Heart Attack - Medical Malpractice Lawyers

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Acute Myocardial Infarction Overview

An acute myocardial infarction which is commonly called a heart attack is the leading cause of morbidity and mortality throughout the world. It occurs when the heart lacks oxygen and a blood supply and myocardial cellular repair mechanisms become overwhelmed. When there is ischemia at a certain level for an extended period of time, there is irreversible myocardial cell death and a myocardial infarction has taken place.

A myocardial infarction or a heart attack can occur whenever there is an increased metabolic demand by the heart that can’t be made up for by the heart’s circulation or when there is a decreased delivery of oxygen and nutrients to the heart muscle by the circulation. A thrombus can form in narrowed coronary arteries and there is no blood flow to the part of the heart supplied by that coronary artery. A high grade (greater than 75 percent) lesion can spasm without a thrombus and this can lead to a heart attack.

Extreme physical exertion can precipitate a heart attack as can severe hypertension and severe aortic valve stenosis. Decreased mean aortic pressure, which is the primary aspect of coronary perfusion pressure, can also precipitate a myocardial infarction.

Myocardial infarctions can be transmural or nontransmural. In a transmural infarct, the damage is completely through the wall of the heart muscle and a nontransmural infarct, only part of the muscle wall is involved. In either case, there is necrosis of the wall of the heart and a risk of scar formation later or a risk of rupture of the wall of the heart, which is almost uniformly fatal. In many cases, there is ST segment elevation and Q wave presence, either of which is associated with a higher morbidity and mortality.

Myocardial infarctions is the leading cause of death in the world. The survival rate from a heart attack is 95 percent, which is a significant improvement over the last few years. The incidence of myocardial infarction increases with age. It depends on all the various risk factors a patient has. Older people just have more.

There are six major risk factors for myocardial infarction. The first is hyperlipidemia, particularly an elevation of LDL cholesterol. Those with diabetes mellitus are at higher risk of getting an MI. Those with high blood pressure, especially if it is undertreated, will be at greater risk of getting a heart attack. Tobacco users put themselves at greater risk of heart attack and males are at higher risk. People with a family history of atherosclerotic arterial disease are at risk for getting an MI themselves.

Most heart attacks are caused by a disruption in the vascular endothelium associated with an atherosclerotic plaque that is unstable and allows for the formation of an intracoronary thrombus. The blood flow through the coronary artery is blocked. If the blockage occurs for twenty minutes or more, irreversible cell death occurs in the heart and a heart attack begins. The severity of the MI depends on three factors: the level of the occlusion, the length of time of the occlusion, and the presence or absence of the collateral circulation.

• Chest pressure or pain that can feel like a fullness or squeezing in the middle of the chest.
• Radiation of the chest pressure into the teeth, jaw, arm, shoulder, or back
• Associated shortness of breath
• Associated epigastric discomfort with or without nausea
• Associated sweating
• Fainting or near fainting
• Cognitive impairment

Treatment of an MI includes giving early thrombolytics to open up the coronary artery so the MI isn’t as severe. Blood pressure is controlled and blood thinners are given as well as antiplatelet agents. Failing to meet standards in caring for a patient with MI can be malpractice.

Medical Malpractice Lawyers

The medical profession which includes doctors, nurses and hospital technicians usually provides a caring service with a high standard of excellence however there are occasions when things do go wrong. Our litigation service is completely free and our lawyers will deal with your case using a contingency fee arrangement which means that if you don’t succeed in receiving a financial settlement then your lawyer won't get paid.

The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here