In the Czech Republic, myocardial infarction is one of the most frequent causes of morbidity and mortality, especially in middle-aged men. Men over the age of 50 and women over the age of 60 are most at risk. This disease does not avoid even younger individuals who have increased blood clotting tendencies, a genetic predisposition, or those who lead a very unsuitable lifestyle. More than one half of the adult population is hospitalised with this diagnosis at departments of internal medicine. Vascular heart disease ranks first among the causes of death in the Czech Republic, with more than fifty thousand people dying annually of this disease.
Symptoms
The disease manifests as a compressive, constrictive or burning chest pain that is more intense and lasts longer than a common attack of angina pectoris. The pain may irradiate into both arms (more often the left), shoulders, lower jaw, diaphragm, abdomen and back. A myocardial infarction is often associated with dyspnoea, anxiety, sometimes vomiting. It may also occur with no previous warning signals, and in a small percentage of cases a painless course is possible (more often in diabetics).
Causes
An occlusion or critical stenosis of a heart artery. The atherosclerotic artery is progressively narrowed by the atherosclerotic plaque (damage of the internal wall). Insufficient blood flow to the heart cells at first manifests as so-called angina pectoris (chest pain). If an infarction occurs, the pain is more intense and does not recede spontaneously or following the administration of nitroglycerine as in the case of angina pectoris. In this situation, there is acute ischaemia of the heart muscle, which lacks an adequate supply of oxygen and nutrients for its activities. If blood flow through the affected artery is not renewed, the muscle cells dies. The function of the heart is endangered depending on the extent of damage. Some patients die before arriving at a hospital from disorders of the heart rhythm. An infarction may lead to a number of complications including rupture of the heart, heart failure and death.
Treatment
In the treatment of a myocardial infarction, time is the key issue- it is necessary to call the emergency services as soon as possible and to transport the patient to a hospital, where the occluded artery can be re-perfused. The first thing a patient can do is to take one table of nitroglycerine sub-lingually (if he/she has it at hand) and 400 mg of acetylsalicylic acid (Aspirin, Anopyrin, Acylpyrin, etc.). On arrival at the hospital, the physician places the patient on an ECG monitor, confirms the diagnosis and administers other drugs and oxygen. In the hospital, it is decided whether the patient will receive drugs that directly dissolve clots, or whether the patient will undergo dilation of the occluded section using a catheter (so-called angioplasty), or whether the patient will require an emergency bypass (replacement of the affected section with another vessel). All these life-saving actions depend on early arrival at the hospital, so that damage to the heart is minimal. Further treatment focuses on supporting vital functions, early physiotherapy and so-called secondary prevention, which apart from the administration of drugs that extend patient survival should include a complete change in current lifestyle.
Prevention
Basic preventive measures include a healthy lifestyle. This means adjustment of diet, leaving out an excess of saturated fats and enriching it with unsaturated, vegetal fats. It is recommended to restrict the intake of simple carbohydrates and to include more fibres, especially raw fruits and vegetables, in the diet. One should maintain body weight in the ideal range and include regular physical activity in one’s program, in accordance with the results of stress tests and physician recommendations. Naturally, one should refrain from smoking and restrict increased consumption of alcohol (a small amount is not harmful).
What does GenScan reveal regarding myocardial infarction?
In relation to predispositions to myocardial infarction, GenScan analyses genes that play a role in lipid metabolism, genes associated with the regulation of vascular lumen, as well as genes that affect blood clotting. The physician will have at his disposal important information that will indicate, which body regions may be affected and damaged in relation to this disease. Based on the GenScan analysis, the physician may recommend individual preventive measures.