[Health Tip] Today is 'Heart Day'... Beware of 'Myocardial Infarction Warning' During Seasonal Change

Published 29 Sep.2023 09:05(KST)

Today (29th) is World Heart Day, established by the World Heart Federation (WHF). It was designated in 2000 to raise awareness and improve understanding of cardiovascular diseases, as the heart and related organs are vital to life yet have low public awareness. According to the Korea Disease Control and Prevention Agency, awareness of early symptoms of myocardial infarction is only 47.1%, less than half of the population.

[Photo by Gangnam Bedro Hospital]

Especially during the chilly transitional seasons, the incidence of cardiovascular diseases can increase, requiring greater caution. Dr. Kim Kyung-soo, Director of Cardiology at Gangnam Bedro Hospital (specialist in cardiology), stated, “Myocardial infarction is the second leading cause of death and the number one cause of sudden death in Korea.” He emphasized, “With an initial mortality rate exceeding 30% and an in-hospital mortality rate of 5-10% even during treatment, myocardial infarction is highly dangerous and progresses rapidly. Therefore, it is essential to understand the warning signs and prevention methods of myocardial infarction and to respond appropriately in emergencies.” In fact, the number of myocardial infarction patients in Korea continues to rise. According to the Health Insurance Review & Assessment Service, the number of acute myocardial infarction patients doubled from about 76,000 in 2013 to approximately 131,000 in 2022, increasing by nearly 6% annually over nine years.

Myocardial infarction is a condition where the coronary arteries supplying blood to the heart are blocked by a thrombus (blood clot), preventing proper blood flow to the heart muscle, which can lead to necrosis, heart attack, and cardiac arrest. Although it is sometimes confused with angina, the two differ in mechanism. Angina occurs when the arteries narrow by 75% to 90%, causing reduced blood supply to the heart, whereas myocardial infarction involves a thrombus completely blocking the artery, cutting off blood flow entirely.

The problem is that unlike angina, which has warning signs such as chest pain, myocardial infarction can occur unexpectedly. Even if there are no prior abnormalities, a thrombus can form and block the coronary artery, causing acute myocardial infarction. Acute myocardial infarction can occur even if the blood vessels are usually clean and electrocardiogram results are normal, due to the formation of a large thrombus for various reasons.

Attention is also needed because myocardial infarction has a poor prognosis. The initial mortality rate is high, and even after recovery, there is a risk of recurrence within the first year. Especially, the mortality rate can rise up to 85% upon recurrence. This is due to the damage to the heart muscle and resulting complications from the initial myocardial infarction, making rapid response crucial. Symptoms must be recognized within the golden hour, emergency measures taken, and treatment to reopen the blocked artery should be administered as soon as possible.

Knowing and responding to the symptoms of myocardial infarction is therefore extremely important. The most common symptom is a pressing or squeezing pain across the entire chest. Symptoms may persist despite rest or taking nitroglycerin, and there may be discomfort like indigestion or pain extending to the neck, jaw, shoulders, or left arm. Dr. Kim Kyung-soo advised, “Symptoms vary by individual, so if you belong to a high-risk group for myocardial infarction, do not ignore even minor signals and make sure to properly identify them.” If symptoms intensify, it is best to immediately visit a hospital for specialized tests such as electrocardiogram, myocardial enzyme tests, and echocardiography, and proceed with treatment.

The most important treatment for myocardial infarction is reperfusion therapy to reopen the blood vessels as quickly as possible. The most common procedure is coronary angioplasty with stent insertion, where a metal mesh stent is used to widen the artery. If the narrowing is severe and this is ineffective, coronary artery bypass graft surgery is performed by grafting a healthy vessel from another part of the body. Stent insertion is an interventional procedure performed while the patient is conscious, whereas bypass surgery requires general anesthesia. Afterward, treatment is continued with a combination of medication and non-medication therapies depending on symptoms.

Director Kim Kyung-su, Department of Cardiology, Gangnam Bedro Hospital <br>[Photo by Gangnam Bedro Hospital]

Director Kim Kyung-su, Department of Cardiology, Gangnam Bedro Hospital
[Photo by Gangnam Bedro Hospital]

The recent increase in myocardial infarction patients is largely attributed to poor lifestyle habits and the rise in adult diseases. Particularly, hyperlipidemia, hypertension, diabetes, smoking, lack of exercise, and high-fat diets are major risk factors. Changing to a low-salt, low-fat diet and quitting smoking can significantly reduce the risk of myocardial infarction. Those in high-risk groups should regularly monitor their cardiovascular health.

Dr. Kim Kyung-soo explained, “Although myocardial infarction is almost impossible to predict or prevent due to its mechanism, knowing the symptoms in advance and responding appropriately can greatly reduce the risk. Especially during transitional seasons with large temperature fluctuations, managing risk factors preventively and paying close attention to vascular health can be an important strategy to maintain a healthy and happy daily life.”