David M. Berry M.D. column 5/13/2014

Published 12:00 am Wednesday, May 14, 2014

Symptoms can vary with heart attacks; testing used to confirm

(Editor’s Note: Tri-Lakes Medical Center Emergency Room physician David Berry answers your questions.)

What is a “heart attack”?

This is a common question. The medical term for “heart attack” is myocardial infarction or MI. Thus, we often hear these terms interchangeably. Myocardium refers to the heart muscle and infarction refers to tissue death. A heart attack or MI is when part of our heart muscle dies.
Our heart is the pump of our body. It pumps blood, oxygen and nutrients to all the cells of our body including the brain, kidneys and intestines.

Like the rest of the tissues in our body the heart itself needs oxygen and nutrients for the cells that make up the heart muscle to stay alive.

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This is done by the heart pumping blood not only out to the body, but to itself. This is done through vessels that feed the heart. When all of these cells are “well fed” the heart muscle is at its peak strength and can pump blood to the distal parts of the body with ease.

When one of these vessels becomes blocked either completely or partially, the blood, with its oxygen and nutrients, cannot reach the part of the heart muscle that particular vessel feeds. If the blocked vessel feeds only a small area of heart muscle the damage will usually be small and may cause minimal weakening of the heart muscle to pump blood for the patient.
Conversely, if the vessel is large or one of the main vessels that feeds a large area of the heart the damage can be quite significant even causing immediate cessation of heart function and death.

Our job in the ER is to identify patients who are having “heart attacks” or myocardial infractions. We do this through the use of EKG and blood testing.

Often it may not be immediately clear whether a patient’s symptoms are a result of dying heart muscle.

This is why a patient will be admitted even if their initial testing seems normal. Remember the affected area can vary and thus symptoms vary.

Secondly, we work to prevent further damage to the heart muscle as well as attempt to return blood flow to the affected part of the heart muscle.

In the worst-case scenarios where the heart stops beating altogether we use medications and sometimes electricity (as seen on TV when the actors yell “Clear!”) in an attempt to restart the heart.

This is why our diet can be important to heart health. Foods high in fat can cause blockages in the vessels to our heart to develop faster while foods low in fat can prevent blockages from forming.

David M. Berry, M.D.

If you have any questions about the ER that you wish Dr. Berry to answer please send them to The Panolian, P. O. Box 1616, Batesville, MS 38606 or publisher@panolian.com