In an acute myocardial infarction, the flow of blood from a blood vessel in the heart is blocked, whereby the cardiac muscle receives insufficient oxygen and heart tissue dies. In many cases, the supply of blood in the deadened portion of the heart can be restored via the so-called balloon technique. But after a myocardial infarct, the heart suffers permanent damage, primarily to the left ventricle.

Myocardial Infarction Cause
The most common cause of acute myocardial infarction is narrowing of the epicardial blood vessels due to atheromatous plaques, otherwise known as hardening of the arteries. Plaque rupture with subsequent exposure of the basement membrane in the lining of the blood vessel results in platelet aggregation, blood clot formation, fibrin accumulation, hemorrhage into the plaque, and varying degrees of vasospasm. This can result in partial or complete blockage of the vessel and subsequent myocardial ischemia. Ischemia means lack of oxygen which results in muscle tissue damage. Total occlusion of the vessel for more than 4-6 hours results in irreversible myocardial necrosis, but reperfusion within this period can salvage the myocardium (heart muscle) and reduce morbidity and mortality.

Myocardial Infarction Risk Factors
Six primary risk factors have been identified with the development of atherosclerotic coronary artery disease and myocardial infarction. These include hyperlipidemia (high blood cholesterol and triglycerides), diabetes mellitus, hypertension, smoking, male gender, and family history of atherosclerotic arterial disease. The presence of any risk factor is associated with doubling the relative risk of developing atherosclerotic coronary artery disease. Stress and lack of exercise are additional factors.

Myocardial Infarction Prevention
There are a number of steps one can take to prevent or reduce the risk for myocardial infarction. These include exercise, low stress, good sleep patterns, healthy diet, and perhaps some supplements such as low doses of certain antioxidants, low doses of lipoic acid, curcumin, the nutrient coq10, etc. There is no proof yet that taking supplements reduces the risk of myocardial infarction, but in my opinion, ongoing studies will likely eventually show that certain supplements, when used properly, can reduce the risk for myocardial infarction.

Folic acid post myocardial infarction
Effect of folic Acid on endothelial function following acute myocardial infarction.
Am J Cardiol. 2007 Feb 15;99(4):476-81. Moens AL, Claeys MJ, Wuyts FL, Goovaerts I, Van Hertbruggen E, Wendelen LC, Van Hoof VO, Vrints CJ. Department of Cardiology, University Hospital of Antwerp, Antwerp, Belgium.
The aim of this study was to test the influence of high-dose folic acid (10 mg a day) on endothelial function in patients referred for coronary intervention after an acute myocardial infarction (AMI) and determine its relation to homocysteine levels. Subjects were randomized to receive first folic acid (10 mg/day; group A) or placebo (group B) for 6 weeks in a double-blind crossover trial with a 2-week washout. In conclusion, 6-week treatment with high-dose folic acid improves endothelial function in post-AMI patients, independent from homocysteine status. Folic acid can be recommended to improve postinfarction endothelial dysfunction in patients with normo- and hyperhomocysteinemia.

Acute Myocardial infarction symptom
The most common symptom of acute myocardial infarction is chest pain described as a pressure sensation, fullness, or squeezing in the midportion of the thorax. The chest pain can radiate into the jaw or teeth, shoulder, arm, and/or back. There is often shortness of breath, sweating, and nausea.

Acute Myocardial Infarction treatment
A life-threatening problem that may happen during and after a myocardial infarction is arrhythmias. Arrhythmias are irregular heartbeats or heart rhythms. Arrhythmias that happen during a myocardial infarction can cause sudden death. A patient hooked up to a heart monitor so that caregivers can watch for arrhythmia problems. Some arrhythmias may be treated with medicine, but some need even faster treatment. Emergency arrhythmia treatment may include defibrillation. This procedure uses an electric shock that is given to the heart. The shock is usually given through paddles or sticky patches placed on the chest or back. The shock may help the heart return to a normal beat.
     Medicines and oxygen for acute myocardial infarction treatment. A patient may need extra oxygen until the heart is getting better blood flow. Oxygen may be administered through a mask or nasal cannula (plastic nose prongs). You may be given medicine to break up clots that are blocking your heart arteries. Blood thinners may be given to keep you from having more blood flow problems in your heart. You may also receive nitroglycerin ("nitro"), and morphine or another kind of pain medicine. You may need medicine to help your heart beat normally, or decrease how hard your heart needs to work. Some medicines may keep you from having spasms in your coronary arteries.
     Angioplasty and other procedures: Heart catheterization is an angiogram of the heart arteries to look for blockages. If there are blockages an angioplasty and other procedures may be performed.

Myocardial Infarction and Stem Cells
Doctors at the Catholic University of Leuven, connected with the University Hospital - Gasthuisberg, the Stem Cell Institute Leuven (SCIL), and the Flanders Interuniversity Institute for Biotechnology (VIB) say that the administration of a patient's own stem cells has a significant positive effect on the heart's recovery after an acute myocardial infarction. In the patients studied, the size of the infarct was clearly reduced. The use of stem cells appears to be safe, and to date no side effects have occurred that can be attributed to the stem cells.

Myocardial Perfusion
A myocardial perfusion imaging stress test is usually done in Nuclear Medicine Departments or Cardiac Clinics. They may perform the test on an outpatient or inpatient basis. The myocardial perfusion imaging test involves an injection of a small amount of radioactive material which circulates in the bloodstream and shows if your heart muscle is receiving adequate blood supply under stress and/or rest conditions. The radioactive injection is a clear liquid called Myoview (Tc99m Tetrofosmin for injection). Another material which could also be used is called Thallium.

Myocardial Ischemia
Myocardial ischemia is a condition in which oxygen deprivation to the heart muscle is accompanied by inadequate removal of metabolites because of reduced blood flow or perfusion. In contrast, mere oxygen deprivation (hypoxia or anoxia) without reduction in the clearance of metabolites occurs in cyanotic congenital heart disease, cor pulmonale, severe anemia, asphyxiation, and carbon monoxide poisoning. Patients with these problems do not exhibit ischemic symptoms.

Evaluating the age of a Myocardial Infarction
Assessment of myocardial attenuation and ventricular dimensions with contrast-enhanced computed tomography is useful in determining the age of a myocardial infarction.