication is bleeding (which can be dangerous), and in some situations thrombolysis may therefore be unsuitable
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Nitroglycerin (drug)
Nitroglycerin, also known as glyceryl trinitrate (GTN), is a medication used for heart failure, high blood pressure, and to treat and prevent chest pain from not enough blood flow to the heart (angina) or due to cocaine.[1] This includes chest pain from a heart attack.[1] It is taken by mouth, under the tongue, applied to the skin, or by injection into a vein.[1] Common side effects include headache and low blood pressure.[1] The low blood pressure can be severe.[1] It is unclear if use in pregnancy is safe for the baby.[1] It should not be used together with medications within the sildenafil (PDE5 inhibitor) family due to the risk of low blood pressure.[1] Nitroglycerin
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Heparin
Heparin, also known as unfractionated heparin (UFH), is medication which is used as an anticoagulant (blood thinner).[3] Specifically it is used to treat and prevent deep vein thrombosis, pulmonary embolism, and arterial thromboembolism.[3] It is also used in the treatment of heart attacks and unstable angina.[3] It is given by injection into a vein.[3] Other uses include inside test tubes and kidney dialysis machines.[4][5] Common side effects include bleeding, pain at the injection site, and low blood platelets.[3] Serious side effects include heparin induced thrombocytopenia.[3] Greater care is needed in those with poor kidney function.[3] Heparin
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Blood Flow
Hemodynamics
Hemodynamics
or hæmodynamics is the dynamics of blood flow. The circulatory system is controlled by homeostatic mechanisms, much as hydraulic circuits are controlled by control systems. Hemodynamic response continuously monitors and adjusts to conditions in the body and its environment. Thus hemodynamics explains the physical laws that govern the flow of blood in the blood vessels. Blood
Blood
flow ensures the transportation of nutrients, hormones, metabolic wastes, O2 and CO2
CO2
throughout the body to maintain cell-level metabolism, the regulation of the pH, osmotic pressure and temperature of the whole body, and the protection from microbial and mechanical harms.[1] Blood
Blood
is a non-Newtonian fluid, best studied using rheology rather than hydrodynamics
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Cardiac Muscle
Cardiac muscle
Cardiac muscle
(heart muscle) is one of the three major types of muscle, the others being skeletal and smooth muscle. It is an involuntary, striated muscle that is found in the walls of the heart. This muscle tissue is known as myocardium, and forms a thick middle layer between the outer layer of the heart wall (the epicardium) and the inner layer (the endocardium). Myocardium
Myocardium
is composed of individual heart muscle cells (cardiomyocytes) joined together by intercalated disks, encased by collagen fibres and other substances forming the extracellular matrix. Cardiac muscle
Cardiac muscle
contracts in a similar manner to skeletal muscle, although with some important differences. An electrical stimulation in the form of an action potential triggers the release of calcium from the cell's internal calcium store, the sarcoplasmic reticulum
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Alcohol
In chemistry, an alcohol is any organic compound in which the hydroxyl functional group (–OH) is bound to a saturated carbon atom.[2] The term alcohol originally referred to the primary alcohol ethanol (ethyl alcohol), which is used as a drug and is the main alcohol present in alcoholic beverages. The suffix -ol appears in the IUPAC
IUPAC
chemical name of all substances where the hydroxyl group is the functional group with the highest priority; in substances where a higher priority group is present the prefix hydroxy- will appear in the International Union of Pure and Applied Chemistry
Chemistry
(IUPAC) name. The suffix -ol in non-systematic names (such as paracetamol or cholesterol) also typically indicates that the substance includes a hydroxyl functional group and, so, can be termed an alcohol. But many substances, particularly sugars (examples glucose and sucrose) contain hydroxyl functional groups without using the suffix
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Coronary Artery
The coronary arteries are the arteries of the coronary circulation that transport blood into and out of the cardiac muscle. They are mainly composed of the left and right coronary arteries both of which give off branches. The left coronary artery, arises from the aorta above the left cusp of the aortic valve and feeds blood to the left side of the heart. It branches into two arteries and sometimes a third branch is formed at the fork, known as a ramus or intermediate artery.[1] The right coronary artery, originates from above the right cusp of the aortic valve
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Coronary Artery Spasm
Coronary vasospasm is a sudden, intense vasoconstriction of an epicardial coronary artery that causes occlusion (stoppage) or near-occlusion of the vessel. It can cause Prinzmetal's angina. It can occur in multiple vessels.[1][2] Atropine
Atropine
has been used to treat the condition.[3] See also[edit]Angiography Cardiac CT Myocardial bridgeReferences[edit]^ Ahooja V, Thatai D (July 2007). "Multivessel coronary vasospasm mimicking triple-vessel obstructive coronary artery disease". J Invasive Cardiol. 19 (7): E178–81. PMID 17620681. Archived from the original on 2009-01-16.  ^ Miwa K, Ishii K, Makita T, Okuda N (May 2004). "Diagnosis of multivessel coronary vasospasm by detecting postischemic regional left ventricular delayed relaxation on echocardiography using color kinesis". Circ. J. 68 (5): 483–7. doi:10.1253/circj.68.483. PMID 15118293
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Diagnostic Method
Medical diagnosis
Medical diagnosis
(abbreviated Dx[1] or DS) is the process of determining which disease or condition explains a person's symptoms and signs. It is most often referred to as diagnosis with the medical context being implicit. The information required for diagnosis is typically collected from a history and physical examination of the person seeking medical care. Often, one or more diagnostic procedures, such as diagnostic tests, are also done during the process. Sometimes posthumous diagnosis is considered a kind of medical diagnosis. Diagnosis
Diagnosis
is often challenging, because many signs and symptoms are nonspecific. For example, redness of the skin (erythema), by itself, is a sign of many disorders and thus does not tell the healthcare professional what is wrong. Thus differential diagnosis, in which several possible explanations are compared and contrasted, must be performed
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Cocaine
Cocaine, also known as coke, is a strong stimulant mostly used as a recreational drug.[10] It is commonly snorted, inhaled as smoke, or as a solution injected into a vein.[9] Mental effects may include loss of contact with reality, an intense feeling of happiness, or agitation.[9] Physical symptoms may include a fast heart rate, sweating, and large pupils.[9] High doses can result in very high blood pressure or body temperature.[11] Effects begin within seconds to minutes of use and last between five and ninety minutes.[9] Cocaine has a small number of accepted medical uses such as numbing and decreasing bleeding during nasal surgery.[12] Cocaine
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Takotsubo Cardiomyopathy
Takotsubo
Takotsubo
cardiomyopathy, also known as stress cardiomyopathy, is a type of non-ischemic cardiomyopathy in which there is a sudden temporary weakening of the muscular portion of the heart.[3] This weakening may be triggered by emotional stress, such as the death of a loved one, a break-up, rejection from a partner or constant anxiety. This leads to one of the common names, broken heart syndrome.[4] Stress cardiomyopathy is now a well-recognized cause of acute heart failure, lethal ventricular arrhythmias, and ventricular rupture.[5] The name "takotsubo syndrome" comes from the Japanese word takotsubo (ja) "octopus trap," because the l
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