IndexIntroductionBodyConclusionIntroductionThe World Health Organization (WHO) announced that cardiovascular diseases are the leading cause of death in the developed world. It is a broad term used for conditions that affect the heart and blood vessels. Although it is a largely preventable and predictable disease, it and stroke caused the deaths of 15.2 million people in 2016 alone. Coronary heart disease encompasses a spectrum of related diseases: stable angina, unstable angina, diffuse coronary insufficiency, and myocardial infarction. In this essay I will describe myocardial infarction (MI), how it develops, which parts of the body it affects, what a case of myocardial infarction looks like, i.e. its clinical characteristics and, finally, what the risk factors and incidence rates are. between different groups of people. . I will also add a note on the differential diagnosis of MI and the modified effect of diabetes mellitus on patients with MI, simultaneously explaining the fatigue experienced by patients. Before moving on to these points, however, I will touch on the fundamental anatomy and physiology of the heart and coronary vessels to better understand the topic. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essayBodyThe heart is a muscular organ in the center of the chest, below the sternum, tilted slightly to the left. It is the central component of the cardiovascular system. It is the size of a closed fist, although it differs in its shape. The heart lies on the diaphragm, a skeletal muscle that separates the thoracic cavity from the abdominal cavity. It is easier to visualize the heart as a cone lying on its side. It pumps all the blood in the body first to the lungs, where oxygen from the alveoli diffuses to the red blood cells, then to the entire body, including the heart itself. It transports this blood through a closed system of blood vessels, the first and most important being the aorta. Two coronary arteries, the left and right coronary arteries, branch from the ascending aorta and supply oxygenated blood to the heart muscles, i.e., the myocardium. The left coronary artery further divides into two main branches, the anterior interventricular branch (left anterior descending branch: LAD) and the circumflex branch. While the two main branches of the right coronary artery are the right marginal branch and the posterior interventricular branch. These arteries surround the heart in such a way that they resemble a crown, hence the name “coronary” arteries. Clinically, doctors use alternative names for coronary vessels. The short left coronary artery is called the left main vessel. One of its primary branches, the anterior interventricular artery, is called the left anterior descending (LAD) artery. Likewise, doctors call the terminal branch of the right coronary artery, posterior interventricular artery, posterior descending artery (PDA). Now that we have reviewed the basic anatomy of the heart and its simplified vascular system, we can move on to our topic, our topic being the presentation of myocardial infarction, a heart disease. Coronary heart disease is a leading cause of heart disease. As mentioned above, the coronary arteries supply the myocardium with oxygenated blood, so for the heart to function smoothly and correctly, we need blood from these arteries to reach the muscles without blockages or obstructions. Atherosclerosis is a disease of the arteries in which they become clogged with fatty deposits called plaques, also known as atheroma. This causes stenosis, the narrowing of the arteries, which consequently decreases blood perfusion of the tissuestarget. This is a serious and potentially life-threatening disease, especially when the narrowed artery leads to a sensitive organ such as the heart or brain. Although this disease rarely manifests itself in the beginning, any symptoms, if left untreated, can develop into other fatal diseases such as coronary heart disease, which is a spectrum of diseases ranging from angina to ischemia-induced unstable angina, then to heart attack myocardium due to almost complete obstruction of the coronary arteries. Heart attack (MI), or heart attack, is one of the most common causes of heart failure. A typical myocardial infarction usually occurs when an atherosclerotic plaque ruptures and forms a blood clot that blocks a coronary supply vessel. Myocytes supplied with blood from the occluded vessel have some outcomes. Collateral channels can completely attenuate the effect of stenosis. Sometimes, collaterals can provide enough blood during inactivity, but fail to keep up during exertion. This usually causes angina, also called angina pectoris, which is a pressure, compression, tightness, or pain in the chest. In case of cardiac ischemia, i.e. reduced blood flow to the heart, the coronary arteries are narrowed. Myocardial ischemia is due to a combination of fixed vessel narrowing and endothelial obstruction. This leads to an imbalance between cardiac output and demand. There may also be non-atherosclerotic causes of ischemia, such as low perfusion due to low blood pressure, decreased oxygen in the blood in cases of anemia and lung disease, and significant increases in the heart's oxygen demand as in cases of acute tachycardia and acute hypertension. . Obstruction of both the venous and arterial sides can lead to necrosis of myocardial tissue. Let's call this a heart attack. There are three crucial factors that determine the severity of ischemia, reduced perfusion of a tissue, and whether it will lead to a myocardial infarction. The speed of onset is an important factor: if the obstruction is rapid, the effects are much more serious than if it is gradual. Another factor is the extent of the obstruction. The higher the percentage of occlusion, the more serious the effects will be. The last factor is the time taken by the arteries to form collateral channels, so the age of the person is a good determinant of the intensity of the effects of ischemia, i.e. the older the patient, the longer the time taken to form the collateral channels, therefore the greater the probability of suffering less damage. When part of the heart muscles dies, it is replaced by fibrous tissue, sometimes called scar tissue. This fibrotic portion is rigid and does not work in harmony with the myocardium, therefore it reduces cardiac contractility. The heart is a hard organ. Even if he takes a lot of damage, he might still survive. Turning to the risk factors of MI and its prevalence in certain groups, epidemiologists divide them into three groups of factors: major static risk factors, major modifiable risk factors, and contributing risk factors. Age is an important factor. Most people who die of a heart attack are 65 or older. Gender is also an important static factor, as men are more likely to suffer a heart attack than women. Women without hormonal imbalances suffer from myocardial infarction after reaching menopause, which on average is 51 years. The last non-modifiable factor is genetic: the children of patients with myocardial infarction are more likely to suffer from it. There is also a pattern of inheritance in different races, for example African Americans have higher blood pressure and are more likely to suffer from heart disease thanCaucasians. Moving on to the main modifiable factors, one of which is strong and prominent is cigarette smoking. The risk of smokers developing coronary heart disease is much greater than that of non-smokers. Cigarette smoking also interacts with other risk factors, worsening the effects of both. Cigarette smoke affects anyone who inhales it, including non-smokers. Hyperlipidemia, another modifiable factor, is the abundance of fats in the blood. Higher than normal cholesterol and triglyceride levels increase the risk of coronary heart disease. Another factor in the same category is hypertension. High blood pressure increases the work done by the heart, making it thicker and stiffer. This causes the heart to function abnormally. A sedentary lifestyle also increases the chances of myocardial infarction since when the body's activity levels are high, blood cholesterol levels decrease and can even lower blood pressure. Another factor is diabetes. Diabetes poses a major risk for developing heart disease even when blood glucose levels are under control. The risk is even greater if blood glucose levels are not controlled. Obese and overweight people should work to make lifestyle changes to lose weight, including through exercise and/or a better diet. Contributing factors include stress, alcohol, nutrition, and diet, which are all secondary and minor factors. When talking about the manifestation of heart attacks in patients, the most symbolic presentation is the clenched fist in the center of the chest indicating the intense, crushing retrosternal pain they are experiencing. The most important symptom of myocardial infarction is chest pain accompanied by fatigue, but common features are dyspnea, vomiting, and collapse or syncope. The pain occurs in the same location as angina but is usually more severe and lasts longer; patients often describe it as a tightness in the chest. Typical cases of myocardial infarction present with chest discomfort and a feeling of general malaise before the infarction. The chest pain experienced in MI is dull, nonlocalized, and vague, meaning the patient cannot pinpoint the exact source of the pain. It is typical for the pain to be in the center of the chest, however, this pain can radiate to the left upper arm and shoulder, lower neck, jaws, and rarely to the lower arm and back. In some cases, it may occur only in the irradiated areas and not in the chest itself. Heart pain is usually induced by exertion, exercise, stress and heavy meals. The pain is mostly relieved by rest after a few minutes of severe discomfort. Unlike cardiac pain, pleural or pericardial pain is described as a sharp sensation that is aggravated by breathing, coughing, or movement. Pain associated with a specific movement (bending, stretching, and rotating) is likely to be musculoskeletal. MI commonly takes several minutes to develop. Likewise, angina gradually increases in proportion to the intensity of the effort. It is very likely that pain that occurs after, rather than during, exertion originates from the musculoskeletal system or from a psychological abnormality. In addition to symptoms and signs, there are constitutional effects that accompany heart attacks of any significant size. Fever is one such effect, another is the release of enzymes by necrotic tissue into the bloodstream, which can be of diagnostic aid. A small heart attack simultaneously triggers short- and long-term compensatory mechanisms. Short-term events help maintain theproduction until long-term pathways have had time to fully activate. There are both local and central short-term reflexes. Interruption of blood flow to myocytes causes increased levels of interstitial metabolites (eg, adenosine, potassium cation, carbon dioxide, lactate). All resistance in the immediate vicinity reflexively dilates through local vascular control mechanisms. Collaterals are normally restricted, but also take part in the vasodilatory response due to increased levels of metabolites. Blood flow through collaterals may allow peripheral areas of a focal infarct to survive the initial ischemic event. Myocyte death impairs myocardial contractility, reducing left ventricular stroke volume and cardiac output. As a result, mean arterial pressure (MAP) decreases. If the infarct is small, these pathways may be sufficient to restore MAP. Some patients with myocardial infarction feel constantly fatigued. Fatigue is a condition characterized by decreased working capacity and reduced productivity, usually accompanied by a feeling of lethargy and tiredness. Chronic fatigue is more or less associated with having had a myocardial infarction or heart disease in general. Studies on this topic divide fatigue into smaller components such as general tiredness, mental tiredness, reduced motivation and reduced activity. Fatigue is also part of an adaptive range with tiredness and exhaustion as starting and ending points respectively, each having been a response to stimulants. To identify the underlying causes of post-heart attack fatigue we must consider it from many points of view. It may have physiological underpinnings due to disease, increased cardiac enzymes, damage to the heart muscle, alterations in electrical and neural transmissions, and a threatened immune system. Since diabetes is an important modifiable risk factor for MI, we should also address the presentation of diabetes in patients to further expand our diagnostic capabilities. Diabetes mellitus (derived from the Greek word diabetes, meaning to pass through, and the Latin word mellitus, meaning sweet or honeyed) is the disease in which the human body does not have adequate resources to store and use glucose, a monosaccharide that produces energy inside cells. This causes blood glucose levels to skyrocket. Insulin is the hormone responsible for storing glucose as glycogen, the stored form of glucose. Glycogen is a multibranched polymer of glucose that is accumulated in response to insulin and broken down in the presence of glucagon. The antagonist hormone of glucagon is insulin. Insulin facilitates the entry of glucose into cells, because glucose cannot enter cells on its own without special transporters. Specialized cells called beta islets within the pancreas produce insulin. Any problem with these cells will cause an inappropriate amount of insulin to flow into the bloodstream. There are two types of diabetes; type 1 and type 2. Type 1, also known as insulin-dependent diabetes, occurs when an autoimmune reaction in which the patient's immune system attacks the insulin-secreting cells in the pancreas, destroying them. This causes the complete non-existence of insulin in circulation. Type 1 is not related to genetics, cannot be controlled by diet, and usually occurs at a young age. Type 2 diabetes, known as insulin-independent diabetes, is obesity-related diabetes. It mainly affects middle-aged people. It is caused by not enough insulin in the flow.