Understanding the Myocardial Infarction

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Firefighters respond to a variety of a calls every day, these include (but are not limited to): fire-related, medical, MVCs and HazMat. Response statistics from Toronto Fire Service’s 2011 annual report show that while fire-related calls have been relatively stagnant throughout the last 7 years, medical calls have been significantly increasing (table 1; figure 1). Heart disease and stroke account for roughly 350,000 hospitalizations per year in Canada and first responses to related illnesses and symptoms will undoubtedly be common (Heart and Stroke Foundation of Canada, 2014). Myocardial Infarction (often referred to as a heart attack) is a common cardiac condition that firefighters will encounter in their career. This paper will discuss Myocardial Infarctions in greater detail than the first responder level and explore what the conditions is at the greater health-care provider level.
A myocardial infarction occurs when blood supply to the heart is limited or stopped because of blockage in a coronary artery. Narrowing of coronary arteries as a result of artherosclerotic plaque buildup “causes more than 90% of heart attacks” (Heart and Stroke Foundation of Canada, 2011). As plaque builds up in the arteries, there is an increased chance that the plaque will rupture and cause a bleed that, subsequently, clots (thrombus). Ischemia (reduced blood flow to tissues) to the tissue the coronary artery supplies with become damaged and, with long enough occlusion, die (American Heart Association, 2012).

Signs and Symptoms

Most myocardial infarctions begin with mild pain or discomfort in the chest. Those suffering often aren't sure what's wrong and wait too long before getting help (American Heart Association, 2012). It is impera...

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...ete occlusion of the vessel and results in greater tissue death. The damage in a transmural MI will generally extend much deeper into the muscle tissue (Heuther and McCance, 2012).

In the event of a myocardial infarction, there is an extreme inflammatory response once the heart begins to repair itself. The necrotic tissue is broken down by enzymes and transported to other parts of the body to be disposed of (Heuther and McCance, 2012). The scar tissue that initially replaces the necrotic tissue is weak and, as a result, it will take the patient a few weeks until they feel as if they can return to low levels of activity. After about six weeks, the necrotic tissue has been completely replaced by scar tissue. However, since the scar tissue cannot contract and relax as cardiac muscle does, it will result in permanent dysfunction (Huether and McCance, 2012).

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