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Myocardial infarction (MI) is the clinical term for a heart attack. It is caused by occlusion (blockage) of the coronary artery (atherosclerosis) or a blood clot (coronary thrombosis), resulting in the partial or total blockage of one of the coronary arteries. When this occurs, the heart muscle (myocardium) does not receive enough oxygen. If the MI is mild, the heart muscle may partially repair itself. Permanent damage may occur when a portion of the heart muscle dies (called an infarction).
MI is characterized by crushing chest pains that may radiate to the left arm, neck, or upper abdomen (which may feel like acute indigestion or a gallbladder attack). The affected person usually has shortness of breath, ashen color, clammy hands, and faints. Treatment within one hour of the heart attack is important and usually includes chewing aspirin and administering CPR. Many individuals die each year of their first MI.
Coronary artery disease (CAD) refers to any one of the conditions that affect the coronary arteries and reduces blood flow and nutrients to the heart.
Traditionally, CAD was seen as a disease of aging and was observed primarily in the elderly. However, atherosclerosis is now occurring more often in younger populations. One out of every three individuals worldwide,
Risk factors. Controlled risk factors associated with CAD include hypertension; cigarette smoking; elevated blood lipids (e.g. cholesterol, triglyceride); a high-fat diet (especially saturated fats and trans-fatty acids); physical inactivity; obesity; diabetes; and stress. Lifestyle changes can assist in prevention of CAD. Uncontrolled risk factors include a family history of CAD, gender (higher in males), and increasing age.
Tobacco use is one of the leading contributors to heart disease. Smoking increases the risk of heart attacks (and increases the risk of lung diseases) by decreasing oxygen flow to the heart and lungs. Hypertension, which makes the heart work harder than normal, can be caused by poor diet, excessive dietary salt, lack of exercise, smoking, and chronic stress. Adult-onset diabetes mellitus may result from poor dietary habits and lack of exercise over a lifetime. Uncontrolled diabetes can lead to heart failure. Exercise can reduce the risk for CAD by increasing coronary blood flow, and it has shown positive effects on blood flow to the heart (myocardial perfusion). Long-term benefits of exercise include lower incidences of coronary heart failure and increased cardiac function in normal subjects.
Prevention. Health professionals recommend that dietary fat be reduced to 30 percent or less of total calories. The diet also should have no more than 10 percent of its calories from saturated fats, no more than 300 milligrams (mg) of cholesterol daily, no more than 2,400 mg of sodium, and at least 3,500 mg of potassium. A plant-based diet consisting primarily of whole grains, fruits, and vegetables is recommended. Eating at least 25 grams of fiber and five servings of fruits and vegetables daily may reduce the risk for heart disease.
Individuals who consume alcohol should do so in moderation. Moderation is defined as two drinks for men and one drink for women daily. Alcohol is a very addictive substance, however, and should not be used as a primary means of prevention. Caffeine in moderation has no adverse effect; however, excessive intake may make the heart pump faster. Increased heart rate stresses the heart and may cause long-term damage to blood vessels.
Establishing good exercise and dietary habits early in childhood is important to prevent heart disease. Regular activity and proper nutrition decreases reactivity to stress and makes the heart stronger and more efficient. At least thirty minutes of moderate exercise daily is recommended to prevent heart disease. Stress management helps to prevent high blood pressure, which is a major contributor to heart disease. Techniques such as yoga, deep breathing, and meditation may prevent coronary disease by improving resistance to stress.
Author Info: Teresa Lyles, The Gale Group Inc., Macmillan Reference USA, New York, Gale Nutrition and Well-Being A to Z, 2004
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