Life-threatening myocardial infarction: recognizing early warning signs, race against time in emergency care, and modern medical intervention [i]

Half of all myocardial infarction patients don't call emergency medical services until two hours or longer after the onset of symptoms. Two-thirds of cases occur outside of hospitals. Many patients die before reaching the hospital. Most myocardial infarction survivors have to endure the consequences of heart damage in the initial hours of the attack. Therefore, time is a crucial factor in determining life and death. Statistics show that in recent years, circulatory failure has become one of the leading causes of death in Austria. Of 10,000 male deaths, 120 are due to myocardial infarction. Furthermore, a large, hidden figure exists because one-third of myocardial infarction patients go undiagnosed. Men over 35 years of age are at risk, with a significantly increased risk of myocardial infarction. A heart attack is a process that develops over time, lasting 4–6 hours. Every minute lost means more cells are deprived of oxygen and nutrients, increasing the risk of complete heart tissue death. If a certain proportion of heart muscle cells die, the heart can no longer maintain its pumping function and stops beating. Modern medicine has reduced the risk of myocardial infarction by inventing new drugs (super aspirin), bringing new hope to heart disease patients to return to a normal life. Medical researchers hope to develop super aspirin that can effectively control thrombus formation and is more easily absorbed by the body than regular aspirin. Modern laser technology can achieve some success: using lasers to create channels near the heart as artificial blood vessels. Thanks to an advanced surgical method-arterial laser regeneration-only a small incision is needed in the chest cavity. Furthermore, in the near future, growth factors produced using gene technology may be used to treat myocardial infarction. These factors are directly implanted into the heart to generate new, undamaged blood vessels (vascular proliferation). In addition, animal experiments in laboratories have begun using "tissue regeneration engineering," implanting human progenitor cells into necrotic tissue caused by infarction, aiming to allow the necrotic tissue to regenerate new myocardial tissue. To treat the sequelae of coronary artery blockage, drugs that can quickly dissolve blood clots and restore normal arterial blood flow should be taken as early as possible. Using genetic engineering techniques, special enzymes modify the body's own t-PA, making it more effective than the original element. These drugs are only effective for a limited time, and must be taken before the heart muscle cells are completely dead. After 6 hours, myocardial infarction is beyond saving. Men must be highly vigilant for the warning signs of myocardial infarction: sudden pain in the left chest or shoulder, difficulty breathing; direct jaw pain, unexplained pain radiating from the upper abdomen to the back, radiating pain in the arm or jaw; a feeling of heaviness in the chest; rapid pulse; low blood pressure; cold sweats; and possible fear, depression, nausea, and vomiting. In addition to emergency treatment, regular or even lifelong medication is unavoidable for heart disease patients. The most important medications include: Nitrates: These drugs can reduce blood flow obstruction to the heart by dilating coronary arteries and blood vessels in the muscles throughout the body. Nitrates can alleviate symptoms but cannot cure the underlying condition. Beta-blockers: These drugs can reduce heart rate and blood pressure, conserve oxygen consumption in the heart muscle, and prevent angina. Calcium channel blockers: They work by dilating blood vessels in the heart and throughout the body, improving myocardial blood supply, and lowering blood pressure. ACE inhibitors: They reduce the workload on the heart by dilating arteries. Antihypertensive drugs: These are newer antihypertensive drugs and can also be taken when the heart is weak. Anticoagulants: They reduce the likelihood of blood clotting and prevent thrombosis. Aspirin (such as ASS tablets): These are platelet aggregation inhibitors that can prevent thrombosis and improve survival rates. [i]