Myocardial infarction (Heart Attack)

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Latest Edit: Hector 2014-1-02 (EDT)

A myocardial infarction or MI occurs when the blood supply to some part of the heart muscle is abruptly stopped. MIs are caused by a number of factors. In most cases a thrombus associated with plaque rupture occludes arteries, also less frequently embolization of arteries leads to MI or coronary spasm in the absence of plaque in arteries.[1]

Myocardial infarction (Heart Attack)
Heart muscle.jpg

Myocardial Infarction (Heart Attack)
Causes Dietary Factors, Smoking, Environmental Toxins, Stress, Prescription Medications
See Also Cardiovascular Conditions, Obesity, Hypertension, Diabetes
Books Books on Cardiovascular Conditions
Articles Articles on Cardiovascular Conditions

Contents

Naturopathic Assessment

The assessment of a heart attack is commonly based on a person's history and on a physical exam. Since there are many causes of chest pain the first task of a naturopathic doctor or any other primary care physician is to rule out life threatening conditions.[2]

Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. With Myocardial infarction, the causes are variable and include lifestyle, social and environmental factors. A detailed assessment is required to determine which risk factors are contributing to the overall risk an individual has of suffering a heart attack.

Lifestyle

Article Nutritional Treatments for Acute Myocardial Infarction , Alt Med; 2010;Vol15(2)
Article Blood Viscosity, Earlier More Accurate Predication of Cardiovascular Event Risk, NDNR; 2012 October[1]


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  • Low amounts of exercise and poor physical condition may be associated with increased risk for MI.[2]

Social

  • Stress is a risk factor for atherosclerosis and MIs.[3]
  • Stress may increase the stickiness of blood and make it more likely to clot.[4]
  • Anxiety, fear, anger, grief and stress may precipitate an MIs as there is an increase in adrenaline and noradrenaline release. These hormones increase the work of the heart, making it beat faster.[5]

Environmental

Medical Interventions

  • Prescription Medications
  • Digoxin, furosemide or cholesterol drugs indicates risk factors for cardiovascular disease and greater suspicion of MI.[2]
  • Reserach is lacking to support the use of hormone replacement therapy for the prevention of heart disease.[7]

Genetics

  • Heart attacks tend to run in families.[3]

Common Questions

Heart attack.jpg

Common questions regarding a heart attack include:[3]

They would also inquire about your dietary and lifestyle habits, your exercise regimen and any acute or chronic stressors.

Diagnostic Testing

The tests used to determine if you had a heart attack and the severity of damage include:

Related Symptoms and Conditions

The factors which increase the risk of a heart attack include:[3]

Conditions that tend to mimic the symptoms of a heart attack include:

  • GERD (Gastroesophageal reflux disease) and PUD (Peptic ulcer disease) are both non-cardiac causes of chest pain, as well as problems with the esophagus like achalasia or esophageal spasms. [2]
  • Costochondritis or bruised and broken ribs need to be differentiated from myocardial infarction – usually the doctor can reproduce the pain caused by these musculoskeletal injuries during physical exam and locate the pain precisely.[2]
  • Drug use including cocaine can cause intense coronary spasm and may present like myocardial infarction or angina.[1]
  • Anxiety and panic attacks can present like a heart attack.[8]

Characteristics

Myocardial infactions occur due to clotting in a coronary blood vessel. Blood supplying the heart muscle comes entirely from two coronary arteries, both lying along the outside surface of the heart. The death of a portion of the heart muscle is considered a myocardial infarct, and the amount of the heart affected by the sudden occlusion will determine the severity of the attack. Myocardial infarction is usually due to left ventricular damage but may occur in the right ventricle, infarcts are classified as such according to precise location and depth.[9]

Common Symptoms

Signs and symptoms include:[2]

  • Sweating, fatigue, anxiety, fast heart rate, fast respiration rate, shortness of breath, pallor, nausea, and vomiting. Pressure or crushing sensation in the chest typically in the center of chest which may radiate to the shoulder, arm or jaw.
  • The pain of on MI typically lasts at least 30 minutes and is not solicited by physical exam by the doctor.
  • With severe MI congestive heart failure may occur causing neck vein distention, pulmonary rales, or extra heart sounds like S3 or S4.
  • Hypotension, shock, or new murmurs may develop.
  • It is important to note that in elderly populations up to 25% of heart attacks occur in the absence of chest pain but there may be CHF, shock, or confusion, especially when complicated by diabetic neuropathy.[2]

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. A strength of naturopathic medicine is to identify and addressing underlying conditions such as hypertension, atherosclerosis and congestive heart failure which increase the risk of a heart attack.[10]

Determining the prognosis for myocardial infarction depends on the speed with which treatment is sought in some cases. Immediate referral is prudent when MI is suspected. Likewise the extent of damaged cardiac muscle depends on the size of coronary vessels affected and the quantity.[11]

If you or someone you know is having a heart attack you should seek emergency medical care at the closest hospital. Naturopathic care can help prevent heart attacks over the long term or help with the recovery after emergency medical care, but in an acute situation an ER is necessary. Advancements in treatment have increased survival and recovery.[11]

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

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Home Care

Home Care strategies include:

  • Becoming educated on healthy dietary and lifestyle practices outlined below.
  • After a heart attack it is helpful to monitor your blood pressure at least bi-weekly.

Lifestyle

Lifestyle recommendations include:

  • Dietary recommendations
  • Increase dietary fibre through vegetables, nuts and seeds, legumes and 100% whole grains at each meal and increase fresh raw fruits for snacks.[12] [13]
  • Use olive oil and small amounts of butter while avoiding rancid oils, deep fried foods, margarines, shortening and heating of polyunsaturated oils.[12]
  • Limit saturated fat intake to less than 7% of energy, trans fat to less than 1% of energy and cholesterol to 300mg per day.[13]
  • Avoid sugar in concentrated forms such as sucrose, glucose, fructose, white sugar, brown sugar, corn syrup, maple syrup, honey and molasses. [12][13]
  • Eliminate caffeine in all forms such as coffee, tea, colas and chocolate.[12]
  • Limit alcohol intake.[12][13]
  • Avoid processed meats as they contain [Food Additives|preservatives]] such as nitrates and nitrites, additionally avoid all food preservatives.[12]
  • Avoid added salt in foods.[13] Less than 3g per day.[10]
  • Eat fish twice per week.[12][13]
  • Drink adequate water daily.
  • Controlled exercise to maintain circulation without causing rupture of scar tissue is advised.[11]
  • Maintain healthy body weight by knowing your caloric needs and knowing the caloric content of foods you consume versus how much you are exercising and burning calories.[13], [11]

Naturopathic Therapies

The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies.

Naturopathic Therapies for myocardial infarctions include:

  • If weight control is part of the case consider differentials such as; excess constitutions, qi and blood stagnation, phlegm, and phlegm damp.[15]
  • Consider acupuncture points such as; CV12, CV6, ST25, HT7, ST34, SP4, PC7, CV4. [15]

References

Reviewed by Iva Lloyd, BScH, RPE, ND [2]

  1. 1.0 1.1 Berga S, Bowman M, Drossman D, Faling J, Frenkel E, Gabbard G et al. editors.(1992) The Merck Manual of Diagnosis and therapy 16th edition. Rathway: Merck & Co Inc.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 El-Hashemy Shehab (2007) Naturopathic Standards of Primary Care CCNM Press Inc.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 Piscopo Gary, Yarnell Eric (2010) Naturopathic Clinical Boards Study Manual Volume I. Healing Mountain Publishing Inc.
  4. tbr
  5. Spieker L, Noll G (Nov 2003) Pathophysiologic cardiovascular changes in stress and depression Ther Umsch.;60(11):667-72.
  6. Ueda K, Nitta H, Ono M (2009) Effects of fine particulate matter on daily mortality for specific heart diseases in Japan. Circ J;73(7):1248-54. PMID:19423947.
  7. 73rd Scientific Session of the American Heart Association. (Nov 2000) AHA
  8. tbr
  9. 9.0 9.1 Hoffmann David (1992) Therapeutic herbalism: A correspondence course in phytotherapy
  10. 10.0 10.1 Prousky Johathan, Hoffer Abram (2008) Principles and Practices of Naturopathic Clinical Nutrition CCNM Press.
  11. 11.0 11.1 11.2 11.3 Mulvihill, Selman, Holdaway, Tompary, Raymond editors (2006) Human Diseases – A Systemic Approach 6th ed. Pearson Educatin Inc.
  12. 12.0 12.1 12.2 12.3 12.4 12.5 12.6 Rowland David (2006) The Nutritional Bypass - Reverse Atherosclerosis Without Surgery. Canada Ic. Rowland Publications.
  13. 13.0 13.1 13.2 13.3 13.4 13.5 13.6 Lichtenstein A, Appel L, Brands M, Carnethon M, Daniels S, Franch H, Franklin B et al. (2006) Diet and lifestyle recommendations revision 2006: A scientific statement from the American Heart Association Nutrition Committee. Circulation;114(1):82-96. PMID:16785338
  14. Iliceto S, Scrutinio D, Bruzzi P, D’Ambrosio G, Boni L, Di Biase M, Biasco G, Hugenholtz P, Rizzon P (Aug 1995) Effects of L-carnitine administration on left ventricular remodeling after acute anterior myocardial infarction: The L-carnitine ecocardiografia digitalizzata infarto meocardico trail (CEDIM). JACC;26(2):380-7.PMID:7608438.
  15. 15.0 15.1 Kuoch David(2011) Acupuncture Desk Reference. 2nd ed. Acumedwest Inc.:pg290-307
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