Acute myocardial infarction (heart attack) is a life-threatening emergency requiring rapid diagnosis and intervention to minimise heart muscle damage and improve survival. Livasa Hospital operates a comprehensive acute coronary syndrome program with 24x7 emergency cardiology services, rapid cath lab activation and skilled intensive care to manage heart attacks effectively.

Understanding Myocardial Infarction

Myocardial infarction occurs when blood flow through a coronary artery becomes blocked, usually by a blood clot forming on a ruptured atherosclerotic plaque. The blocked artery prevents oxygen delivery to the heart muscle, causing myocardial cells to die (necrosis). The extent of tissue damage depends on:

• Location and size of the blocked artery

• Duration of blockage

• Adequacy of collateral circulation

• Time from symptom onset to reperfusion

Classification:

• STEMI (ST-elevation MI) – Complete coronary occlusion with diagnostic ST-segment elevation on ECG

• NSTEMI (Non-STEMI) – Partial occlusion without ST elevation

• Anterior MI – Left anterior descending coronary territory; generally more extensive

• Inferior MI – Right coronary artery territory

• Posterior MI – Circumflex coronary territory

Recognition of Heart Attack Symptoms

Immediate medical attention is essential for:

• Chest pain or pressure – Sudden onset, crushing or heaviness

• Radiating pain – To arm, shoulder, neck or jaw

• Shortness of breath – With or without chest pain

• Diaphoresis – Sudden profuse sweating

• Nausea or vomiting – Particularly with inferior MI

• Dizziness or syncope – From hypotension or arrhythmia

Women and diabetics may present atypically with fatigue, dyspnoea or vague discomfort.

Time is critical: Door-to-balloon time <90 minutes is the goal.

Emergency Department Protocol at Livasa Hospital

Upon arrival:

1. Rapid triage – Recognition of potential MI

2. Immediate ECG – Within 10 minutes of arrival

3. Cardiac biomarkers – Troponin levels to confirm myocardial necrosis

4. Chest X-ray – Rule out other diagnoses

5. Cardiology consultation – Immediate specialist assessment

6. Cath lab activation – For STEMI or high-risk NSTEMI

Reperfusion Strategies

Primary Percutaneous Coronary Intervention (Primary PCI):

• Emergent coronary angiography followed immediately by balloon angioplasty and stenting

• Restores blood flow to the infarcted area

• Minimises myocardial damage

• Better outcomes than thrombolytic therapy

• Goal: Door-to-balloon time <90 minutes

Thrombolytic Therapy:

• Medication-based clot dissolution

• Used when PCI unavailable within 120 minutes

• Less effective than primary PCI but life-saving when PCI delayed

Medications in Acute MI

Acute Phase:

• Dual antiplatelet therapy – Aspirin and P2Y12 inhibitor

• Anticoagulation – Unfractionated heparin or low-molecular-weight heparin

• Beta-blockers – Reduce heart rate and contractility

• ACE inhibitors – Prevent remodelling

• Statins – Plaque stabilisation

• Nitrates – Symptom relief

Chronic Phase:

• Continuation of dual antiplatelet therapy (typically 1 year)

• Long-term beta-blockers, ACE inhibitors, statins

• Medications adjusted based on complications

Post-MI Complications

Monitoring and management of potential complications:

• Cardiogenic shock – Low cardiac output hypotension

• Arrhythmias – Ventricular fibrillation, complete heart block

• Mechanical complications – Ventricular septal defect, papillary muscle rupture, free wall rupture

• Myocarditis – Inflammatory extension

• Heart failure – Acute or chronic ventricular dysfunction

• Recurrent ischaemia – Inadequate revascularisation

Cardiac Rehabilitation Post-MI

All MI survivors benefit from:

• Supervised exercise training

• Risk factor modification

• Psychological support

• Return-to-work guidance

• Long-term risk factor management

Why Choose Livasa Hospital for MI?

• 24x7 emergency cardiology services

• Rapid cath lab activation (door-to-balloon <90 minutes)

• Experienced interventional cardiologists

• Comprehensive ICU and critical care

• Full spectrum of post-MI management services

NAP – Contact Details

Livasa Hospital Mohali
Sector 71, Sahibzada Ajit Singh Nagar (SAS Nagar)
Mohali, Punjab – 160071
Phone: +91-80788 80788 (24/7 Emergency)
Website: www.livasahospitals.com

If experiencing chest pain or MI symptoms, call +91-80788 80788 immediately for emergency treatment.