2.2. MI = Myocardial infarction (heart attack)

If a patient says she feels like she is going to die, take her seriously. She might code before finishing a sentence about her cat. Heart patients in particular get premonitions, a sixth sense related to poor oxygen perfusion to the heart, a nagging sense of doom, as they repeat, "I just don't feel right."

Many women don't experience the typical symptoms of a heart attack (chest pain/pressure radiating to arms, irregular heart beat, shortness of breath). Instead, they report indigestion, pain between shoulders, an aching jaw, even a choking sensation. Also: fatigue, sleep disturbance, and dyspnea (labored breathing). The elderly may present with disorientation or acute confusion due to decreased blood flow to the brain, with no complaints about the organ in actual distress--the heart.
Not to be confused with the act of leaping off a cliff, into the sea, just for fun, an elevated ST segment on the electrocardiogram is referred to as "tombstoning," because the final squiggle looks like a tombstone waiting for a cross or angel to go on top. This indicates a zone of injury in the heart. If injury continues, tissue starts to die. Obvious physical changes occur in the heart beginning six hours after a myocardial infarction.

Time is heart muscle.

Sometimes when a blood vessel supplying the heart becomes blocked and dies, a new one grows larger and takes over--a patient's body giving itself a free coronary bypass.

A CABG (pronounced "cabbage," coronary artery bypass grafting) involves taking vein or artery grafts from the patient's body and patching them onto the heart to create diversions from bad vessels.

A robot, controlled remotely by a renowned heart surgeon in Europe, can perform open heart surgery in California.

An LVAD (left ventricular assist device) is an implant + backpack that pumps blood for a patient whose heart has failed. In case no lessons were learned from Grey's Anatomy (the show, not the anatomy atlas), no, cutting the LVAD wire will not get one's patient a new heart.


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