The heart functions by receiving nutrients and oxygen from three coronary arteries (coronary arteries). If any of these three coronary arteries are blocked by cholesterol, calcium, or blood clots, myocardial infarction, in which the tissue of the heart muscle dies, occurs.
When myocardial infarction occurs and the heart muscle dies, fatal arrhythmias such as ventricular tachycardia or ventricular fibrillation may occur and lead to death. Myocardial infarction is a terrible disease in which about 30 to 40% of patients die before arriving at the hospital, and about 5 to 10% of patients die even after arriving at the hospital and receiving treatment. Sudden cardiac death or sudden death occurs within 1 hour after chest pain occurs, and the most common cause of sudden cardiac death is myocardial infarction. Risk factors that can easily cause myocardial infarction include old age, smoking, hypertension, diabetes, family history of ischemic heart disease among parents/siblings aged 55 years or younger for males and 65 years for females or younger, obesity, and lack of exercise. In addition, stress can also cause myocardial infarction. As a result of a survey conducted on patients hospitalized for myocardial infarction at a nearby hospital during the Iraq War in 1990, there is a report that the number of shelling during the war and the incidence of myocardial infarction are exactly the same. When others do something well, people who clap, respond, and laugh a lot have less stress and less likely to have a myocardial infarction. occurs
Most patients with myocardial infarction complain of sudden chest pain. ‘I squeeze my chest’, ‘I feel like my chest is strong’, and most of the cases complaining of pain in the middle or slightly left side of the chest. However, even without these symptoms, there are cases where people complain that ‘the stomach hurts’ or ‘the tip of the chin hurts’. In addition, although atypical, there are cases where only nausea and vomiting symptoms are present without chest pain, and there are cases where patients complain of ‘indigestion’ or ‘stomach pain’. Chest pain usually occurs with shortness of breath and complains of radiating pain that spreads to the inside of the left shoulder or left arm. This chest pain lasts more than 20 minutes and does not improve with nitroglycerin sublingual tablets administered under the tongue.
What is the most important thing when the above symptoms of myocardial infarction appear? The point is that you need to go to the hospital as soon as possible. According to Korean statistics, only 23% go to the hospital within an hour after chest pain occurs, 16% go within 1-2 hours, 33% go within 2-6 hours, and go after 6 hours. 28% of cases. This means that 3 out of 10 people do not go to the hospital for more than 6 hours even though their heart hurts so much. Why on earth do I not go to the hospital when my heart hurts so much? It is something we must address.
The most important treatment principle for myocardial infarction is to minimize damage to the heart muscle by opening the blocked coronary artery in a short time. A good effect can be seen if the blocked coronary artery is pierced through surgery or medicine within 2 hours after chest pain occurs. Even if you successfully open a blocked coronary artery, if you come to the hospital late, the worse the result.
The mortality rate increases by about 1% for every hour of delay in arriving at the hospital for myocardial infarction patients. Almost all hospitals in Korea where coronary artery intervention is available perform procedures to open clogged coronary arteries within 90 minutes after myocardial infarction patients arrive at the hospital. In the case of Chonnam National University Hospital Cardiac Center, it takes 60 minutes for a myocardial infarction patient to come to the emergency room and perform a procedure to open a clogged coronary artery, regardless of whether it is day, night or dawn.
If symptoms of myocardial infarction lasting more than 20 minutes appear, do not hesitate to call 119 and use an ambulance to quickly go to the emergency room of a university hospital or a general hospital where myocardial infarction can be treated. Myocardial infarction, if your chest hurts, don’t delay and go to the hospital… .
Chonnam National University Hospital Cardiovascular Internal Medicine Professor Hong Young-joon
2023-09-07 08:40:00
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