Treatment of an MI is time critical.Aspirin is an appropriate immediate treatment for a suspected MI.Nitroglycerin or
opioids may be used to help with chest pain; however, they do not improve overall outcomes.Supplemental oxygen should be used in those with low oxygen levels or shortness of breath. In a STEMI, treatments attempt to restore blood flow to the heart, and include
percutaneous coronary intervention (PCI), where the arteries are pushed open and may be stented, or
thrombolysis, where the blockage is removed using medications. People who have a non-ST elevation myocardial infarction (NSTEMI) are often managed with the blood thinner
heparin, with the additional use of PCI in those at high risk. In people with blockages of multiple coronary arteries and diabetes,
coronary artery bypass surgery (CABG) may be recommended rather than angioplasty. After an MI, lifestyle modifications, along with long term treatment with aspirin,
beta blockers, and
statins, are typically recommended.
Worldwide, about 15.9 million myocardial infarctions occurred in 2015. More than 3 million people had an ST elevation MI and more than 4 million had an NSTEMI. STEMIs occur about twice as often in men as women. About one million people have an MI each year in the United States. In the developed world the risk of death in those who have had an STEMI is about 10%. Rates of MI for a given age have decreased globally between 1990 and 2010. In 2011, AMI was one of the top five most expensive conditions during inpatient hospitalizations in the US, with a cost of about $11.5 billion for 612,000 hospital stays.
Myocardial infarction (MI) refers to tissue death (
infarction) of the heart muscle (
myocardium). It is a type of
acute coronary syndrome, which describes a sudden or short-term change in symptoms related to blood flow to the heart. Unlike other causes of acute coronary syndromes, such as
unstable angina, a myocardial
infarction occurs when there is cell death, as measured by a
blood test for
biomarkers (the cardiac protein
troponin or the cardiac enzyme
CK-MB). When there is evidence of an MI, it may be classified as an ST elevation myocardial infarction (STEMI) or Non-ST elevation myocardial infarction (NSTEMI) based on the results of an
The phrase "heart attack" is often used non-specifically to refer to a myocardial infarction and to sudden cardiac death. An MI is different from—but can cause—
cardiac arrest, where the heart is not contracting at all or so poorly that all vital organs cease to function, thus causing death. It is also distinct from
heart failure, in which the pumping action of the heart is impaired. However, an MI may lead to heart failure.