Myocardial Infarction Case Study full custom essay
Risk factors
Myocardial infarction, commonly known as heart attack is a condition that is
characterized by the necrosis (death) of the myocardium due to limited oxygen supply which is
prolonged. Acute myocardial infarction is a common cardiovascular event that results in cardiac
remodelling (Boon & Dimmeler 2015). The risk factors that are associated to the illness are
broadly categorized into two; modifiable and non modifiable risk factors. Modifiable risk factors
are those that are associated with behaviour and habits and thus they can be managed through
behavioural change. However, the non modifiable are those that are exist by nature and thus the
patients have no control over them except for the management of the illness. Modifiable include;
smoking and tobacco use, increased levels of cholesterol, obesity, psychosocial stress, diabetes,
hypertension, and sedentary lifestyle. Non modifiable risk factors include; gender/sex, age,
genetics, and a familial history of coronary heart disease.
Cell injury
There are various types of cell injuries. However, necrosis is the type of injury that is
associated with hypoxia which is reduction of oxygen supply. Necrosis is the unnatural and un-
programmed death of cells which is associated to cell injury such is in the case of hypoxia.
Reversible and non reversible cell injury
Reversible cell injury is a temporary type of cell injury that occurs for a short period of
time when there is mild to moderate injury of the cells. The cells are able to revert back to their
normal state once the cause of injury is removed. For example when oxygen is limited for only a
short period of time the myocardial cells may regain their normal state. Oxygen is used in
patients with acute myocardial infarction (Bonace et al.,2015). However, non reversible is a type
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of injury that results to permanent damage of the cells when the cause of cell injury is prolonged.
Thus, even after the removal of the cause the cells are unable to regain their nature as they are
completely dead.
Pathophysiology
The heart is supplied with blood by blood vessels which are the arteries and veins. When
lipid and cholesterol exudates lodge at the arteries they result to stenosis. The reason for the
reduced lumen size is these lipids get covered in two types of cells. Low density lipids are the
main causative agent for coronary heart disease, (Zanoni .P. et al. 2016). The connective tissue
cells surround them forming a mesh framework around. The macrophages become trapped
around this mesh framework resulting to the lumen of the artery decreasing in size. Initially,
someone is able to function when the narrowing is insignificant. Whenever there is >50%
narrowing the patient begins experiencing signs of angina and chest congestion. When the
narrowing advances to >75% the resultant effects can be myocardial infarction.
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References
Boon, R. A., & Dimmeler, S. (2015). MicroRNAs in myocardial infarction. Nature Reviews
Cardiology, 12(3), 135.
Bonaca, M. P., Bhatt, D. L., Cohen, M., Steg, P. G., Storey, R. F., Jensen, E. C., … & Bengtsson,
O. (2015). Long-term use of ticagrelor in patients with prior myocardial infarction. New
England Journal of Medicine, 372(19), 1791-1800.
Zanoni, P., Khetarpal, S. A., Larach, D. B., Hancock-Cerutti, W. F., Millar, J. S., Cuchel, M., …
& Trompet, S. (2016). Rare variant in scavenger receptor BI raises HDL cholesterol and
increases risk of coronary heart disease. Science, 351(6278), 1166-1171.
