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class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Risk factors subsection </button> <ul id="toc-Risk_factors-sublist" class="vector-toc-list"> <li id="toc-Diet" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Diet"> <div class="vector-toc-text"> 3.1 Diet </div> </a> <ul id="toc-Diet-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Genetics" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Genetics"> <div class="vector-toc-text"> 3.2 Genetics </div> </a> <ul id="toc-Genetics-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_2" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_2"> <div class="vector-toc-text"> 3.3 Other </div> </a> <ul id="toc-Other_2-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Mechanism" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Mechanism"> <div class="vector-toc-text"> 4 Mechanism </div> </a> <button aria-controls="toc-Mechanism-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Mechanism subsection </button> <ul id="toc-Mechanism-sublist" class="vector-toc-list"> <li id="toc-Atherosclerosis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Atherosclerosis"> <div class="vector-toc-text"> 4.1 Atherosclerosis </div> </a> <ul id="toc-Atherosclerosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_causes" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_causes"> <div class="vector-toc-text"> 4.2 Other causes </div> </a> <ul id="toc-Other_causes-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Tissue_death" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Tissue_death"> <div class="vector-toc-text"> 4.3 Tissue death </div> </a> <ul id="toc-Tissue_death-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> 5 Diagnosis </div> </a> <button aria-controls="toc-Diagnosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Diagnosis subsection </button> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> <li id="toc-Criteria" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Criteria"> <div class="vector-toc-text"> 5.1 Criteria </div> </a> <ul id="toc-Criteria-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Types" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Types"> <div class="vector-toc-text"> 5.2 Types </div> </a> <ul id="toc-Types-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Cardiac_biomarkers" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Cardiac_biomarkers"> <div class="vector-toc-text"> 5.3 Cardiac biomarkers </div> </a> <ul id="toc-Cardiac_biomarkers-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Electrocardiogram" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Electrocardiogram"> <div class="vector-toc-text"> 5.4 Electrocardiogram </div> </a> <ul id="toc-Electrocardiogram-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Imaging" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Imaging"> <div class="vector-toc-text"> 5.5 Imaging </div> </a> <ul id="toc-Imaging-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Differential_diagnosis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Differential_diagnosis"> <div class="vector-toc-text"> 5.6 Differential diagnosis </div> </a> <ul id="toc-Differential_diagnosis-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> 6 Prevention </div> </a> <button aria-controls="toc-Prevention-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Prevention subsection </button> <ul id="toc-Prevention-sublist" class="vector-toc-list"> <li id="toc-Primary_prevention" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Primary_prevention"> <div class="vector-toc-text"> 6.1 Primary prevention </div> </a> <ul id="toc-Primary_prevention-sublist" class="vector-toc-list"> <li id="toc-Lifestyle" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Lifestyle"> <div class="vector-toc-text"> 6.1.1 Lifestyle </div> </a> <ul id="toc-Lifestyle-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Medication" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Medication"> <div class="vector-toc-text"> 6.1.2 Medication </div> </a> <ul id="toc-Medication-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Secondary_prevention" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Secondary_prevention"> <div class="vector-toc-text"> 6.2 Secondary prevention </div> </a> <ul id="toc-Secondary_prevention-sublist" class="vector-toc-list"> <li id="toc-Medications" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Medications"> <div class="vector-toc-text"> 6.2.1 Medications </div> </a> <ul id="toc-Medications-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_3" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Other_3"> <div class="vector-toc-text"> 6.2.2 Other </div> </a> <ul id="toc-Other_3-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-First_aid" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#First_aid"> <div class="vector-toc-text"> 7 First aid </div> </a> <ul id="toc-First_aid-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Management" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Management"> <div class="vector-toc-text"> 8 Management </div> </a> <button aria-controls="toc-Management-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Management subsection </button> <ul id="toc-Management-sublist" class="vector-toc-list"> <li id="toc-Pain_2" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Pain_2"> <div class="vector-toc-text"> 8.1 Pain </div> </a> <ul id="toc-Pain_2-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Antithrombotics" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Antithrombotics"> <div class="vector-toc-text"> 8.2 Antithrombotics </div> </a> <ul id="toc-Antithrombotics-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Angiogram" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Angiogram"> <div class="vector-toc-text"> 8.3 Angiogram </div> </a> <ul id="toc-Angiogram-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Fibrinolysis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Fibrinolysis"> <div class="vector-toc-text"> 8.4 Fibrinolysis </div> </a> <ul id="toc-Fibrinolysis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_4" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_4"> <div class="vector-toc-text"> 8.5 Other </div> </a> <ul id="toc-Other_4-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Rehabilitation_and_exercise" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Rehabilitation_and_exercise"> <div class="vector-toc-text"> 8.6 Rehabilitation and exercise </div> </a> <ul id="toc-Rehabilitation_and_exercise-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> 9 Prognosis </div> </a> <button aria-controls="toc-Prognosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Prognosis subsection </button> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> <li id="toc-Complications" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Complications"> <div class="vector-toc-text"> 9.1 Complications </div> </a> <ul id="toc-Complications-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> 10 Epidemiology </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Social_determinants_of_health" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Social_determinants_of_health"> <div class="vector-toc-text"> 11 Social determinants of health </div> </a> <ul id="toc-Social_determinants_of_health-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Society_and_culture" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Society_and_culture"> <div class="vector-toc-text"> 12 Society and culture </div> </a> <button aria-controls="toc-Society_and_culture-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Society and culture subsection </button> <ul id="toc-Society_and_culture-sublist" class="vector-toc-list"> <li id="toc-Legal_implications" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Legal_implications"> <div class="vector-toc-text"> 12.1 Legal implications </div> </a> <ul id="toc-Legal_implications-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> 13 References </div> </a> <button aria-controls="toc-References-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle References subsection </button> <ul id="toc-References-sublist" class="vector-toc-list"> <li id="toc-Sources" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Sources"> <div class="vector-toc-text"> 13.1 Sources </div> </a> <ul id="toc-Sources-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> 14 Further reading </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> 15 External links </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" > Toggle the table of contents </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading">Myocardial infarction</h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 119 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-119" aria-hidden="true" > 119 languages </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-af mw-list-item"><a href="https://af.wikipedia.org/wiki/Hartaanval" title="Hartaanval – Afrikaans" lang="af" hreflang="af" data-title="Hartaanval" data-language-autonym="Afrikaans" data-language-local-name="Afrikaans" class="interlanguage-link-target">Afrikaans</a></li><li class="interlanguage-link interwiki-als mw-list-item"><a href="https://als.wikipedia.org/wiki/Myokardinfarkt" title="Myokardinfarkt – Alemannic" lang="gsw" hreflang="gsw" data-title="Myokardinfarkt" data-language-autonym="Alemannisch" data-language-local-name="Alemannic" class="interlanguage-link-target">Alemannisch</a></li><li class="interlanguage-link interwiki-ar badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://ar.wikipedia.org/wiki/%D9%86%D9%88%D8%A8%D8%A9_%D9%82%D9%84%D8%A8%D9%8A%D8%A9" title="نوبة قلبية – Arabic" lang="ar" hreflang="ar" data-title="نوبة قلبية" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target">العربية</a></li><li class="interlanguage-link interwiki-an mw-list-item"><a href="https://an.wikipedia.org/wiki/Infarto_de_miocardio" title="Infarto de miocardio – Aragonese" lang="an" hreflang="an" data-title="Infarto de miocardio" data-language-autonym="Aragonés" data-language-local-name="Aragonese" class="interlanguage-link-target">Aragonés</a></li><li class="interlanguage-link interwiki-as badge-Q17559452 badge-recommendedarticle mw-list-item" title="recommended article"><a href="https://as.wikipedia.org/wiki/%E0%A6%AE%E0%A6%BE%E0%A6%87%E0%A6%85%27%E0%A6%95%E0%A6%BE%E0%A7%B0%E0%A7%8D%E0%A6%A6%E0%A6%BF%E0%A6%AF%E0%A6%BC%E0%A7%87%E0%A6%B2_%E0%A6%87%E0%A6%A8%E0%A6%AB%E0%A6%BE%E0%A7%B0%E0%A7%8D%E0%A6%95%E0%A6%9A%E0%A6%A8" title="মাইঅ'কাৰ্দিয়েল ইনফাৰ্কচন – Assamese" lang="as" hreflang="as" data-title="মাইঅ'কাৰ্দিয়েল ইনফাৰ্কচন" data-language-autonym="অসমীয়া" data-language-local-name="Assamese" class="interlanguage-link-target">অসমীয়া</a></li><li class="interlanguage-link interwiki-ast mw-list-item"><a href="https://ast.wikipedia.org/wiki/Infartu_agudu_de_miocardiu" title="Infartu agudu de miocardiu – Asturian" lang="ast" hreflang="ast" data-title="Infartu agudu de miocardiu" data-language-autonym="Asturianu" data-language-local-name="Asturian" class="interlanguage-link-target">Asturianu</a></li><li class="interlanguage-link interwiki-gn mw-list-item"><a href="https://gn.wikipedia.org/wiki/%C3%91e%27%C3%A3soro" title="Ñe'ãsoro – Guarani" lang="gn" hreflang="gn" data-title="Ñe'ãsoro" data-language-autonym="Avañe'ẽ" data-language-local-name="Guarani" class="interlanguage-link-target">Avañe'ẽ</a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/%C3%9Cr%C9%99k_tutmas%C4%B1" title="Ürək tutması – Azerbaijani" lang="az" hreflang="az" data-title="Ürək tutması" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target">Azərbaycanca</a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%D8%A7%DB%86%D8%B1%DA%A9_%D8%AD%D9%85%D9%84%D9%87%E2%80%8C%D8%B3%DB%8C" title="اۆرک حمله‌سی – South Azerbaijani" lang="azb" hreflang="azb" data-title="اۆرک حمله‌سی" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target">تۆرکجه</a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%B9%E0%A7%83%E0%A7%8E%E0%A6%AA%E0%A7%87%E0%A6%B6%E0%A7%80%E0%A6%B0_%E0%A6%B0%E0%A6%95%E0%A7%8D%E0%A6%A4%E0%A6%BE%E0%A6%AD%E0%A6%BE%E0%A6%AC%E0%A6%9C%E0%A6%A8%E0%A6%BF%E0%A6%A4_%E0%A6%AE%E0%A7%83%E0%A6%A4%E0%A7%8D%E0%A6%AF%E0%A7%81" title="হৃৎপেশীর রক্তাভাবজনিত মৃত্যু – Bangla" lang="bn" hreflang="bn" data-title="হৃৎপেশীর রক্তাভাবজনিত মৃত্যু" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target">বাংলা</a></li><li class="interlanguage-link interwiki-ba mw-list-item"><a href="https://ba.wikipedia.org/wiki/%D0%9C%D0%B8%D0%BE%D0%BA%D0%B0%D1%80%D0%B4_%D0%B8%D0%BD%D1%84%D0%B0%D1%80%D0%BA%D1%82%D1%8B" title="Миокард инфаркты – Bashkir" lang="ba" hreflang="ba" data-title="Миокард инфаркты" data-language-autonym="Башҡортса" data-language-local-name="Bashkir" class="interlanguage-link-target">Башҡортса</a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%86%D0%BD%D1%84%D0%B0%D1%80%D0%BA%D1%82_%D0%BC%D1%96%D1%8F%D0%BA%D0%B0%D1%80%D0%B4%D0%B0" title="Інфаркт міякарда – Belarusian" lang="be" hreflang="be" data-title="Інфаркт міякарда" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target">Беларуская</a></li><li class="interlanguage-link interwiki-be-x-old mw-list-item"><a href="https://be-tarask.wikipedia.org/wiki/%D0%86%D0%BD%D1%84%D0%B0%D1%80%D0%BA%D1%82_%D0%BC%D1%96%D1%8F%D0%BA%D0%B0%D1%80%D0%B4%D0%B0" title="Інфаркт міякарда – Belarusian (Taraškievica orthography)" lang="be-tarask" hreflang="be-tarask" data-title="Інфаркт міякарда" data-language-autonym="Беларуская (тарашкевіца)" data-language-local-name="Belarusian (Taraškievica orthography)" class="interlanguage-link-target">Беларуская (тарашкевіца)</a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%98%D0%BD%D1%84%D0%B0%D1%80%D0%BA%D1%82_%D0%BD%D0%B0_%D0%BC%D0%B8%D0%BE%D0%BA%D0%B0%D1%80%D0%B4%D0%B0" title="Инфаркт на миокарда – Bulgarian" lang="bg" hreflang="bg" data-title="Инфаркт на миокарда" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target">Български</a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Infarkt_miokarda" title="Infarkt miokarda – Bosnian" lang="bs" hreflang="bs" data-title="Infarkt miokarda" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target">Bosanski</a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Infart_de_miocardi" title="Infart de miocardi – Catalan" lang="ca" hreflang="ca" data-title="Infart de miocardi" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target">Català</a></li><li class="interlanguage-link interwiki-cv mw-list-item"><a href="https://cv.wikipedia.org/wiki/%D0%9C%D0%B8%D0%BE%D0%BA%D0%B0%D1%80%D0%B4_%D0%B8%D0%BD%D1%84%D0%B0%D1%80%D0%BA%D1%87%C4%95" title="Миокард инфаркчĕ – Chuvash" lang="cv" hreflang="cv" data-title="Миокард инфаркчĕ" data-language-autonym="Чӑвашла" data-language-local-name="Chuvash" class="interlanguage-link-target">Чӑвашла</a></li><li class="interlanguage-link interwiki-ceb mw-list-item"><a href="https://ceb.wikipedia.org/wiki/Atake_sa_kasingkasing" title="Atake sa kasingkasing – Cebuano" lang="ceb" hreflang="ceb" data-title="Atake sa kasingkasing" data-language-autonym="Cebuano" data-language-local-name="Cebuano" class="interlanguage-link-target">Cebuano</a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Infarkt_myokardu" title="Infarkt myokardu – Czech" lang="cs" hreflang="cs" data-title="Infarkt myokardu" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target">Čeština</a></li><li class="interlanguage-link interwiki-cy mw-list-item"><a href="https://cy.wikipedia.org/wiki/Trawiad_ar_y_galon" title="Trawiad ar y galon – Welsh" lang="cy" hreflang="cy" data-title="Trawiad ar y galon" data-language-autonym="Cymraeg" data-language-local-name="Welsh" class="interlanguage-link-target">Cymraeg</a></li><li class="interlanguage-link interwiki-da badge-Q70893996 mw-list-item" title=""><a href="https://da.wikipedia.org/wiki/Myokardieinfarkt" title="Myokardieinfarkt – Danish" lang="da" hreflang="da" data-title="Myokardieinfarkt" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target">Dansk</a></li><li class="interlanguage-link interwiki-de badge-Q17437798 badge-goodarticle mw-list-item" title="good article badge"><a href="https://de.wikipedia.org/wiki/Herzinfarkt" title="Herzinfarkt – German" lang="de" hreflang="de" data-title="Herzinfarkt" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target">Deutsch</a></li><li class="interlanguage-link interwiki-dv mw-list-item"><a href="https://dv.wikipedia.org/wiki/%DE%80%DE%A7%DE%83%DE%93%DE%B0_%DE%87%DE%AC%DE%93%DE%AD%DE%86%DE%B0_%DE%96%DE%AC%DE%80%DE%AA%DE%82%DE%B0" title="ހާރޓް އެޓޭކް ޖެހުން – Divehi" lang="dv" hreflang="dv" data-title="ހާރޓް އެޓޭކް ޖެހުން" data-language-autonym="ދިވެހިބަސް" data-language-local-name="Divehi" class="interlanguage-link-target">ދިވެހިބަސް</a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/M%C3%BCokardi_infarkt" title="Müokardi infarkt – Estonian" lang="et" hreflang="et" data-title="Müokardi infarkt" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target">Eesti</a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%88%CE%BC%CF%86%CF%81%CE%B1%CE%B3%CE%BC%CE%B1_%CF%84%CE%BF%CF%85_%CE%BC%CF%85%CE%BF%CE%BA%CE%B1%CF%81%CE%B4%CE%AF%CE%BF%CF%85" title="Έμφραγμα του μυοκαρδίου – Greek" lang="el" hreflang="el" data-title="Έμφραγμα του μυοκαρδίου" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target">Ελληνικά</a></li><li class="interlanguage-link interwiki-es badge-Q17437798 badge-goodarticle mw-list-item" title="good article badge"><a href="https://es.wikipedia.org/wiki/Infarto_agudo_de_miocardio" title="Infarto agudo de miocardio – Spanish" lang="es" hreflang="es" data-title="Infarto agudo de miocardio" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target">Español</a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Korinfarkto" title="Korinfarkto – Esperanto" lang="eo" hreflang="eo" data-title="Korinfarkto" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target">Esperanto</a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Miokardio_infartu_akutu" title="Miokardio infartu akutu – Basque" lang="eu" hreflang="eu" data-title="Miokardio infartu akutu" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target">Euskara</a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%B3%DA%A9%D8%AA%D9%87_%D9%82%D9%84%D8%A8%DB%8C" title="سکته قلبی – Persian" lang="fa" hreflang="fa" data-title="سکته قلبی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target">فارسی</a></li><li class="interlanguage-link interwiki-hif mw-list-item"><a href="https://hif.wikipedia.org/wiki/Dil_ke_daura" title="Dil ke daura – Fiji Hindi" lang="hif" hreflang="hif" data-title="Dil ke daura" data-language-autonym="Fiji Hindi" data-language-local-name="Fiji Hindi" class="interlanguage-link-target">Fiji Hindi</a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Infarctus_du_myocarde" title="Infarctus du myocarde – French" lang="fr" hreflang="fr" data-title="Infarctus du myocarde" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target">Français</a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Taom_cro%C3%AD" title="Taom croí – Irish" lang="ga" hreflang="ga" data-title="Taom croí" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target">Gaeilge</a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Infarto_agudo_de_miocardio" title="Infarto agudo de miocardio – Galician" lang="gl" hreflang="gl" data-title="Infarto agudo de miocardio" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target">Galego</a></li><li class="interlanguage-link interwiki-gu mw-list-item"><a href="https://gu.wikipedia.org/wiki/%E0%AA%B9%E0%AB%83%E0%AA%A6%E0%AA%AF%E0%AA%B0%E0%AB%8B%E0%AA%97%E0%AA%A8%E0%AB%8B_%E0%AA%B9%E0%AB%81%E0%AA%AE%E0%AA%B2%E0%AB%8B" title="હૃદયરોગનો હુમલો – Gujarati" lang="gu" hreflang="gu" data-title="હૃદયરોગનો હુમલો" data-language-autonym="ગુજરાતી" data-language-local-name="Gujarati" class="interlanguage-link-target">ગુજરાતી</a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%8B%AC%EA%B7%BC_%EA%B2%BD%EC%83%89" title="심근 경색 – Korean" lang="ko" hreflang="ko" data-title="심근 경색" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target">한국어</a></li><li class="interlanguage-link interwiki-ha mw-list-item"><a href="https://ha.wikipedia.org/wiki/Ciwon_zuciya" title="Ciwon zuciya – Hausa" lang="ha" hreflang="ha" data-title="Ciwon zuciya" data-language-autonym="Hausa" data-language-local-name="Hausa" class="interlanguage-link-target">Hausa</a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%8D%D6%80%D5%BF%D5%A1%D5%B4%D5%AF%D5%A1%D5%B6%D5%AB_%D5%AB%D5%B6%D6%86%D5%A1%D6%80%D5%AF%D5%BF" title="Սրտամկանի ինֆարկտ – Armenian" lang="hy" hreflang="hy" data-title="Սրտամկանի ինֆարկտ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target">Հայերեն</a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%B9%E0%A5%83%E0%A4%A6%E0%A4%AF%E0%A4%BE%E0%A4%98%E0%A4%BE%E0%A4%A4" title="हृदयाघात – Hindi" lang="hi" hreflang="hi" data-title="हृदयाघात" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target">हिन्दी</a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Infarkt_miokarda" title="Infarkt miokarda – Croatian" lang="hr" hreflang="hr" data-title="Infarkt miokarda" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target">Hrvatski</a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Serangan_jantung" title="Serangan jantung – Indonesian" lang="id" hreflang="id" data-title="Serangan jantung" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target">Bahasa Indonesia</a></li><li class="interlanguage-link interwiki-ia mw-list-item"><a href="https://ia.wikipedia.org/wiki/Infarcto_del_myocardio" title="Infarcto del myocardio – Interlingua" lang="ia" hreflang="ia" data-title="Infarcto del myocardio" data-language-autonym="Interlingua" data-language-local-name="Interlingua" class="interlanguage-link-target">Interlingua</a></li><li class="interlanguage-link interwiki-is mw-list-item"><a href="https://is.wikipedia.org/wiki/Hjarta%C3%A1fall" title="Hjartaáfall – Icelandic" lang="is" hreflang="is" data-title="Hjartaáfall" data-language-autonym="Íslenska" data-language-local-name="Icelandic" class="interlanguage-link-target">Íslenska</a></li><li class="interlanguage-link interwiki-it badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://it.wikipedia.org/wiki/Infarto_miocardico_acuto" title="Infarto miocardico acuto – Italian" lang="it" hreflang="it" data-title="Infarto miocardico acuto" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target">Italiano</a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%90%D7%95%D7%98%D7%9D_%D7%A9%D7%A8%D7%99%D7%A8_%D7%94%D7%9C%D7%91" title="אוטם שריר הלב – Hebrew" lang="he" hreflang="he" data-title="אוטם שריר הלב" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target">עברית</a></li><li class="interlanguage-link interwiki-kn mw-list-item"><a href="https://kn.wikipedia.org/wiki/%E0%B2%B9%E0%B3%83%E0%B2%A6%E0%B2%AF%E0%B2%BE%E0%B2%98%E0%B2%BE%E0%B2%A4" title="ಹೃದಯಾಘಾತ – Kannada" lang="kn" hreflang="kn" data-title="ಹೃದಯಾಘಾತ" data-language-autonym="ಕನ್ನಡ" data-language-local-name="Kannada" class="interlanguage-link-target">ಕನ್ನಡ</a></li><li class="interlanguage-link interwiki-pam mw-list-item"><a href="https://pam.wikipedia.org/wiki/Ataki_keng_pusu" title="Ataki keng pusu – Pampanga" lang="pam" hreflang="pam" data-title="Ataki keng pusu" data-language-autonym="Kapampangan" data-language-local-name="Pampanga" class="interlanguage-link-target">Kapampangan</a></li><li class="interlanguage-link interwiki-ks mw-list-item"><a href="https://ks.wikipedia.org/wiki/%D8%AF%D9%90%D9%84%D9%8F%DA%A9_%D8%AF%D9%88%D8%B1%D9%95" title="دِلُک دورٕ – Kashmiri" lang="ks" hreflang="ks" data-title="دِلُک دورٕ" data-language-autonym="कॉशुर / کٲشُر" data-language-local-name="Kashmiri" class="interlanguage-link-target">कॉशुर / کٲشُر</a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%9C%D0%B8%D0%BE%D0%BA%D0%B0%D1%80%D0%B4_%D0%B8%D0%BD%D1%84%D0%B0%D1%80%D0%BA%D1%82%D1%8B" title="Миокард инфаркты – Kazakh" lang="kk" hreflang="kk" data-title="Миокард инфаркты" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target">Қазақша</a></li><li class="interlanguage-link interwiki-kw mw-list-item"><a href="https://kw.wikipedia.org/wiki/Shora_kolon" title="Shora kolon – Cornish" lang="kw" hreflang="kw" data-title="Shora kolon" data-language-autonym="Kernowek" data-language-local-name="Cornish" class="interlanguage-link-target">Kernowek</a></li><li class="interlanguage-link interwiki-sw mw-list-item"><a href="https://sw.wikipedia.org/wiki/Shtuko_la_moyo" title="Shtuko la moyo – Swahili" lang="sw" hreflang="sw" data-title="Shtuko la moyo" data-language-autonym="Kiswahili" data-language-local-name="Swahili" class="interlanguage-link-target">Kiswahili</a></li><li class="interlanguage-link interwiki-ht mw-list-item"><a href="https://ht.wikipedia.org/wiki/Kriz_kadyak" title="Kriz kadyak – Haitian Creole" lang="ht" hreflang="ht" data-title="Kriz kadyak" data-language-autonym="Kreyòl ayisyen" data-language-local-name="Haitian Creole" class="interlanguage-link-target">Kreyòl ayisyen</a></li><li class="interlanguage-link interwiki-gcr mw-list-item"><a href="https://gcr.wikipedia.org/wiki/Infarctus_di_myokard" title="Infarctus di myokard – Guianan Creole" lang="gcr" hreflang="gcr" data-title="Infarctus di myokard" data-language-autonym="Kriyòl gwiyannen" data-language-local-name="Guianan Creole" class="interlanguage-link-target">Kriyòl gwiyannen</a></li><li class="interlanguage-link interwiki-ku mw-list-item"><a href="https://ku.wikipedia.org/wiki/Mirina_mas%C3%BBlkey%C3%AAn_dil" title="Mirina masûlkeyên dil – Kurdish" lang="ku" hreflang="ku" data-title="Mirina masûlkeyên dil" data-language-autonym="Kurdî" data-language-local-name="Kurdish" class="interlanguage-link-target">Kurdî</a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%9C%D0%B8%D0%BE%D0%BA%D0%B0%D1%80%D0%B4%D0%B4%D1%8B%D0%BD_%D0%B8%D0%BD%D1%84%D0%B0%D1%80%D0%BA%D1%82%D1%8B" title="Миокарддын инфаркты – Kyrgyz" lang="ky" hreflang="ky" data-title="Миокарддын инфаркты" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target">Кыргызча</a></li><li class="interlanguage-link interwiki-lo mw-list-item"><a href="https://lo.wikipedia.org/wiki/%E0%BA%81%E0%BA%B2%E0%BA%99%E0%BB%82%E0%BA%88%E0%BA%A1%E0%BA%95%E0%BA%B5%E0%BA%AB%E0%BA%BB%E0%BA%A7%E0%BB%83%E0%BA%88" title="ການໂຈມຕີຫົວໃຈ – Lao" lang="lo" hreflang="lo" data-title="ການໂຈມຕີຫົວໃຈ" data-language-autonym="ລາວ" data-language-local-name="Lao" class="interlanguage-link-target">ລາວ</a></li><li class="interlanguage-link interwiki-la mw-list-item"><a href="https://la.wikipedia.org/wiki/Infarctus_cordis" title="Infarctus cordis – Latin" lang="la" hreflang="la" data-title="Infarctus cordis" data-language-autonym="Latina" data-language-local-name="Latin" class="interlanguage-link-target">Latina</a></li><li class="interlanguage-link interwiki-lv mw-list-item"><a href="https://lv.wikipedia.org/wiki/Miokarda_infarkts" title="Miokarda infarkts – Latvian" lang="lv" hreflang="lv" data-title="Miokarda infarkts" data-language-autonym="Latviešu" data-language-local-name="Latvian" class="interlanguage-link-target">Latviešu</a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Miokardo_infarktas" title="Miokardo infarktas – Lithuanian" lang="lt" hreflang="lt" data-title="Miokardo infarktas" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target">Lietuvių</a></li><li class="interlanguage-link interwiki-li mw-list-item"><a href="https://li.wikipedia.org/wiki/Hertaanval" title="Hertaanval – Limburgish" lang="li" hreflang="li" data-title="Hertaanval" data-language-autonym="Limburgs" data-language-local-name="Limburgish" class="interlanguage-link-target">Limburgs</a></li><li class="interlanguage-link interwiki-lmo mw-list-item"><a href="https://lmo.wikipedia.org/wiki/Infart_del_miocardi" title="Infart del miocardi – Lombard" lang="lmo" hreflang="lmo" data-title="Infart del miocardi" data-language-autonym="Lombard" data-language-local-name="Lombard" class="interlanguage-link-target">Lombard</a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Sz%C3%ADvinfarktus" title="Szívinfarktus – Hungarian" lang="hu" hreflang="hu" data-title="Szívinfarktus" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target">Magyar</a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%A1%D1%80%D1%86%D0%B5%D0%B2_%D1%83%D0%B4%D0%B0%D1%80" title="Срцев удар – Macedonian" lang="mk" hreflang="mk" data-title="Срцев удар" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target">Македонски</a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%B9%E0%B5%83%E0%B4%A6%E0%B4%AF%E0%B4%BE%E0%B4%98%E0%B4%BE%E0%B4%A4%E0%B4%82" title="ഹൃദയാഘാതം – Malayalam" lang="ml" hreflang="ml" data-title="ഹൃദയാഘാതം" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target">മലയാളം</a></li><li class="interlanguage-link interwiki-mr mw-list-item"><a href="https://mr.wikipedia.org/wiki/%E0%A4%B9%E0%A5%83%E0%A4%A6%E0%A4%AF%E0%A4%BE%E0%A4%98%E0%A4%BE%E0%A4%A4" title="हृदयाघात – Marathi" lang="mr" hreflang="mr" data-title="हृदयाघात" data-language-autonym="मराठी" data-language-local-name="Marathi" class="interlanguage-link-target">मराठी</a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Penginfarkan_miokardium" title="Penginfarkan miokardium – Malay" lang="ms" hreflang="ms" data-title="Penginfarkan miokardium" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target">Bahasa Melayu</a></li><li class="interlanguage-link interwiki-mn mw-list-item"><a href="https://mn.wikipedia.org/wiki/%D0%97%D2%AF%D1%80%D1%85%D0%BD%D0%B8%D0%B9_%D1%88%D0%B8%D0%B3%D0%B4%D1%8D%D1%8D%D1%81" title="Зүрхний шигдээс – Mongolian" lang="mn" hreflang="mn" data-title="Зүрхний шигдээс" data-language-autonym="Монгол" data-language-local-name="Mongolian" class="interlanguage-link-target">Монгол</a></li><li class="interlanguage-link interwiki-my mw-list-item"><a href="https://my.wikipedia.org/wiki/%E1%80%94%E1%80%BE%E1%80%9C%E1%80%AF%E1%80%B6%E1%80%B8%E1%80%9B%E1%80%B1%E1%80%AC%E1%80%82%E1%80%AB" title="နှလုံးရောဂါ – Burmese" lang="my" hreflang="my" data-title="နှလုံးရောဂါ" data-language-autonym="မြန်မာဘာသာ" data-language-local-name="Burmese" class="interlanguage-link-target">မြန်မာဘာသာ</a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Hartinfarct" title="Hartinfarct – Dutch" lang="nl" hreflang="nl" data-title="Hartinfarct" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target">Nederlands</a></li><li class="interlanguage-link interwiki-new mw-list-item"><a href="https://new.wikipedia.org/wiki/%E0%A4%AE%E0%A4%BE%E0%A4%AF%E0%A5%8B%E0%A4%95%E0%A4%BE%E0%A4%B0%E0%A5%8D%E0%A4%A1%E0%A4%BF%E0%A4%AF%E0%A4%B2_%E0%A4%87%E0%A4%A8%E0%A5%8D%E0%A4%AB%E0%A4%BE%E0%A4%B0%E0%A5%8D%E0%A4%95%E0%A5%8D%E0%A4%B8%E0%A4%A8" title="मायोकार्डियल इन्फार्क्सन – Newari" lang="new" hreflang="new" data-title="मायोकार्डियल इन्फार्क्सन" data-language-autonym="नेपाल भाषा" data-language-local-name="Newari" class="interlanguage-link-target">नेपाल भाषा</a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E5%BF%83%E7%AD%8B%E6%A2%97%E5%A1%9E" title="心筋梗塞 – Japanese" lang="ja" hreflang="ja" data-title="心筋梗塞" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target">日本語</a></li><li class="interlanguage-link interwiki-ce mw-list-item"><a href="https://ce.wikipedia.org/wiki/%D0%98%D1%80%D0%B0_%D0%BC%D0%B8%D0%BE%D0%BA%D0%B0%D1%80%D0%B4%D0%B0%D0%BD_%D0%B8%D0%BD%D1%84%D0%B0%D1%80%D0%BA%D1%82" title="Ира миокардан инфаркт – Chechen" lang="ce" hreflang="ce" data-title="Ира миокардан инфаркт" data-language-autonym="Нохчийн" data-language-local-name="Chechen" class="interlanguage-link-target">Нохчийн</a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Hjerteinfarkt" title="Hjerteinfarkt – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Hjerteinfarkt" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target">Norsk bokmål</a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Hjarteattakk" title="Hjarteattakk – Norwegian Nynorsk" lang="nn" hreflang="nn" data-title="Hjarteattakk" data-language-autonym="Norsk nynorsk" data-language-local-name="Norwegian Nynorsk" class="interlanguage-link-target">Norsk nynorsk</a></li><li class="interlanguage-link interwiki-oc mw-list-item"><a href="https://oc.wikipedia.org/wiki/Infart_miocardiac" title="Infart miocardiac – Occitan" lang="oc" hreflang="oc" data-title="Infart miocardiac" data-language-autonym="Occitan" data-language-local-name="Occitan" class="interlanguage-link-target">Occitan</a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%B9%E0%AD%83%E0%AC%A6%E0%AD%8D%E2%80%8C%E0%AC%98%E0%AC%BE%E0%AC%A4" title="ହୃଦ୍‌ଘାତ – Odia" lang="or" hreflang="or" data-title="ହୃଦ୍‌ଘାତ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target">ଓଡ଼ିଆ</a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Miokard_infarkti" title="Miokard infarkti – Uzbek" lang="uz" hreflang="uz" data-title="Miokard infarkti" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target">Oʻzbekcha / ўзбекча</a></li><li class="interlanguage-link interwiki-pa mw-list-item"><a href="https://pa.wikipedia.org/wiki/%E0%A8%A6%E0%A8%BF%E0%A8%B2_%E0%A8%A6%E0%A8%BE_%E0%A8%A6%E0%A9%8C%E0%A8%B0%E0%A8%BE" title="ਦਿਲ ਦਾ ਦੌਰਾ – Punjabi" lang="pa" hreflang="pa" data-title="ਦਿਲ ਦਾ ਦੌਰਾ" data-language-autonym="ਪੰਜਾਬੀ" data-language-local-name="Punjabi" class="interlanguage-link-target">ਪੰਜਾਬੀ</a></li><li class="interlanguage-link interwiki-pnb mw-list-item"><a href="https://pnb.wikipedia.org/wiki/%D8%AF%D9%84_%D8%AF%D8%A7_%D8%AF%D9%88%D8%B1%DB%81" title="دل دا دورہ – Western Punjabi" lang="pnb" hreflang="pnb" data-title="دل دا دورہ" data-language-autonym="پنجابی" data-language-local-name="Western Punjabi" class="interlanguage-link-target">پنجابی</a></li><li class="interlanguage-link interwiki-blk mw-list-item"><a href="https://blk.wikipedia.org/wiki/%E1%80%9E%EA%A9%BB%E1%80%9B%E1%80%AC%E1%82%8F%E1%80%9B%E1%80%B1%E1%80%AC%E1%82%8F%E1%80%82%E1%80%AB%E1%82%8F" title="သꩻရာႏရောႏဂါႏ – Pa'O" lang="blk" hreflang="blk" data-title="သꩻရာႏရောႏဂါႏ" data-language-autonym="ပအိုဝ်ႏဘာႏသာႏ" data-language-local-name="Pa'O" class="interlanguage-link-target">ပအိုဝ်ႏဘာႏသာႏ</a></li><li class="interlanguage-link interwiki-ps mw-list-item"><a href="https://ps.wikipedia.org/wiki/%D8%AF_%D8%B2%DA%93%D9%87_%D8%AD%D9%85%D9%84%D9%87_(%D9%86%D8%A7%D8%B1%D9%88%D8%BA%D9%8A)" title="د زړه حمله (ناروغي) – Pashto" lang="ps" hreflang="ps" data-title="د زړه حمله (ناروغي)" data-language-autonym="پښتو" data-language-local-name="Pashto" class="interlanguage-link-target">پښتو</a></li><li class="interlanguage-link interwiki-jam mw-list-item"><a href="https://jam.wikipedia.org/wiki/Aat_atak" title="Aat atak – Jamaican Creole English" lang="jam" hreflang="jam" data-title="Aat atak" data-language-autonym="Patois" data-language-local-name="Jamaican Creole English" class="interlanguage-link-target">Patois</a></li><li class="interlanguage-link interwiki-nds mw-list-item"><a href="https://nds.wikipedia.org/wiki/Hartinfarkt" title="Hartinfarkt – Low German" lang="nds" hreflang="nds" data-title="Hartinfarkt" data-language-autonym="Plattdüütsch" data-language-local-name="Low German" class="interlanguage-link-target">Plattdüütsch</a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Zawa%C5%82_mi%C4%99%C5%9Bnia_sercowego" title="Zawał mięśnia sercowego – Polish" lang="pl" hreflang="pl" data-title="Zawał mięśnia sercowego" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target">Polski</a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Enfarte_agudo_do_mioc%C3%A1rdio" title="Enfarte agudo do miocárdio – Portuguese" lang="pt" hreflang="pt" data-title="Enfarte agudo do miocárdio" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target">Português</a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Infarct_miocardic" title="Infarct miocardic – Romanian" lang="ro" hreflang="ro" data-title="Infarct miocardic" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target">Română</a></li><li class="interlanguage-link interwiki-qu mw-list-item"><a href="https://qu.wikipedia.org/wiki/Sunqu_p%27itiy" title="Sunqu p'itiy – Quechua" lang="qu" hreflang="qu" data-title="Sunqu p'itiy" data-language-autonym="Runa Simi" data-language-local-name="Quechua" class="interlanguage-link-target">Runa Simi</a></li><li class="interlanguage-link interwiki-rue mw-list-item"><a href="https://rue.wikipedia.org/wiki/%D0%A1%D0%B5%D1%80%D0%B4%D1%86%D1%8C%D0%BE%D0%B2%D1%8B%D0%B9_%D0%BD%D0%B0%D0%BF%D0%B0%D0%B4" title="Сердцьовый напад – Rusyn" lang="rue" hreflang="rue" data-title="Сердцьовый напад" data-language-autonym="Русиньскый" data-language-local-name="Rusyn" class="interlanguage-link-target">Русиньскый</a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%98%D0%BD%D1%84%D0%B0%D1%80%D0%BA%D1%82_%D0%BC%D0%B8%D0%BE%D0%BA%D0%B0%D1%80%D0%B4%D0%B0" title="Инфаркт миокарда – Russian" lang="ru" hreflang="ru" data-title="Инфаркт миокарда" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target">Русский</a></li><li class="interlanguage-link interwiki-sah mw-list-item"><a href="https://sah.wikipedia.org/wiki/%D0%98%D0%BD%D1%84%D0%B0%D1%80%D0%BA%D1%82" title="Инфаркт – Yakut" lang="sah" hreflang="sah" data-title="Инфаркт" data-language-autonym="Саха тыла" data-language-local-name="Yakut" class="interlanguage-link-target">Саха тыла</a></li><li class="interlanguage-link interwiki-sa mw-list-item"><a href="https://sa.wikipedia.org/wiki/%E0%A4%B9%E0%A5%83%E0%A4%A6%E0%A4%AF%E0%A4%BE%E0%A4%98%E0%A4%BE%E0%A4%A4%E0%A4%83" title="हृदयाघातः – Sanskrit" lang="sa" hreflang="sa" data-title="हृदयाघातः" data-language-autonym="संस्कृतम्" data-language-local-name="Sanskrit" class="interlanguage-link-target">संस्कृतम्</a></li><li class="interlanguage-link interwiki-sq mw-list-item"><a href="https://sq.wikipedia.org/wiki/Pika_n%C3%AB_Zem%C3%ABr" title="Pika në Zemër – Albanian" lang="sq" hreflang="sq" data-title="Pika në Zemër" data-language-autonym="Shqip" data-language-local-name="Albanian" class="interlanguage-link-target">Shqip</a></li><li class="interlanguage-link interwiki-si mw-list-item"><a href="https://si.wikipedia.org/wiki/%E0%B7%84%E0%B7%98%E0%B6%AF%E0%B6%BA%E0%B7%8F%E0%B6%B6%E0%B7%8F%E0%B6%B0%E0%B6%BA" title="හෘදයාබාධය – Sinhala" lang="si" hreflang="si" data-title="හෘදයාබාධය" data-language-autonym="සිංහල" data-language-local-name="Sinhala" class="interlanguage-link-target">සිංහල</a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Myocardial_infarction" title="Myocardial infarction – Simple English" lang="en-simple" hreflang="en-simple" data-title="Myocardial infarction" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target">Simple English</a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Infarkt_myokardu" title="Infarkt myokardu – Slovak" lang="sk" hreflang="sk" data-title="Infarkt myokardu" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target">Slovenčina</a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Miokardni_infarkt" title="Miokardni infarkt – Slovenian" lang="sl" hreflang="sl" data-title="Miokardni infarkt" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target">Slovenščina</a></li><li class="interlanguage-link interwiki-szl mw-list-item"><a href="https://szl.wikipedia.org/wiki/Hercszlag" title="Hercszlag – Silesian" lang="szl" hreflang="szl" data-title="Hercszlag" data-language-autonym="Ślůnski" data-language-local-name="Silesian" class="interlanguage-link-target">Ślůnski</a></li><li class="interlanguage-link interwiki-ckb mw-list-item"><a href="https://ckb.wikipedia.org/wiki/%D8%AC%DB%95%DA%B5%D8%AF%DB%95%DB%8C_%D8%AF%DA%B5" title="جەڵدەی دڵ – Central Kurdish" lang="ckb" hreflang="ckb" data-title="جەڵدەی دڵ" data-language-autonym="کوردی" data-language-local-name="Central Kurdish" class="interlanguage-link-target">کوردی</a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%A1%D1%80%D1%87%D0%B0%D0%BD%D0%B8_%D1%83%D0%B4%D0%B0%D1%80" title="Срчани удар – Serbian" lang="sr" hreflang="sr" data-title="Срчани удар" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target">Српски / srpski</a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Sr%C4%8Dani_udar" title="Srčani udar – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Srčani udar" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target">Srpskohrvatski / српскохрватски</a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Syd%C3%A4ninfarkti" title="Sydäninfarkti – Finnish" lang="fi" hreflang="fi" data-title="Sydäninfarkti" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target">Suomi</a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Hj%C3%A4rtinfarkt" title="Hjärtinfarkt – Swedish" lang="sv" hreflang="sv" data-title="Hjärtinfarkt" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target">Svenska</a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Atake_sa_puso" title="Atake sa puso – Tagalog" lang="tl" hreflang="tl" data-title="Atake sa puso" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target">Tagalog</a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%AE%E0%AE%BE%E0%AE%B0%E0%AE%9F%E0%AF%88%E0%AE%AA%E0%AF%8D%E0%AE%AA%E0%AF%81" title="மாரடைப்பு – Tamil" lang="ta" hreflang="ta" data-title="மாரடைப்பு" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target">தமிழ்</a></li><li class="interlanguage-link interwiki-tt mw-list-item"><a href="https://tt.wikipedia.org/wiki/%D0%9C%D0%B8%D0%BE%D0%BA%D0%B0%D1%80%D0%B4_%D0%B8%D0%BD%D1%84%D0%B0%D1%80%D0%BA%D1%82%D1%8B" title="Миокард инфаркты – Tatar" lang="tt" hreflang="tt" data-title="Миокард инфаркты" data-language-autonym="Татарча / tatarça" data-language-local-name="Tatar" class="interlanguage-link-target">Татарча / tatarça</a></li><li class="interlanguage-link interwiki-shn mw-list-item"><a href="https://shn.wikipedia.org/wiki/%E1%80%90%E1%81%A2%E1%80%84%E1%80%BA%E1%80%B8%E1%80%95%E1%80%B5%E1%81%BC%E1%80%BA%E1%82%81%E1%80%B0%E1%80%9D%E1%80%BA%E1%81%B8%E1%82%82%E1%80%BA" title="တၢင်းပဵၼ်ႁူဝ်ၸႂ် – Shan" lang="shn" hreflang="shn" data-title="တၢင်းပဵၼ်ႁူဝ်ၸႂ်" data-language-autonym="တႆး" data-language-local-name="Shan" class="interlanguage-link-target">တႆး</a></li><li class="interlanguage-link interwiki-te mw-list-item"><a href="https://te.wikipedia.org/wiki/%E0%B0%97%E0%B1%81%E0%B0%82%E0%B0%A1%E0%B1%86%E0%B0%AA%E0%B1%8B%E0%B0%9F%E0%B1%81" title="గుండెపోటు – Telugu" lang="te" hreflang="te" data-title="గుండెపోటు" data-language-autonym="తెలుగు" data-language-local-name="Telugu" class="interlanguage-link-target">తెలుగు</a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%81%E0%B8%A5%E0%B9%89%E0%B8%B2%E0%B8%A1%E0%B9%80%E0%B8%99%E0%B8%B7%E0%B9%89%E0%B8%AD%E0%B8%AB%E0%B8%B1%E0%B8%A7%E0%B9%83%E0%B8%88%E0%B8%95%E0%B8%B2%E0%B8%A2%E0%B9%80%E0%B8%AB%E0%B8%95%E0%B8%B8%E0%B8%82%E0%B8%B2%E0%B8%94%E0%B9%80%E0%B8%A5%E0%B8%B7%E0%B8%AD%E0%B8%94" title="กล้ามเนื้อหัวใจตายเหตุขาดเลือด – Thai" lang="th" hreflang="th" data-title="กล้ามเนื้อหัวใจตายเหตุขาดเลือด" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target">ไทย</a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Kalp_krizi" title="Kalp krizi – Turkish" lang="tr" hreflang="tr" data-title="Kalp krizi" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target">Türkçe</a></li><li class="interlanguage-link interwiki-uk badge-Q70893996 mw-list-item" title=""><a 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Click here for more information." src="//upload.wikimedia.org/wikipedia/en/thumb/9/94/Symbol_support_vote.svg/19px-Symbol_support_vote.svg.png" decoding="async" width="19" height="20" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/94/Symbol_support_vote.svg/29px-Symbol_support_vote.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/94/Symbol_support_vote.svg/39px-Symbol_support_vote.svg.png 2x" data-file-width="180" data-file-height="185" /></a></div></div> <div id="mw-indicator-pp-default" class="mw-indicator"><div class="mw-parser-output"><a href="/wiki/Wikipedia:Protection_policy#semi" title="This article is semi-protected until December 31, 2025 at 10:05 UTC."><img alt="Page semi-protected" src="//upload.wikimedia.org/wikipedia/en/thumb/1/1b/Semi-protection-shackle.svg/20px-Semi-protection-shackle.svg.png" decoding="async" width="20" height="20" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/1/1b/Semi-protection-shackle.svg/30px-Semi-protection-shackle.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/1/1b/Semi-protection-shackle.svg/40px-Semi-protection-shackle.svg.png 2x" data-file-width="512" data-file-height="512" /></a></div></div> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Interruption of cardiac blood supply</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">"Heart attack" redirects here. For other uses, see <a href="/wiki/Heart_attack_(disambiguation)" class="mw-disambig" title="Heart attack (disambiguation)">Heart attack (disambiguation)</a>.</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Not to be confused with <a href="/wiki/Cardiac_arrest" title="Cardiac arrest">cardiac arrest</a>, <a href="/wiki/Heart_failure" title="Heart failure">heart failure</a>, or <a href="/wiki/Heart_block" title="Heart block">heart block</a>.</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox infobox-has-images-with-white-backgrounds"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Myocardial infarction</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Acute myocardial infarction (AMI), heart attack</td></tr><tr><td colspan="2" class="infobox-full-data"><a href="/wiki/File:Blausen_0463_HeartAttack.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/fb/Blausen_0463_HeartAttack.png/220px-Blausen_0463_HeartAttack.png" decoding="async" width="220" height="293" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/fb/Blausen_0463_HeartAttack.png/330px-Blausen_0463_HeartAttack.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/fb/Blausen_0463_HeartAttack.png/440px-Blausen_0463_HeartAttack.png 2x" data-file-width="768" data-file-height="1024" /></a></td></tr><tr><td colspan="2" class="infobox-full-data">A myocardial infarction occurs when an <a href="/wiki/Atherosclerosis" title="Atherosclerosis">atherosclerotic</a> <a href="/wiki/Atheroma" title="Atheroma">plaque</a> slowly builds up in the inner lining of a <a href="/wiki/Coronary_artery" class="mw-redirect" title="Coronary artery">coronary artery</a> and then suddenly ruptures, causing catastrophic <a href="/wiki/Thrombus" title="Thrombus">thrombus</a> formation, totally occluding the artery and preventing blood flow downstream to the heart muscle.</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Cardiology" title="Cardiology">Cardiology</a>, <a href="/wiki/Emergency_medicine" title="Emergency medicine">emergency medicine</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data"><a href="/wiki/Chest_pain" title="Chest pain">Chest pain</a>, <a href="/wiki/Shortness_of_breath" title="Shortness of breath">shortness of breath</a>, <a href="/wiki/Nausea" title="Nausea">nausea</a>/<a href="/wiki/Vomiting" title="Vomiting">vomiting</a>, <a href="/wiki/Dizziness" title="Dizziness">dizziness</a> or <a href="/wiki/Presyncope" class="mw-redirect" title="Presyncope">lightheadedness</a>, <a href="/wiki/Diaphoresis" class="mw-redirect" title="Diaphoresis">cold sweat</a>, <a href="/wiki/Fatigue_(medical)" class="mw-redirect" title="Fatigue (medical)">feeling tired</a>; arm, neck, back, jaw, or stomach pain,<a href="#cite_note-HLB2014-1">[1]</a><a href="#cite_note-2">[2]</a> <a href="/wiki/Altered_level_of_consciousness" title="Altered level of consciousness">decreased level</a> or <a href="/wiki/Unconsciousness" title="Unconsciousness">total loss of consciousness</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="infobox-data"><a href="/wiki/Heart_failure" title="Heart failure">Heart failure</a>, <a href="/wiki/Cardiac_arrhythmia" class="mw-redirect" title="Cardiac arrhythmia">irregular heartbeat</a>, <a href="/wiki/Cardiogenic_shock" title="Cardiogenic shock">cardiogenic shock</a>, <a href="/wiki/Coma" title="Coma">coma</a>, <a href="/wiki/Cardiac_arrest" title="Cardiac arrest">cardiac arrest</a><a href="#cite_note-HLB2013MI-3">[3]</a><a href="#cite_note-Heart2015-4">[4]</a></td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data"><a href="/wiki/Angina" title="Angina">Angina</a> or <a href="/wiki/Coronary_artery_disease" title="Coronary artery disease">coronary artery disease</a> usually<a href="#cite_note-HLB2013MI-3">[3]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Risk_factor" title="Risk factor">Risk factors</a></th><td class="infobox-data"><a href="/wiki/Hypertension" title="Hypertension">High blood pressure</a>, <a href="/wiki/Tobacco_smoking" title="Tobacco smoking">smoking</a>, <a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">diabetes</a>, <a href="/wiki/Sedentary_lifestyle" title="Sedentary lifestyle">lack of exercise</a>, <a href="/wiki/Obesity" title="Obesity">obesity</a>, <a href="/wiki/Hypercholesterolaemia" class="mw-redirect" title="Hypercholesterolaemia">high blood cholesterol</a><a href="#cite_note-Meh2014-5">[5]</a><a href="#cite_note-WHO2011-6">[6]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data"><a href="/wiki/Electrocardiogram" class="mw-redirect" title="Electrocardiogram">Electrocardiograms</a> (ECGs), blood tests, <a href="/wiki/Coronary_angiography" class="mw-redirect" title="Coronary angiography">coronary angiography</a><a href="#cite_note-HLB2013D-7">[7]</a></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data"><a href="/wiki/Percutaneous_coronary_intervention" title="Percutaneous coronary intervention">Percutaneous coronary intervention</a>, <a href="/wiki/Thrombolysis" title="Thrombolysis">thrombolysis</a><a href="#cite_note-Europe2012-8">[8]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medication" title="Medication">Medication</a></th><td class="infobox-data"><a href="/wiki/Aspirin" title="Aspirin">Aspirin</a>, <a href="/wiki/Nitroglycerin_(drug)" class="mw-redirect" title="Nitroglycerin (drug)">nitroglycerin</a>, <a href="/wiki/Heparin" title="Heparin">heparin</a><a href="#cite_note-Europe2012-8">[8]</a><a href="#cite_note-Oc2010-9">[9]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Prognosis" title="Prognosis">Prognosis</a></th><td class="infobox-data">STEMI 10% risk of death (developed world)<a href="#cite_note-Europe2012-8">[8]</a></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">15.9 million (2015)<a href="#cite_note-GBD2015Pre-10">[10]</a></td></tr></tbody></table><style data-mw-deduplicate="TemplateStyles:r1236303919">@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}</style> A myocardial infarction (MI), commonly known as a heart attack, occurs when <a href="/wiki/Ischemia" title="Ischemia">blood flow decreases</a> or stops in one of the <a href="/wiki/Coronary_arteries" title="Coronary arteries">coronary arteries</a> of the <a href="/wiki/Heart" title="Heart">heart</a>, causing <a href="/wiki/Infarction" title="Infarction">infarction</a> (tissue death) to the <a href="/wiki/Heart_muscle" class="mw-redirect" title="Heart muscle">heart muscle</a>.<a href="#cite_note-HLB2014-1">[1]</a> The most common symptom is retrosternal <a href="/wiki/Angina" title="Angina">chest pain or discomfort</a> that classically radiates to the left shoulder, arm, or jaw.<a href="#cite_note-HLB2014-1">[1]</a> The pain may occasionally feel like <a href="/wiki/Heartburn" title="Heartburn">heartburn</a>.<a href="#cite_note-HLB2014-1">[1]</a> This is the dangerous type of <a href="/wiki/Acute_coronary_syndrome" title="Acute coronary syndrome">acute coronary syndrome</a>. Other symptoms may include <a href="/wiki/Shortness_of_breath" title="Shortness of breath">shortness of breath</a>, <a href="/wiki/Nausea" title="Nausea">nausea</a>, <a href="/wiki/Presyncope" class="mw-redirect" title="Presyncope">feeling faint</a>, a <a href="/wiki/Diaphoresis" class="mw-redirect" title="Diaphoresis">cold sweat</a>, <a href="/wiki/Fatigue" title="Fatigue">feeling tired</a>, and <a href="/wiki/Decreased_level_of_consciousness" class="mw-redirect" title="Decreased level of consciousness">decreased level of consciousness</a>.<a href="#cite_note-HLB2014-1">[1]</a> About 30% of people have atypical symptoms.<a href="#cite_note-Europe2012-8">[8]</a> Women more often present without chest pain and instead have neck pain, arm pain or feel tired.<a href="#cite_note-11">[11]</a> Among those over 75 years old, about 5% have had an MI with little or no history of symptoms.<a href="#cite_note-Val2011-12">[12]</a> An MI may cause <a href="/wiki/Heart_failure" title="Heart failure">heart failure</a>, an <a href="/wiki/Cardiac_arrhythmia" class="mw-redirect" title="Cardiac arrhythmia">irregular heartbeat</a>, <a href="/wiki/Cardiogenic_shock" title="Cardiogenic shock">cardiogenic shock</a> or <a href="/wiki/Cardiac_arrest" title="Cardiac arrest">cardiac arrest</a>.<a href="#cite_note-HLB2013MI-3">[3]</a><a href="#cite_note-Heart2015-4">[4]</a> Most MIs occur due to <a href="/wiki/Coronary_artery_disease" title="Coronary artery disease">coronary artery disease</a>.<a href="#cite_note-HLB2013MI-3">[3]</a> Risk factors include <a href="/wiki/Hypertension" title="Hypertension">high blood pressure</a>, <a href="/wiki/Tobacco_smoking" title="Tobacco smoking">smoking</a>, <a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">diabetes</a>, <a href="/wiki/Lack_of_exercise" class="mw-redirect" title="Lack of exercise">lack of exercise</a>, <a href="/wiki/Obesity" title="Obesity">obesity</a>, <a href="/wiki/Hypercholesterolaemia" class="mw-redirect" title="Hypercholesterolaemia">high blood cholesterol</a>, poor diet, and <a href="/wiki/Excessive_alcohol_intake" class="mw-redirect" title="Excessive alcohol intake">excessive alcohol intake</a>.<a href="#cite_note-Meh2014-5">[5]</a><a href="#cite_note-WHO2011-6">[6]</a> The complete blockage of a <a href="/wiki/Coronary_artery" class="mw-redirect" title="Coronary artery">coronary artery</a> caused by a rupture of an <a href="/wiki/Atherosclerosis" title="Atherosclerosis">atherosclerotic plaque</a> is usually the underlying mechanism of an MI.<a href="#cite_note-HLB2013MI-3">[3]</a> MIs are less commonly caused by <a href="/wiki/Coronary_artery_spasm" class="mw-redirect" title="Coronary artery spasm">coronary artery spasms</a>, which may be due to <a href="/wiki/Cocaine" title="Cocaine">cocaine</a>, significant emotional stress (often known as <a href="/wiki/Takotsubo_syndrome" class="mw-redirect" title="Takotsubo syndrome">Takotsubo syndrome</a> or broken heart syndrome) and extreme cold, among others.<a href="#cite_note-13">[13]</a><a href="#cite_note-14">[14]</a> Many tests are helpful with diagnosis, including <a href="/wiki/Electrocardiogram" class="mw-redirect" title="Electrocardiogram">electrocardiograms</a> (ECGs), blood tests and <a href="/wiki/Coronary_angiography" class="mw-redirect" title="Coronary angiography">coronary angiography</a>.<a href="#cite_note-HLB2013D-7">[7]</a> An ECG, which is a recording of the heart's electrical activity, may confirm an ST elevation MI (<a href="#STEMI">STEMI</a>), if <a href="/wiki/ST_elevation" title="ST elevation">ST elevation</a> is present.<a href="#cite_note-Europe2012-8">[8]</a><a href="#cite_note-15">[15]</a> Commonly used blood tests include <a href="/wiki/Troponin" title="Troponin">troponin</a> and less often <a href="/wiki/CPK-MB_test" title="CPK-MB test">creatine kinase MB</a>.<a href="#cite_note-HLB2013D-7">[7]</a> Treatment of an MI is time-critical.<a href="#cite_note-Davidsons2010-16">[16]</a> <a href="/wiki/Aspirin" title="Aspirin">Aspirin</a> is an appropriate immediate treatment for a suspected MI.<a href="#cite_note-Oc2010-9">[9]</a> <a href="/wiki/Nitroglycerin_(drug)" class="mw-redirect" title="Nitroglycerin (drug)">Nitroglycerin</a> or <a href="/wiki/Opioid" title="Opioid">opioids</a> may be used to help with chest pain; however, they do not improve overall outcomes.<a href="#cite_note-Europe2012-8">[8]</a><a href="#cite_note-Oc2010-9">[9]</a> <a href="/wiki/Oxygen_therapy" title="Oxygen therapy">Supplemental oxygen</a> is recommended in those with <a href="/wiki/Hypoxia_(medical)" class="mw-redirect" title="Hypoxia (medical)">low oxygen levels</a> or shortness of breath.<a href="#cite_note-Oc2010-9">[9]</a> In a STEMI, treatments attempt to restore blood flow to the heart and include <a href="/wiki/Percutaneous_coronary_intervention" title="Percutaneous coronary intervention">percutaneous coronary intervention</a> (PCI), where the arteries are pushed open and may be <a href="/wiki/Stent" title="Stent">stented</a>, or <a href="/wiki/Thrombolysis" title="Thrombolysis">thrombolysis</a>, where the blockage is removed using medications.<a href="#cite_note-Europe2012-8">[8]</a> People who have a non-ST elevation myocardial infarction (<a href="#NSTEMI">NSTEMI</a>) are often managed with the blood thinner <a href="/wiki/Heparin" title="Heparin">heparin</a>, with the additional use of PCI in those at high risk.<a href="#cite_note-Oc2010-9">[9]</a> In people with blockages of multiple coronary arteries and diabetes, <a href="/wiki/Coronary_artery_bypass_surgery" title="Coronary artery bypass surgery">coronary artery bypass surgery</a> (CABG) may be recommended rather than <a href="/wiki/Angioplasty" title="Angioplasty">angioplasty</a>.<a href="#cite_note-Hamm2011-17">[17]</a> After an MI, lifestyle modifications, along with long-term treatment with aspirin, <a href="/wiki/Beta_blockers" class="mw-redirect" title="Beta blockers">beta blockers</a> and <a href="/wiki/Statin" title="Statin">statins</a>, are typically recommended.<a href="#cite_note-Europe2012-8">[8]</a> Worldwide, about 15.9 million myocardial infarctions occurred in 2015.<a href="#cite_note-GBD2015Pre-10">[10]</a> More than 3 million people had an ST elevation MI, and more than 4 million had an NSTEMI.<a href="#cite_note-Lancet08-18">[18]</a> STEMIs occur about twice as often in men as women.<a href="#cite_note-AHA2013-19">[19]</a> About one million people have an MI each year in the United States.<a href="#cite_note-HLB2013MI-3">[3]</a> In the developed world, the risk of death in those who have had a STEMI is about 10%.<a href="#cite_note-Europe2012-8">[8]</a> Rates of MI for a given age have decreased globally between 1990 and 2010.<a href="#cite_note-20">[20]</a> In 2011, an MI was one of the top five most expensive conditions during inpatient hospitalizations in the US, with a cost of about $11.5 billion for 612,000 hospital stays.<a href="#cite_note-21">[21]</a> <style data-mw-deduplicate="TemplateStyles:r886046785">.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}</style><div class="toclimit-3"><meta property="mw:PageProp/toc" /></div> <div class="mw-heading mw-heading2"><h2 id="Terminology">Terminology</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Acute_coronary_syndrome" title="Acute coronary syndrome">Acute coronary syndrome</a></div> Myocardial infarction (MI) refers to tissue death (<a href="/wiki/Infarction" title="Infarction">infarction</a>) of the heart muscle (<a href="/wiki/Myocardium" class="mw-redirect" title="Myocardium">myocardium</a>) caused by <a href="/wiki/Myocardial_ischemia" class="mw-redirect" title="Myocardial ischemia">ischemia</a>, the lack of oxygen delivery to myocardial tissue. It is a type of <a href="/wiki/Acute_coronary_syndrome" title="Acute coronary syndrome">acute coronary syndrome</a>, which describes a sudden or short-term change in symptoms related to blood flow to the heart.<a href="#cite_note-FOOTNOTEMorrowBraunwald20161–3Dwight201641-22">[22]</a> Unlike the other type of acute coronary syndrome, <a href="/wiki/Unstable_angina" title="Unstable angina">unstable angina</a>, a myocardial <a href="/wiki/Infarction" title="Infarction">infarction</a> occurs when there is <a href="/wiki/Cell_death" title="Cell death">cell death</a>, which can be estimated by measuring by a <a href="/wiki/Blood_test" title="Blood test">blood test</a> for <a href="/wiki/Biomarker_(medicine)" title="Biomarker (medicine)">biomarkers</a> (the cardiac protein <a href="/wiki/Troponin" title="Troponin">troponin</a>).<a href="#cite_note-FOOTNOTEMorrowBraunwald20161–3-23">[23]</a> When there is evidence of an MI, it may be classified as an ST elevation myocardial infarction (STEMI) or Non-ST elevation myocardial infarction (NSTEMI) based on the results of an <a href="/wiki/ECG" class="mw-redirect" title="ECG">ECG</a>.<a href="#cite_note-THIRDDEF-24">[24]</a> The phrase "heart attack" is often used non-specifically to refer to myocardial infarction. An MI is different from—but can cause—<a href="/wiki/Cardiac_arrest" title="Cardiac arrest">cardiac arrest</a>, where the heart is not contracting at all or so poorly that all vital organs cease to function, thus leading to death.<a href="#cite_note-FOOTNOTEBlumenthalMargolis20074–5-25">[25]</a> It is also distinct from <a href="/wiki/Heart_failure" title="Heart failure">heart failure</a>, in which the pumping action of the heart is impaired. However, an MI may lead to heart failure.<a href="#cite_note-FOOTNOTEMorrowBohula2016295-26">[26]</a> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2></div> <style data-mw-deduplicate="TemplateStyles:r1273380762/mw-parser-output/.tmulti">.mw-parser-output .tmulti .multiimageinner{display:flex;flex-direction:column}.mw-parser-output .tmulti .trow{display:flex;flex-direction:row;clear:left;flex-wrap:wrap;width:100%;box-sizing:border-box}.mw-parser-output .tmulti .tsingle{margin:1px;float:left}.mw-parser-output .tmulti .theader{clear:both;font-weight:bold;text-align:center;align-self:center;background-color:transparent;width:100%}.mw-parser-output .tmulti .thumbcaption{background-color:transparent}.mw-parser-output .tmulti .text-align-left{text-align:left}.mw-parser-output .tmulti .text-align-right{text-align:right}.mw-parser-output .tmulti .text-align-center{text-align:center}@media all and (max-width:720px){.mw-parser-output .tmulti .thumbinner{width:100%!important;box-sizing:border-box;max-width:none!important;align-items:center}.mw-parser-output .tmulti .trow{justify-content:center}.mw-parser-output .tmulti .tsingle{float:none!important;max-width:100%!important;box-sizing:border-box;text-align:center}.mw-parser-output .tmulti .tsingle .thumbcaption{text-align:left}.mw-parser-output .tmulti .trow>.thumbcaption{text-align:center}}@media screen{html.skin-theme-clientpref-night .mw-parser-output .tmulti .multiimageinner span:not(.skin-invert-image):not(.skin-invert):not(.bg-transparent) img{background-color:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .tmulti .multiimageinner span:not(.skin-invert-image):not(.skin-invert):not(.bg-transparent) img{background-color:white}}</style><div class="thumb tmulti tright"><div class="thumbinner multiimageinner" style="width:254px;max-width:254px"><div class="trow"><div class="tsingle" style="width:252px;max-width:252px"><div class="thumbimage"><a href="/wiki/File:Acute_myocardial_infarction_pain_svg_hariadhi.svg" class="mw-file-description"><img alt="View of the chest with common areas of MI coloured" src="//upload.wikimedia.org/wikipedia/commons/thumb/8/8a/Acute_myocardial_infarction_pain_svg_hariadhi.svg/250px-Acute_myocardial_infarction_pain_svg_hariadhi.svg.png" decoding="async" width="250" height="250" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/8a/Acute_myocardial_infarction_pain_svg_hariadhi.svg/375px-Acute_myocardial_infarction_pain_svg_hariadhi.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/8a/Acute_myocardial_infarction_pain_svg_hariadhi.svg/500px-Acute_myocardial_infarction_pain_svg_hariadhi.svg.png 2x" data-file-width="512" data-file-height="512" /></a></div></div></div><div class="trow"><div class="tsingle" style="width:252px;max-width:252px"><div class="thumbimage"><a href="/wiki/File:Acute_myocardial_infarction_pain_back_svg_hariadhi.svg" class="mw-file-description"><img alt="View of the back with common areas of MI coloured" src="//upload.wikimedia.org/wikipedia/commons/thumb/2/26/Acute_myocardial_infarction_pain_back_svg_hariadhi.svg/250px-Acute_myocardial_infarction_pain_back_svg_hariadhi.svg.png" decoding="async" width="250" height="250" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/26/Acute_myocardial_infarction_pain_back_svg_hariadhi.svg/375px-Acute_myocardial_infarction_pain_back_svg_hariadhi.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/26/Acute_myocardial_infarction_pain_back_svg_hariadhi.svg/500px-Acute_myocardial_infarction_pain_back_svg_hariadhi.svg.png 2x" data-file-width="512" data-file-height="512" /></a></div><div class="thumbcaption">Areas where pain is experienced in myocardial infarction, showing common (dark red) and less common (light red) areas on the chest (top) and back (bottom).</div></div></div></div></div> Chest pain that may or may not radiate to other parts of the body is the most typical and significant symptom of myocardial infarction. It might be accompanied by other symptoms such as sweating.<a href="#cite_note-FOOTNOTEMorrow201659–61-27">[27]</a> <div class="mw-heading mw-heading3"><h3 id="Pain">Pain</h3></div> <a href="/wiki/Chest_pain" title="Chest pain">Chest pain</a> is one of the most common symptoms of acute myocardial infarction and is often described as a sensation of tightness, pressure, or squeezing. Pain radiates most often to the left arm, but may also radiate to the lower jaw, neck, right arm, back, and upper <a href="/wiki/Abdomen" title="Abdomen">abdomen</a>.<a href="#cite_note-Harrisons2015-28">[28]</a><a href="#cite_note-FOOTNOTEMorrow201659–60-29">[29]</a> The pain most suggestive of an acute MI, with the highest <a href="/wiki/Likelihood_function" title="Likelihood function">likelihood ratio</a>, is pain radiating to the right arm and shoulder.<a href="#cite_note-Harrisons2015B-30">[30]</a><a href="#cite_note-FOOTNOTEMorrow201659–60-29">[29]</a> Similarly, chest pain similar to a previous heart attack is also suggestive.<a href="#cite_note-Gupta2016-31">[31]</a> The pain associated with MI is usually diffuse, does not change with position, and lasts for more than 20 minutes.<a href="#cite_note-THIRDDEF-24">[24]</a> It might be described as pressure, tightness, knifelike, tearing, burning sensation (all these are also manifested during other diseases). It could be felt as an unexplained anxiety, and pain might be absent altogether.<a href="#cite_note-FOOTNOTEMorrow201659–60-29">[29]</a> <a href="/wiki/Levine%27s_sign" title="Levine's sign">Levine's sign</a>, in which a person localizes the chest pain by clenching one or both fists over their <a href="/wiki/Human_sternum" class="mw-redirect" title="Human sternum">sternum</a>, has classically been thought to be predictive of cardiac chest pain, although a prospective observational study showed it had a poor <a href="/wiki/Positive_predictive_value" class="mw-redirect" title="Positive predictive value">positive predictive value</a>.<a href="#cite_note-pmid17208083-32">[32]</a> Typically, chest pain because of ischemia, be it unstable angina or myocardial infarction, lessens with the use of <a href="/wiki/Nitroglycerin_(drug)" class="mw-redirect" title="Nitroglycerin (drug)">nitroglycerin</a>, but nitroglycerin may also relieve chest pain arising from non-cardiac causes.<a href="#cite_note-FOOTNOTEAllisonMurphy2012197Morrow201660-33">[33]</a> <div class="mw-heading mw-heading3"><h3 id="Other">Other</h3></div> Chest pain may be accompanied by <a href="/wiki/Diaphoresis" class="mw-redirect" title="Diaphoresis">sweating</a>, nausea or vomiting, and <a href="/wiki/Syncope_(medicine)" title="Syncope (medicine)">fainting</a>,<a href="#cite_note-THIRDDEF-24">[24]</a><a href="#cite_note-Harrisons2015B-30">[30]</a> and these symptoms may also occur without any pain at all.<a href="#cite_note-Harrisons2015-28">[28]</a> Dizziness or lightheadedness is common and occurs due to reduction in oxygen and blood to the brain. In females, the most common symptoms of myocardial infarction include shortness of breath, weakness, and <a href="/wiki/Fatigue_(physical)" class="mw-redirect" title="Fatigue (physical)">fatigue</a>.<a href="#cite_note-ACSwomen-34">[34]</a> Females are more likely to have unusual or unexplained tiredness and nausea or vomiting as symptoms.<a href="#cite_note-35">[35]</a> Females having heart attacks are more likely to have palpitations, back pain, labored breath, vomiting, and left arm pain than males, although the studies showing these differences had high variability.<a href="#cite_note-36">[36]</a> Females are less likely to report chest pain during a heart attack and more likely to report nausea, jaw pain, neck pain, cough, and fatigue, although these findings are inconsistent across studies.<a href="#cite_note-37">[37]</a> Females with heart attacks also had more indigestion, <a href="/wiki/Dizziness" title="Dizziness">dizziness</a>, <a href="/wiki/Anorexia_(symptom)" title="Anorexia (symptom)">loss of appetite</a>, and loss of consciousness.<a href="#cite_note-38">[38]</a> <a href="/wiki/Shortness_of_breath" title="Shortness of breath">Shortness of breath</a> is a common, and sometimes the only symptom, occurring when damage to the heart limits the <a href="/wiki/Cardiac_output" title="Cardiac output">output</a> of the <a href="/wiki/Left_ventricle" class="mw-redirect" title="Left ventricle">left ventricle</a>, with breathlessness arising either from <a href="/wiki/Hypoxemia" title="Hypoxemia">low oxygen in the blood</a> or <a href="/wiki/Pulmonary_edema" title="Pulmonary edema">pulmonary edema</a>.<a href="#cite_note-Harrisons2015-28">[28]</a><a href="#cite_note-39">[39]</a> Other less common symptoms include weakness, <a href="/wiki/Light-headedness" class="mw-redirect" title="Light-headedness">light-headedness</a>, <a href="/wiki/Palpitation" class="mw-redirect" title="Palpitation">palpitations</a>, and abnormalities in <a href="/wiki/Heart_rate" title="Heart rate">heart rate</a> or <a href="/wiki/Blood_pressure" title="Blood pressure">blood pressure</a>.<a href="#cite_note-Davidsons2010-16">[16]</a> These symptoms are likely induced by a massive surge of <a href="/wiki/Catecholamines" class="mw-redirect" title="Catecholamines">catecholamines</a> from the <a href="/wiki/Sympathetic_nervous_system" title="Sympathetic nervous system">sympathetic nervous system</a>, which occurs in response to pain and, where present, low <a href="/wiki/Blood_pressure" title="Blood pressure">blood pressure</a>.<a href="#cite_note-40">[40]</a> <a href="/wiki/Unconsciousness" title="Unconsciousness">Loss of consciousness</a> can occur in myocardial infarctions due to inadequate blood flow to the <a href="/wiki/Brain" title="Brain">brain</a> and <a href="/wiki/Cardiogenic_shock" title="Cardiogenic shock">cardiogenic shock</a>, and <a href="/wiki/Sudden_cardiac_death" class="mw-redirect" title="Sudden cardiac death">sudden death</a>, frequently due to the development of <a href="/wiki/Ventricular_fibrillation" title="Ventricular fibrillation">ventricular fibrillation</a>.<a href="#cite_note-ESC_STEMI-41">[41]</a> When the brain was without oxygen for too long due to a myocardial infarction, <a href="/wiki/Coma" title="Coma">coma</a> and <a href="/wiki/Vegetative_state" title="Vegetative state">persistent vegetative state</a> can occur. Cardiac arrest, and atypical symptoms such as <a href="/wiki/Palpitations" title="Palpitations">palpitations</a>, occur more frequently in females, the elderly, those with diabetes, in people who have just had surgery, and in critically ill patients.<a href="#cite_note-THIRDDEF-24">[24]</a> <div class="mw-heading mw-heading3"><h3 id="Absence">Absence</h3></div> "Silent" myocardial infarctions can happen without any symptoms at all.<a href="#cite_note-Val2011-12">[12]</a> These cases can be discovered later on <a href="/wiki/Electrocardiograms" class="mw-redirect" title="Electrocardiograms">electrocardiograms</a>, using blood enzyme tests, or at <a href="/wiki/Autopsy" title="Autopsy">autopsy</a> after a person has died. Such silent myocardial infarctions represent between 22 and 64% of all infarctions,<a href="#cite_note-Val2011-12">[12]</a> and are more common in the <a href="/wiki/Elderly" class="mw-redirect" title="Elderly">elderly</a>,<a href="#cite_note-Val2011-12">[12]</a> in those with <a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">diabetes mellitus</a><a href="#cite_note-Davidsons2010-16">[16]</a> and after <a href="/wiki/Heart_transplantation" title="Heart transplantation">heart transplantation</a>. In people with diabetes, differences in <a href="/wiki/Threshold_of_pain" title="Threshold of pain">pain threshold</a>, <a href="/wiki/Autonomic_neuropathy" title="Autonomic neuropathy">autonomic neuropathy</a>, and <a href="/wiki/Psychology" title="Psychology">psychological</a> factors have been cited as possible explanations for the lack of symptoms.<a href="#cite_note-Diabetologica2004-David-42">[42]</a> In heart transplantation, the <a href="/wiki/Organ_donation" title="Organ donation">donor</a> heart is not fully innervated by the nervous system of the recipient.<a href="#cite_note-rubin-43">[43]</a> <div class="mw-heading mw-heading2"><h2 id="Risk_factors">Risk factors</h2></div> The most prominent risk factors for myocardial infarction are older age, actively <a href="/wiki/Smoking" title="Smoking">smoking</a>, <a href="/wiki/Hypertension" title="Hypertension">high blood pressure</a>, <a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">diabetes mellitus</a>, and total <a href="/wiki/Cholesterol" title="Cholesterol">cholesterol</a> and <a href="/wiki/High-density_lipoprotein" title="High-density lipoprotein">high-density lipoprotein</a> levels.<a href="#cite_note-FOOTNOTEGazianoGaziano201611-22-44">[44]</a> Many risk factors of myocardial infarction are shared with <a href="/wiki/Coronary_artery_disease" title="Coronary artery disease">coronary artery disease</a>, the primary cause of myocardial infarction,<a href="#cite_note-Davidsons2010-16">[16]</a> with other risk factors including male sex, low levels of physical activity, a past <a href="/wiki/Family_history_(medicine)" title="Family history (medicine)">family history</a>, <a href="/wiki/Obesity" title="Obesity">obesity</a>, and <a href="/wiki/Alcohol_use" class="mw-redirect" title="Alcohol use">alcohol use</a>.<a href="#cite_note-Davidsons2010-16">[16]</a> Risk factors for myocardial disease are often included in risk factor stratification scores, such as the <a href="/wiki/Framingham_Risk_Score" title="Framingham Risk Score">Framingham Risk Score</a>.<a href="#cite_note-AHA2013-19">[19]</a> At any given age, men are more at risk than women for the development of cardiovascular disease.<a href="#cite_note-EUROPEAN2012-45">[45]</a> <a href="/wiki/Hypercholesterolemia" title="Hypercholesterolemia">High levels of blood cholesterol</a> is a known risk factor, particularly high <a href="/wiki/Low-density_lipoprotein" title="Low-density lipoprotein">low-density lipoprotein</a>, low <a href="/wiki/High-density_lipoprotein" title="High-density lipoprotein">high-density lipoprotein</a>, and high <a href="/wiki/Triglycerides" class="mw-redirect" title="Triglycerides">triglycerides</a>.<a href="#cite_note-pmid=16697342-46">[46]</a> Many risk factors for myocardial infarction are potentially modifiable, with the most important being <a href="/wiki/Tobacco_smoking" title="Tobacco smoking">tobacco smoking</a> (including <a href="/wiki/Secondhand_smoke" class="mw-redirect" title="Secondhand smoke">secondhand smoke</a>).<a href="#cite_note-Davidsons2010-16">[16]</a> Smoking appears to be the cause of about 36% and obesity the cause of 20% of <a href="/wiki/Coronary_artery_disease" title="Coronary artery disease">coronary artery disease</a>.<a href="#cite_note-Kivi2012-47">[47]</a> Lack of physical activity has been linked to 7–12% of cases.<a href="#cite_note-Kivi2012-47">[47]</a><a href="#cite_note-48">[48]</a> Less common causes include stress-related causes such as <a href="/wiki/Workplace_stress" class="mw-redirect" title="Workplace stress">job stress</a>, which accounts for about 3% of cases,<a href="#cite_note-Kivi2012-47">[47]</a> and chronic high stress levels.<a href="#cite_note-pmid=22473079-49">[49]</a> <div class="mw-heading mw-heading3"><h3 id="Diet">Diet</h3></div> There is varying evidence about the importance of <a href="/wiki/Saturated_fat" title="Saturated fat">saturated fat</a> in the development of myocardial infarctions. Eating polyunsaturated fat instead of <a href="/wiki/Saturated_fat" title="Saturated fat">saturated fats</a> has been shown in studies to be associated with a decreased risk of myocardial infarction,<a href="#cite_note-:1-50">[50]</a> while other studies find little evidence that reducing dietary saturated fat or increasing <a href="/wiki/Polyunsaturated_fat" title="Polyunsaturated fat">polyunsaturated fat</a> intake affects heart attack risk.<a href="#cite_note-Chow2014-51">[51]</a><a href="#cite_note-52">[52]</a> Dietary cholesterol does not appear to have a significant effect on blood cholesterol and thus recommendations about its consumption may not be needed.<a href="#cite_note-53">[53]</a> <a href="/wiki/Trans_fats" class="mw-redirect" title="Trans fats">Trans fats</a> do appear to increase risk.<a href="#cite_note-Chow2014-51">[51]</a> Acute and prolonged intake of high quantities of alcoholic drinks (3–4 or more daily) increases the risk of a heart attack.<a href="#cite_note-Krenz2012-54">[54]</a> <div class="mw-heading mw-heading3"><h3 id="Genetics">Genetics</h3></div> Family history of <a href="/wiki/Ischemic_heart_disease" class="mw-redirect" title="Ischemic heart disease">ischemic heart disease</a> or MI, particularly if one has a male first-degree relative (father, brother) who had a myocardial infarction before age 55 years, or a female first-degree relative (mother, sister) less than age 65 increases a person's risk of MI.<a href="#cite_note-EUROPEAN2012-45">[45]</a> <a href="/wiki/Genome-wide_association_studies" class="mw-redirect" title="Genome-wide association studies">Genome-wide association studies</a> have found 27 genetic variants that are associated with an increased risk of myocardial infarction.<a href="#cite_note-Genomics_of_Cardiovascular_Disease-55">[55]</a> The strongest association of MI has been found with <a href="/wiki/Chromosome_9" title="Chromosome 9">chromosome 9</a> on the short arm p at <a href="/wiki/Locus_(genetics)" title="Locus (genetics)">locus</a> 21, which contains genes CDKN2A and 2B, although the <a href="/wiki/Single_nucleotide_polymorphisms" class="mw-redirect" title="Single nucleotide polymorphisms">single nucleotide polymorphisms</a> that are implicated are within a non-coding region.<a href="#cite_note-Genomics_of_Cardiovascular_Disease-55">[55]</a> The majority of these variants are in regions that have not been previously implicated in coronary artery disease. The following genes have an association with MI: <a href="/wiki/PCSK9" title="PCSK9">PCSK9</a>, <a href="/wiki/SORT1" class="mw-redirect" title="SORT1">SORT1</a>, <a href="/wiki/MIA3" class="mw-redirect" title="MIA3">MIA3</a>, <a href="/wiki/WDR12" title="WDR12">WDR12</a>, <a href="/wiki/MRAS" title="MRAS">MRAS</a>, <a href="/wiki/PHACTR1" class="mw-redirect" title="PHACTR1">PHACTR1</a>, <a href="/wiki/Lipoprotein(a)" title="Lipoprotein(a)">LPA</a>, <a href="/wiki/TCF21" class="mw-redirect" title="TCF21">TCF21</a>, <a href="/w/index.php?title=MTHFDSL&action=edit&redlink=1" class="new" title="MTHFDSL (page does not exist)">MTHFDSL</a>, <a href="/wiki/ZC3HC1" title="ZC3HC1">ZC3HC1</a>, <a href="/wiki/CDKN2A" title="CDKN2A">CDKN2A</a>, <a href="/wiki/CDKN2B" title="CDKN2B">2B</a>, <a href="/wiki/ABO" class="mw-redirect" title="ABO">ABO</a>, <a href="/w/index.php?title=PDGF0&action=edit&redlink=1" class="new" title="PDGF0 (page does not exist)">PDGF0</a>, <a href="/wiki/APOA5" title="APOA5">APOA5</a>, <a href="/w/index.php?title=MNF1ASM283&action=edit&redlink=1" class="new" title="MNF1ASM283 (page does not exist)">MNF1ASM283</a>, <a href="/wiki/Collagen,_type_IV,_alpha_1" title="Collagen, type IV, alpha 1">COL4A1</a>, <a href="/w/index.php?title=HHIPC1&action=edit&redlink=1" class="new" title="HHIPC1 (page does not exist)">HHIPC1</a>, <a href="/wiki/SMAD3" class="mw-redirect" title="SMAD3">SMAD3</a>, <a href="/wiki/ADAMTS7" title="ADAMTS7">ADAMTS7</a>, <a href="/w/index.php?title=RAS1&action=edit&redlink=1" class="new" title="RAS1 (page does not exist)">RAS1</a>, <a href="/wiki/SMG6" title="SMG6">SMG6</a>, <a href="/wiki/SNF8" title="SNF8">SNF8</a>, <a href="/wiki/LDLR" class="mw-redirect" title="LDLR">LDLR</a>, <a href="/wiki/SLC5A3" class="mw-redirect" title="SLC5A3">SLC5A3</a>, <a href="/wiki/MRPS6" title="MRPS6">MRPS6</a>, <a href="/wiki/KCNE2" title="KCNE2">KCNE2</a>.<a href="#cite_note-Genomics_of_Cardiovascular_Disease-55">[55]</a> <div class="mw-heading mw-heading3"><h3 id="Other_2">Other</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Overwork" title="Overwork">Overwork</a>, <a href="/wiki/Karoshi" title="Karoshi">Karoshi</a>, and <a href="/wiki/996_working_hour_system" title="996 working hour system">996 working hour system</a></div> The risk of having a myocardial infarction increases with older age, low physical activity, and low <a href="/wiki/Socioeconomic_status" title="Socioeconomic status">socioeconomic status</a>.<a href="#cite_note-EUROPEAN2012-45">[45]</a> Heart attacks appear to occur more commonly in the morning hours, especially between 6AM and noon.<a href="#cite_note-Culic2007-56">[56]</a> Evidence suggests that heart attacks are at least three times more likely to occur in the morning than in the late evening.<a href="#cite_note-Shaw2009-57">[57]</a> <a href="/wiki/Shift_work" title="Shift work">Shift work</a> is also associated with a higher risk of MI.<a href="#cite_note-Vyas2012-58">[58]</a> One analysis has found an increase in heart attacks immediately following the start of <a href="/wiki/Daylight_saving_time" title="Daylight saving time">daylight saving time</a>.<a href="#cite_note-59">[59]</a> Women who use <a href="/wiki/Combined_oral_contraceptive_pill" title="Combined oral contraceptive pill">combined oral contraceptive pills</a> have a modestly increased risk of myocardial infarction, especially in the presence of other risk factors.<a href="#cite_note-60">[60]</a> The use of <a href="/wiki/Non-steroidal_anti_inflammatory_drugs" class="mw-redirect" title="Non-steroidal anti inflammatory drugs">non-steroidal anti inflammatory drugs</a> (NSAIDs), even for as short as a week, increases risk.<a href="#cite_note-61">[61]</a> <a href="/wiki/Endometriosis" title="Endometriosis">Endometriosis</a> in women under the age of 40 is an identified risk factor.<a href="#cite_note-62">[62]</a> <a href="/wiki/Air_pollution" title="Air pollution">Air pollution</a> is also an important modifiable risk. Short-term exposure to air pollution such as <a href="/wiki/Carbon_monoxide" title="Carbon monoxide">carbon monoxide</a>, <a href="/wiki/Nitrogen_dioxide" title="Nitrogen dioxide">nitrogen dioxide</a>, and <a href="/wiki/Sulfur_dioxide" title="Sulfur dioxide">sulfur dioxide</a> (but not <a href="/wiki/Ozone" title="Ozone">ozone</a>) has been associated with MI and other acute cardiovascular events.<a href="#cite_note-63">[63]</a> For sudden cardiac deaths, every increment of 30 units in Pollutant Standards Index correlated with an 8% increased risk of out-of-hospital cardiac arrest on the day of exposure.<a href="#cite_note-64">[64]</a> Extremes of temperature are also associated.<a href="#cite_note-65">[65]</a> A number of acute and chronic <a href="/wiki/Infections" class="mw-redirect" title="Infections">infections</a> including <a href="/wiki/Chlamydophila_pneumoniae" class="mw-redirect" title="Chlamydophila pneumoniae">Chlamydophila pneumoniae</a>, <a href="/wiki/Influenza" title="Influenza">influenza</a>, <a href="/wiki/Helicobacter_pylori" title="Helicobacter pylori">Helicobacter pylori</a>, and <a href="/wiki/Porphyromonas_gingivalis" title="Porphyromonas gingivalis">Porphyromonas gingivalis</a> among others have been linked to atherosclerosis and myocardial infarction.<a href="#cite_note-Chat2012-66">[66]</a> Myocardial infarction can also occur as a late consequence of <a href="/wiki/Kawasaki_disease" title="Kawasaki disease">Kawasaki disease</a>.<a href="#cite_note-Sanchez2014-67">[67]</a> Calcium deposits in the coronary arteries can be detected with <a href="/wiki/CT_scan" title="CT scan">CT scans</a>. Calcium seen in coronary arteries can provide predictive information beyond that of classical risk factors.<a href="#cite_note-68">[68]</a> <a href="/wiki/Hyperhomocysteinemia" title="Hyperhomocysteinemia">High blood levels of the amino acid homocysteine</a> is associated with premature atherosclerosis;<a href="#cite_note-69">[69]</a> whether elevated homocysteine in the normal range is causal is controversial.<a href="#cite_note-70">[70]</a> In people without evident <a href="/wiki/Coronary_artery_disease" title="Coronary artery disease">coronary artery disease</a>, possible causes for the myocardial infarction are <a href="/wiki/Coronary_spasm" class="mw-redirect" title="Coronary spasm">coronary spasm</a> or <a href="/wiki/Spontaneous_coronary_artery_dissection" title="Spontaneous coronary artery dissection">coronary artery dissection</a>.<a href="#cite_note-71">[71]</a> <div class="mw-heading mw-heading2"><h2 id="Mechanism">Mechanism</h2></div> <div class="mw-heading mw-heading3"><h3 id="Atherosclerosis">Atherosclerosis</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Atherosclerosis" title="Atherosclerosis">Atherosclerosis</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><video id="mwe_player_2" poster="//upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Heart_attack_animation.ogv/220px--Heart_attack_animation.ogv.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="220" height="248" data-durationhint="183" data-mwtitle="Heart_attack_animation.ogv" data-mwprovider="wikimediacommons" resource="/wiki/File:Heart_attack_animation.ogv"><source src="//upload.wikimedia.org/wikipedia/commons/5/5c/Heart_attack_animation.ogv" type="video/ogg; codecs="theora, vorbis"" data-width="340" data-height="384" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/5/5c/Heart_attack_animation.ogv/Heart_attack_animation.ogv.144p.mjpeg.mov" type="video/quicktime" data-transcodekey="144p.mjpeg.mov" data-width="128" data-height="144" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/5/5c/Heart_attack_animation.ogv/Heart_attack_animation.ogv.240p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="240p.vp9.webm" data-width="212" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/5/5c/Heart_attack_animation.ogv/Heart_attack_animation.ogv.360p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="360p.vp9.webm" data-width="318" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/5/5c/Heart_attack_animation.ogv/Heart_attack_animation.ogv.360p.webm" type="video/webm; codecs="vp8, vorbis"" data-transcodekey="360p.webm" data-width="318" data-height="360" /></video><figcaption>The animation shows plaque buildup or a <a href="/wiki/Vasospasm" title="Vasospasm">coronary artery spasm</a> can lead to a heart attack and how blocked blood flow in a coronary artery can lead to a heart attack.</figcaption></figure> The most common cause of a myocardial infarction is the rupture of an atherosclerotic plaque on an <a href="/wiki/Artery" title="Artery">artery</a> supplying heart muscle.<a href="#cite_note-ESC_STEMI-41">[41]</a><a href="#cite_note-Reed2017-72">[72]</a> Plaques can become unstable, rupture, and additionally promote the formation of a <a href="/wiki/Thrombus" title="Thrombus">blood clot</a> that blocks the artery; this can occur in minutes. Blockage of an artery can lead to tissue death in tissue being supplied by that artery.<a href="#cite_note-Davidsons2010B-73">[73]</a> Atherosclerotic plaques are often present for decades before they result in symptoms.<a href="#cite_note-Davidsons2010B-73">[73]</a> The gradual buildup of <a href="/wiki/Cholesterol" title="Cholesterol">cholesterol</a> and fibrous tissue in plaques in the wall of the <a href="/wiki/Coronary_artery" class="mw-redirect" title="Coronary artery">coronary arteries</a> or other arteries, typically over decades, is termed <a href="/wiki/Atherosclerosis" title="Atherosclerosis">atherosclerosis</a>.<a href="#cite_note-pmid20065951-74">[74]</a> Atherosclerosis is characterized by progressive inflammation of the walls of the arteries.<a href="#cite_note-Davidsons2010B-73">[73]</a> Inflammatory cells, particularly <a href="/wiki/Macrophage" title="Macrophage">macrophages</a>, move into affected arterial walls. Over time, they become laden with cholesterol products, particularly <a href="/wiki/LDL" class="mw-redirect" title="LDL">LDL</a>, and become <a href="/wiki/Foam_cell" title="Foam cell">foam cells</a>. A <a href="/wiki/Atheroma" title="Atheroma">cholesterol core</a> forms as foam cells die. In response to <a href="/wiki/Growth_factor" title="Growth factor">growth factors</a> secreted by macrophages, <a href="/wiki/Smooth_muscle" title="Smooth muscle">smooth muscle</a> and other cells move into the plaque and act to stabilize it. A stable plaque may have a thick fibrous cap with <a href="/wiki/Calcification" title="Calcification">calcification</a>. If there is ongoing inflammation, the cap may be thin or ulcerate. Exposed to the pressure associated with blood flow, plaques, especially those with a thin lining, may rupture and trigger the formation of a blood clot (thrombus).<a href="#cite_note-Davidsons2010B-73">[73]</a> The cholesterol crystals have been associated with plaque rupture through mechanical injury and inflammation.<a href="#cite_note-75">[75]</a> <div class="mw-heading mw-heading3"><h3 id="Other_causes"> Other causes</h3></div> Atherosclerotic disease is not the only cause of myocardial infarction, but it may exacerbate or contribute to other causes. A myocardial infarction may result from a heart with a limited blood supply subject to increased oxygen demands, such as in fever, <a href="/wiki/Tachycardia" title="Tachycardia">a fast heart rate</a>, <a href="/wiki/Hyperthyroidism" title="Hyperthyroidism">hyperthyroidism</a>, <a href="/wiki/Anemia" title="Anemia">too few red blood cells in the bloodstream</a>, or <a href="/wiki/Hypotension" title="Hypotension">low blood pressure</a>. Damage or failure of procedures such as <a href="/wiki/Percutaneous_coronary_intervention" title="Percutaneous coronary intervention">percutaneous coronary intervention</a> (PCI) or <a href="/wiki/Coronary_artery_bypass_graft" class="mw-redirect" title="Coronary artery bypass graft">coronary artery bypass grafts</a> (CABG) may cause a myocardial infarction. Spasm of coronary arteries, such as <a href="/wiki/Prinzmetal%27s_angina" class="mw-redirect" title="Prinzmetal's angina">Prinzmetal's angina</a> may cause blockage.<a href="#cite_note-THIRDDEF-24">[24]</a><a href="#cite_note-Harrisons2015-28">[28]</a> <div class="mw-heading mw-heading3"><h3 id="Tissue_death">Tissue death</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Heart_ant_wall_infarction.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/92/Heart_ant_wall_infarction.jpg/220px-Heart_ant_wall_infarction.jpg" decoding="async" width="220" height="184" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/92/Heart_ant_wall_infarction.jpg/330px-Heart_ant_wall_infarction.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/92/Heart_ant_wall_infarction.jpg/440px-Heart_ant_wall_infarction.jpg 2x" data-file-width="1668" data-file-height="1396" /></a><figcaption>Cross section showing anterior left ventricle wall infarction</figcaption></figure> If impaired blood flow to the heart lasts long enough, it triggers a process called the <a href="/wiki/Ischemic_cascade" title="Ischemic cascade">ischemic cascade</a>; the heart cells in the territory of the blocked coronary artery die (<a href="https://en.wiktionary.org/wiki/infarction" class="extiw" title="wikt:infarction">infarction</a>), chiefly through <a href="/wiki/Necrosis" title="Necrosis">necrosis</a>, and do not grow back. A <a href="/wiki/Collagen" title="Collagen">collagen</a> <a href="/wiki/Scar" title="Scar">scar</a> forms in their place.<a href="#cite_note-Davidsons2010B-73">[73]</a> When an artery is blocked, cells lack <a href="/wiki/Oxygen" title="Oxygen">oxygen</a>, needed to produce <a href="/wiki/Adenosine_triphosphate" title="Adenosine triphosphate">ATP</a> in <a href="/wiki/Mitochondria" class="mw-redirect" title="Mitochondria">mitochondria</a>. ATP is required for the maintenance of electrolyte balance, particularly through the <a href="/wiki/Na/K_ATPase" class="mw-redirect" title="Na/K ATPase">Na/K ATPase</a>. This leads to an ischemic cascade of intracellular changes, necrosis and <a href="/wiki/Apoptosis" title="Apoptosis">apoptosis</a> of affected cells.<a href="#cite_note-BUJA2005-76">[76]</a> Cells in the area with the worst blood supply, just below the inner surface of the heart (<a href="/wiki/Endocardium" title="Endocardium">endocardium</a>), are most susceptible to damage.<a href="#cite_note-77">[77]</a><a href="#cite_note-BOLOOKI2010-78">[78]</a> Ischemia first affects this region, the subendocardial region, and tissue begins to die within 15–30 minutes of loss of blood supply.<a href="#cite_note-AARONSON2013-79">[79]</a> The dead tissue is surrounded by a zone of potentially reversible ischemia that progresses to become a full-thickness transmural infarct.<a href="#cite_note-BUJA2005-76">[76]</a><a href="#cite_note-AARONSON2013-79">[79]</a> The initial "wave" of infarction can take place over 3–4 hours.<a href="#cite_note-Davidsons2010B-73">[73]</a><a href="#cite_note-BUJA2005-76">[76]</a> These changes are seen on <a href="/wiki/Gross_pathology" title="Gross pathology">gross pathology</a> and cannot be predicted by the presence or absence of Q waves on an ECG.<a href="#cite_note-BOLOOKI2010-78">[78]</a> The position, size and extent of an infarct depends on the affected artery, totality of the blockage, duration of the blockage, the presence of <a href="/wiki/Collateralization" title="Collateralization">collateral blood vessels</a>, oxygen demand, and success of interventional procedures.<a href="#cite_note-Harrisons2015-28">[28]</a><a href="#cite_note-Reed2017-72">[72]</a> Tissue death and <a href="/wiki/Myocardial_scarring" title="Myocardial scarring">myocardial scarring</a> alter the normal conduction pathways of the heart and weaken affected areas. The size and location put a person at risk of <a href="/wiki/Heart_arrhythmia" class="mw-redirect" title="Heart arrhythmia">abnormal heart rhythms (arrhythmias)</a> or <a href="/wiki/Heart_block" title="Heart block">heart block</a>, <a href="/wiki/Ventricular_aneurysm" title="Ventricular aneurysm">aneurysm of the heart ventricles</a>, <a href="/wiki/Dressler%27s_syndrome" class="mw-redirect" title="Dressler's syndrome">inflammation of the heart wall</a> following infarction, and rupture of the heart wall that can have catastrophic consequences.<a href="#cite_note-Reed2017-72">[72]</a><a href="#cite_note-Kutty2013-80">[80]</a> Injury to the myocardium also occurs during re-perfusion. This might manifest as ventricular arrhythmia. The re-perfusion injury is a consequence of the calcium and sodium uptake from the cardiac cells and the release of oxygen radicals during reperfusion. No-reflow phenomenon—when blood is still unable to be distributed to the affected myocardium despite clearing the occlusion—also contributes to myocardial injury. Topical endothelial swelling is one of many factors contributing to this phenomenon.<a href="#cite_note-KlonerHale-81">[81]</a> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Diagnosis_of_myocardial_infarction" title="Diagnosis of myocardial infarction">Diagnosis of myocardial infarction</a></div> <div class="mw-heading mw-heading3"><h3 id="Criteria">Criteria</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Patterns_of_topographic_distribution_of_myocardial_infarction.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e8/Patterns_of_topographic_distribution_of_myocardial_infarction.jpg/220px-Patterns_of_topographic_distribution_of_myocardial_infarction.jpg" decoding="async" width="220" height="157" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e8/Patterns_of_topographic_distribution_of_myocardial_infarction.jpg/330px-Patterns_of_topographic_distribution_of_myocardial_infarction.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e8/Patterns_of_topographic_distribution_of_myocardial_infarction.jpg/440px-Patterns_of_topographic_distribution_of_myocardial_infarction.jpg 2x" data-file-width="1302" data-file-height="928" /></a><figcaption>Topographic distribution of MI</figcaption></figure> A myocardial infarction, according to established consensus, is defined by elevated cardiac <a href="/wiki/Biomarkers" class="mw-redirect" title="Biomarkers">biomarkers</a> with a rising or falling trend and at least one of the following:<a href="#cite_note-82">[82]</a> <ul><li>Symptoms relating to ischemia</li> <li>Changes on an <a href="/wiki/Electrocardiogram" class="mw-redirect" title="Electrocardiogram">electrocardiogram</a> (ECG), such as <a href="/wiki/ST_segment" title="ST segment">ST segment</a> changes, new <a href="/wiki/Left_bundle_branch_block" title="Left bundle branch block">left bundle branch block</a>, or pathologic <a href="/wiki/QRS_complex#Q_wave" title="QRS complex">Q waves</a></li> <li>Changes in the motion of the heart wall on imaging</li> <li>Demonstration of a thrombus on <a href="/wiki/Angiogram" class="mw-redirect" title="Angiogram">angiogram</a> or at <a href="/wiki/Autopsy" title="Autopsy">autopsy</a>.</li></ul> <div class="mw-heading mw-heading3"><h3 id="Types">Types</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Electrocardiography_in_myocardial_infarction" title="Electrocardiography in myocardial infarction">Electrocardiography in myocardial infarction</a></div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">"STEMI" redirects here. For the Christian evangelist organization, see <a href="/wiki/Stephen_Tong#Ministry" title="Stephen Tong">Stephen Tong § Ministry</a>.</div> A myocardial infarction is usually clinically classified as an ST-elevation MI (STEMI) or a non-ST elevation MI (NSTEMI). These are based on <a href="/wiki/ST_elevation" title="ST elevation">ST elevation</a>, a portion of a heartbeat graphically recorded on an <a href="/wiki/ECG" class="mw-redirect" title="ECG">ECG</a>.<a href="#cite_note-THIRDDEF-24">[24]</a> STEMIs make up about 25–40% of myocardial infarctions.<a href="#cite_note-AHA2013-19">[19]</a> A more explicit classification system, based on international consensus in 2012, also exists. This classifies myocardial infarctions into five types:<a href="#cite_note-THIRDDEF-24">[24]</a> <ol><li>Spontaneous MI related to plaque erosion and/or rupture fissuring, or dissection</li> <li>MI related to ischemia, such as from increased oxygen demand or decreased supply, e.g., coronary artery spasm, coronary embolism, anemia, arrhythmias, high blood pressure, or low blood pressure</li> <li>Sudden unexpected cardiac death, including cardiac arrest, where symptoms may suggest MI, an ECG may be taken with suggestive changes, or a blood clot is found in a coronary artery by angiography and/or at autopsy, but where blood samples could not be obtained, or at a time before the appearance of cardiac biomarkers in the blood</li> <li>Associated with <a href="/wiki/Coronary_angioplasty" class="mw-redirect" title="Coronary angioplasty">coronary angioplasty</a> or <a href="/wiki/Stent" title="Stent">stents</a> <ul><li>Associated with <a href="/wiki/Percutaneous_coronary_intervention" title="Percutaneous coronary intervention">percutaneous coronary intervention</a> (PCI)</li> <li>Associated with stent thrombosis as documented by angiography or at autopsy</li></ul></li> <li>Associated with <a href="/wiki/Coronary_artery_bypass_graft" class="mw-redirect" title="Coronary artery bypass graft">CABG</a></li> <li>Associated with <a href="/wiki/Spontaneous_coronary_artery_dissection" title="Spontaneous coronary artery dissection">spontaneous coronary artery dissection</a> in young, fit women</li></ol> <div class="mw-heading mw-heading3"><h3 id="Cardiac_biomarkers">Cardiac biomarkers</h3></div> There are many different <a href="/wiki/Biomarker" title="Biomarker">biomarkers</a> used to determine the presence of cardiac muscle damage. <a href="/wiki/Troponin" title="Troponin">Troponins</a>, measured through a blood test, are considered to be the best,<a href="#cite_note-AHA2013-19">[19]</a> and are preferred because they have greater <a href="/wiki/Sensitivity_and_specificity" title="Sensitivity and specificity">sensitivity and specificity</a> for measuring injury to the heart muscle than other tests.<a href="#cite_note-Reed2017-72">[72]</a> A rise in troponin occurs within 2–3 hours of injury to the heart muscle, and peaks within 1–2 days. The level of the troponin, as well as a change over time, are useful in measuring and diagnosing or excluding myocardial infarctions, and the diagnostic accuracy of troponin testing is improving over time.<a href="#cite_note-Reed2017-72">[72]</a> One high-sensitivity cardiac troponin can rule out a heart attack as long as the ECG is normal.<a href="#cite_note-83">[83]</a><a href="#cite_note-84">[84]</a> Other tests, such as <a href="/wiki/CK-MB" class="mw-redirect" title="CK-MB">CK-MB</a> or <a href="/wiki/Myoglobin" title="Myoglobin">myoglobin</a>, are discouraged.<a href="#cite_note-AHANSTEMI2014-85">[85]</a> CK-MB is not as specific as troponins for acute myocardial injury, and may be elevated with past cardiac surgery, inflammation or electrical cardioversion; it rises within 4–8 hours and returns to normal within 2–3 days.<a href="#cite_note-Harrisons2015-28">[28]</a> <a href="/wiki/Copeptin" title="Copeptin">Copeptin</a> may be useful to rule out MI rapidly when used along with troponin.<a href="#cite_note-86">[86]</a> <div class="mw-heading mw-heading3"><h3 id="Electrocardiogram">Electrocardiogram</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Inferior_and_RtV_MI_12_lead.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/8a/Inferior_and_RtV_MI_12_lead.jpg/350px-Inferior_and_RtV_MI_12_lead.jpg" decoding="async" width="350" height="191" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/8a/Inferior_and_RtV_MI_12_lead.jpg/525px-Inferior_and_RtV_MI_12_lead.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/8a/Inferior_and_RtV_MI_12_lead.jpg/700px-Inferior_and_RtV_MI_12_lead.jpg 2x" data-file-width="4241" data-file-height="2316" /></a><figcaption>A 12-lead ECG showing an inferior STEMI due to reduced perfusion through the <a href="/wiki/Right_coronary_artery" title="Right coronary artery">right coronary artery</a>. Elevation of the <a href="/wiki/ST_segment" title="ST segment">ST segment</a> can be seen in leads II, III and aVF.</figcaption></figure> <a href="/wiki/Electrocardiogram" class="mw-redirect" title="Electrocardiogram">Electrocardiograms</a> (ECGs) are a series of leads placed on a person's chest that measure electrical activity associated with contraction of the heart muscle.<a href="#cite_note-Davidsons2010C-87">[87]</a> The taking of an ECG is an important part of the workup of an AMI,<a href="#cite_note-THIRDDEF-24">[24]</a> and ECGs are often not just taken once but may be repeated over minutes to hours, or in response to changes in signs or symptoms.<a href="#cite_note-THIRDDEF-24">[24]</a> ECG readouts produce a waveform with different labeled features.<a href="#cite_note-Davidsons2010C-87">[87]</a> In addition to a rise in biomarkers, a rise in the <a href="/wiki/ST_segment" title="ST segment">ST segment</a>, changes in the shape or flipping of <a href="/wiki/T_wave" title="T wave">T waves</a>, new <a href="/wiki/QRS_complex#Q_wave" title="QRS complex">Q waves</a>, or a new <a href="/wiki/Left_bundle_branch_block" title="Left bundle branch block">left bundle branch block</a> can be used to diagnose an AMI.<a href="#cite_note-THIRDDEF-24">[24]</a> In addition, <a href="/wiki/ST_elevation" title="ST elevation">ST elevation</a> can be used to diagnose an ST segment myocardial infarction (STEMI). A rise must be new in V2 and V3 ≥2 mm (0,2 mV) for males or ≥1.5 mm (0.15 mV) for females or ≥1 mm (0.1 mV) in two other <a href="/wiki/Contiguous_leads" class="mw-redirect" title="Contiguous leads">adjacent chest or limb leads</a>.<a href="#cite_note-AHA2013-19">[19]</a><a href="#cite_note-THIRDDEF-24">[24]</a> ST elevation is associated with infarction, and may be preceded by changes indicating ischemia, such as ST depression or inversion of the T waves.<a href="#cite_note-Davidsons2010C-87">[87]</a> Abnormalities can help differentiate the location of an infarct, based on the leads that are affected by changes.<a href="#cite_note-Davidsons2010-16">[16]</a> Early STEMIs may be preceded by peaked T waves.<a href="#cite_note-AHA2013-19">[19]</a> Other ECG abnormalities relating to complications of acute myocardial infarctions may also be evident, such as <a href="/wiki/Atrial_fibrillation" title="Atrial fibrillation">atrial</a> or <a href="/wiki/Ventricular_fibrillation" title="Ventricular fibrillation">ventricular fibrillation</a>.<a href="#cite_note-88">[88]</a> <div class="mw-heading mw-heading3"><h3 id="Imaging">Imaging</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:ECG_V2-4_ST_change.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/61/ECG_V2-4_ST_change.jpg/220px-ECG_V2-4_ST_change.jpg" decoding="async" width="220" height="138" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/61/ECG_V2-4_ST_change.jpg/330px-ECG_V2-4_ST_change.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/61/ECG_V2-4_ST_change.jpg/440px-ECG_V2-4_ST_change.jpg 2x" data-file-width="1271" data-file-height="799" /></a><figcaption>ECG : AMI with ST elevation in V2-4</figcaption></figure> Noninvasive imaging plays an important role in the diagnosis and characterisation of myocardial infarction.<a href="#cite_note-THIRDDEF-24">[24]</a> Tests such as <a href="/wiki/Chest_X-ray" class="mw-redirect" title="Chest X-ray">chest X-rays</a> can be used to explore and exclude alternate causes of a person's symptoms.<a href="#cite_note-THIRDDEF-24">[24]</a> <a href="/wiki/Echocardiography" title="Echocardiography">Echocardiography</a> may assist in modifying clinical suspicion of ongoing myocardial infarction in patients that can't be ruled out or ruled in following initial <a href="/wiki/Electrocardiography" title="Electrocardiography">ECG</a> and <a href="/wiki/Troponin" title="Troponin">Troponin</a> testing.<a href="#cite_note-auto-89">[89]</a> <a href="/wiki/Myocardial_perfusion_imaging" title="Myocardial perfusion imaging">Myocardial perfusion imaging</a> has no role in the acute diagnostic algorithm; however, it can confirm a clinical suspicion of Chronic Coronary Syndrome when the patient's history, <a href="/wiki/Physical_examination" title="Physical examination">physical examination</a> (including <a href="/wiki/Cardiac_examination" title="Cardiac examination">cardiac examination</a>) ECG, and cardiac biomarkers suggest coronary artery disease.<a href="#cite_note-WISELY2017-90">[90]</a> <a href="/wiki/Echocardiography" title="Echocardiography">Echocardiography</a>, an <a href="/wiki/Ultrasound" title="Ultrasound">ultrasound</a> scan of the heart, is able to visualize the heart, its size, shape, and any abnormal motion of the heart walls as they beat that may indicate a myocardial infarction. The flow of blood can be imaged, and <a href="/wiki/Contrast_dye" class="mw-redirect" title="Contrast dye">contrast dyes</a> may be given to improve image.<a href="#cite_note-THIRDDEF-24">[24]</a> Other scans using <a href="/wiki/Radioactive" class="mw-redirect" title="Radioactive">radioactive</a> contrast include <a href="/wiki/SPECT" class="mw-redirect" title="SPECT">SPECT</a> <a href="/wiki/CT-scans" class="mw-redirect" title="CT-scans">CT-scans</a> using <a href="/wiki/Thallium_chloride" class="mw-redirect" title="Thallium chloride">thallium</a>, <a href="/wiki/Technetium_(99mTc)_sestamibi" title="Technetium (99mTc) sestamibi">sestamibi</a> (<a href="/wiki/MIBI_scan" class="mw-redirect" title="MIBI scan">MIBI scans</a>) or <a href="/wiki/Tetrofosmin" class="mw-redirect" title="Tetrofosmin">tetrofosmin</a>; or a <a href="/wiki/PET_scan" class="mw-redirect" title="PET scan">PET scan</a> using <a href="/wiki/Fludeoxyglucose_(18F)" class="mw-redirect" title="Fludeoxyglucose (18F)">Fludeoxyglucose</a> or <a href="/wiki/Rubidium-82" title="Rubidium-82">rubidium-82</a>.<a href="#cite_note-THIRDDEF-24">[24]</a> These <a href="/wiki/Nuclear_medicine" title="Nuclear medicine">nuclear medicine</a> scans can visualize the perfusion of heart muscle.<a href="#cite_note-THIRDDEF-24">[24]</a> SPECT may also be used to determine viability of tissue, and whether areas of ischemia are inducible.<a href="#cite_note-THIRDDEF-24">[24]</a><a href="#cite_note-91">[91]</a> Medical societies and professional guidelines recommend that the physician confirm a person is at high risk for Chronic Coronary Syndrome before conducting diagnostic non-invasive imaging tests to make a diagnosis,<a href="#cite_note-WISELY2017-90">[90]</a><a href="#cite_note-NICECG94-92">[92]</a><a href="#cite_note-auto-89">[89]</a> as such tests are unlikely to change management and result in increased costs.<a href="#cite_note-WISELY2017-90">[90]</a> Patients who have a normal ECG and who are able to exercise, for example, most likely do not merit routine imaging.<a href="#cite_note-WISELY2017-90">[90]</a> <ul class="gallery mw-gallery-traditional"> <li class="gallerybox" style="width: 235px"> <div class="thumb" style="width: 230px; height: 230px;"><video id="mwe_player_0" poster="//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/UOTW_36_-_Ultrasound_of_the_Week_1.webm/200px--UOTW_36_-_Ultrasound_of_the_Week_1.webm.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="200" height="119" data-durationhint="7" data-mwtitle="UOTW_36_-_Ultrasound_of_the_Week_1.webm" data-mwprovider="wikimediacommons"><source src="//upload.wikimedia.org/wikipedia/commons/d/d6/UOTW_36_-_Ultrasound_of_the_Week_1.webm" type="video/webm; codecs="vp8"" data-width="792" data-height="470" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/d/d6/UOTW_36_-_Ultrasound_of_the_Week_1.webm/UOTW_36_-_Ultrasound_of_the_Week_1.webm.240p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="240p.vp9.webm" data-width="404" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/d/d6/UOTW_36_-_Ultrasound_of_the_Week_1.webm/UOTW_36_-_Ultrasound_of_the_Week_1.webm.360p.webm" type="video/webm; codecs="vp8, vorbis"" data-transcodekey="360p.webm" data-width="606" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/d/d6/UOTW_36_-_Ultrasound_of_the_Week_1.webm/UOTW_36_-_Ultrasound_of_the_Week_1.webm.360p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="360p.vp9.webm" data-width="606" data-height="360" /></video></div> <div class="gallerytext">Poor movement of the heart due to an MI as seen on ultrasound<a href="#cite_note-UOTW36-93">[93]</a></div> </li> <li class="gallerybox" style="width: 235px"> <div class="thumb" style="width: 230px; height: 230px;"><video id="mwe_player_1" poster="//upload.wikimedia.org/wikipedia/commons/thumb/8/8a/UOTW_36_-_Ultrasound_of_the_Week_2.webm/200px--UOTW_36_-_Ultrasound_of_the_Week_2.webm.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="200" height="119" data-durationhint="8" data-mwtitle="UOTW_36_-_Ultrasound_of_the_Week_2.webm" data-mwprovider="wikimediacommons"><source src="//upload.wikimedia.org/wikipedia/commons/8/8a/UOTW_36_-_Ultrasound_of_the_Week_2.webm" type="video/webm; codecs="vp8"" data-width="792" data-height="470" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/8/8a/UOTW_36_-_Ultrasound_of_the_Week_2.webm/UOTW_36_-_Ultrasound_of_the_Week_2.webm.240p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="240p.vp9.webm" data-width="404" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/8/8a/UOTW_36_-_Ultrasound_of_the_Week_2.webm/UOTW_36_-_Ultrasound_of_the_Week_2.webm.360p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="360p.vp9.webm" data-width="606" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/8/8a/UOTW_36_-_Ultrasound_of_the_Week_2.webm/UOTW_36_-_Ultrasound_of_the_Week_2.webm.360p.webm" type="video/webm; codecs="vp8, vorbis"" data-transcodekey="360p.webm" data-width="606" data-height="360" /></video></div> <div class="gallerytext">Pulmonary edema due to an MI as seen on ultrasound<a href="#cite_note-UOTW36-93">[93]</a></div> </li> </ul> <div class="mw-heading mw-heading3"><h3 id="Differential_diagnosis">Differential diagnosis</h3></div> There are many causes of <a href="/wiki/Chest_pain" title="Chest pain">chest pain</a>, which can originate from the heart, <a href="/wiki/Lung" title="Lung">lungs</a>, <a href="/wiki/Gastrointestinal_tract" title="Gastrointestinal tract">gastrointestinal tract</a>, <a href="/wiki/Aorta" title="Aorta">aorta</a>, and other muscles, bones and nerves surrounding the chest.<a href="#cite_note-Davidsons2010D-94">[94]</a> In addition to myocardial infarction, other causes include <a href="/wiki/Angina_pectoris" class="mw-redirect" title="Angina pectoris">angina</a>, insufficient blood supply (<a href="/wiki/Ischemia" title="Ischemia">ischemia</a>) to the heart muscles without evidence of cell death, <a href="/wiki/Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">gastroesophageal reflux disease</a>; <a href="/wiki/Pulmonary_embolism" title="Pulmonary embolism">pulmonary embolism</a>, tumors of the lungs, <a href="/wiki/Pneumonia" title="Pneumonia">pneumonia</a>, <a href="/wiki/Rib_fracture" title="Rib fracture">rib fracture</a>, <a href="/wiki/Costochondritis" title="Costochondritis">costochondritis</a>, <a href="/wiki/Heart_failure" title="Heart failure">heart failure</a> and other musculoskeletal injuries.<a href="#cite_note-Davidsons2010D-94">[94]</a><a href="#cite_note-THIRDDEF-24">[24]</a> Rarer severe differential diagnoses include <a href="/wiki/Aortic_dissection" title="Aortic dissection">aortic dissection</a>, <a href="/wiki/Esophageal_rupture" title="Esophageal rupture">esophageal rupture</a>, <a href="/wiki/Tension_pneumothorax" class="mw-redirect" title="Tension pneumothorax">tension pneumothorax</a>, and <a href="/wiki/Pericardial_effusion" title="Pericardial effusion">pericardial effusion</a> causing <a href="/wiki/Cardiac_tamponade" title="Cardiac tamponade">cardiac tamponade</a>.<a href="#cite_note-pmid16199332-95">[95]</a> The chest pain in an MI may mimic <a href="/wiki/Heartburn" title="Heartburn">heartburn</a>.<a href="#cite_note-ESC_STEMI-41">[41]</a> Causes of sudden-onset <a href="/wiki/Breathlessness" class="mw-redirect" title="Breathlessness">breathlessness</a> generally involve the lungs or heart – including <a href="/wiki/Pulmonary_edema" title="Pulmonary edema">pulmonary edema</a>, pneumonia, <a href="/wiki/Allergy" title="Allergy">allergic</a> reactions and <a href="/wiki/Asthma" title="Asthma">asthma</a>, and pulmonary embolus, <a href="/wiki/ARDS" class="mw-redirect" title="ARDS">acute respiratory distress syndrome</a> and <a href="/wiki/Metabolic_acidosis" title="Metabolic acidosis">metabolic acidosis</a>.<a href="#cite_note-Davidsons2010D-94">[94]</a> There are many different causes of fatigue, and myocardial infarction is not a common cause.<a href="#cite_note-96">[96]</a> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2></div> There is a large crossover between the lifestyle and activity recommendations to prevent a myocardial infarction, and those that may be adopted as <a href="/wiki/Secondary_prevention" class="mw-redirect" title="Secondary prevention">secondary prevention</a> after an initial myocardial infarction,<a href="#cite_note-Reed2017-72">[72]</a> because of shared risk factors and an aim to reduce atherosclerosis affecting heart vessels.<a href="#cite_note-Harrisons2015-28">[28]</a> The <a href="/wiki/Influenza_vaccine" title="Influenza vaccine">influenza vaccine</a> also appear to protect against myocardial infarction with a benefit of 15 to 45%.<a href="#cite_note-97">[97]</a> <div class="mw-heading mw-heading3"><h3 id="Primary_prevention">Primary prevention</h3></div> <div class="mw-heading mw-heading4"><h4 id="Lifestyle">Lifestyle</h4></div> Physical activity can reduce the risk of cardiovascular disease, and people at risk are advised to engage in 150 minutes of moderate or 75 minutes of vigorous intensity <a href="/wiki/Aerobic_exercise" title="Aerobic exercise">aerobic exercise</a> a week.<a href="#cite_note-NICECG181-98">[98]</a> Keeping a healthy weight, drinking alcohol within the recommended limits, and <a href="/wiki/Smoking_cessation" title="Smoking cessation">quitting smoking</a> reduce the risk of cardiovascular disease.<a href="#cite_note-NICECG181-98">[98]</a> Substituting <a href="/wiki/Unsaturated_fat" title="Unsaturated fat">unsaturated fats</a> such as <a href="/wiki/Olive_oil" title="Olive oil">olive oil</a> and <a href="/wiki/Rapeseed_oil" title="Rapeseed oil">rapeseed oil</a> instead of saturated fats may reduce the risk of myocardial infarction,<a href="#cite_note-:1-50">[50]</a> although there is not universal agreement.<a href="#cite_note-Chow2014-51">[51]</a> Dietary modifications are recommended by some national authorities, with recommendations including increasing the intake of wholegrain starch, reducing sugar intake (particularly of refined sugar), consuming five portions of fruit and vegetables daily, consuming two or more portions of fish per week, and consuming 4–5 portions of unsalted <a href="/wiki/Nut_(fruit)" title="Nut (fruit)">nuts</a>, <a href="/wiki/Seed" title="Seed">seeds</a>, or <a href="/wiki/Legume" title="Legume">legumes</a> per week.<a href="#cite_note-NICECG181-98">[98]</a> The dietary pattern with the greatest support is the <a href="/wiki/Mediterranean_diet" title="Mediterranean diet">Mediterranean diet</a>.<a href="#cite_note-99">[99]</a> <a href="/wiki/Vitamin" title="Vitamin">Vitamins</a> and mineral supplements are of no proven benefit,<a href="#cite_note-100">[100]</a> and neither are plant <a href="/wiki/Stanol" class="mw-redirect" title="Stanol">stanols</a> or <a href="/wiki/Phytosterol" title="Phytosterol">sterols</a>.<a href="#cite_note-NICECG181-98">[98]</a> <a href="/wiki/Public_health" title="Public health">Public health</a> measures may also act at a population level to reduce the risk of myocardial infarction, for example by reducing unhealthy diets (excessive salt, saturated fat, and trans-fat) including food labeling and marketing requirements as well as requirements for catering and restaurants and stimulating physical activity. This may be part of regional cardiovascular disease prevention programs or through the <a href="/wiki/Health_impact_assessment" title="Health impact assessment">health impact assessment</a> of regional and local plans and policies.<a href="#cite_note-NICEPH25-101">[101]</a> Most guidelines recommend combining different preventive strategies. A 2015 Cochrane Review found some evidence that such an approach might help with <a href="/wiki/Blood_pressure" title="Blood pressure">blood pressure</a>, <a href="/wiki/Body_mass_index" title="Body mass index">body mass index</a> and <a href="/wiki/Waist_circumference" class="mw-redirect" title="Waist circumference">waist circumference</a>. However, there was insufficient evidence to show an effect on mortality or actual cardio-vascular events.<a href="#cite_note-102">[102]</a> <div class="mw-heading mw-heading4"><h4 id="Medication">Medication</h4></div> <a href="/wiki/Statin" title="Statin">Statins</a>, drugs that act to lower blood cholesterol, decrease the incidence and mortality rates of myocardial infarctions.<a href="#cite_note-103">[103]</a> They are often recommended in those at an elevated risk of cardiovascular diseases.<a href="#cite_note-NICECG181-98">[98]</a> <a href="/wiki/Aspirin" title="Aspirin">Aspirin</a> has been studied extensively in people considered at increased risk of myocardial infarction. Based on numerous studies in different groups (e.g. people with or without diabetes), there does not appear to be a benefit strong enough to outweigh the risk of excessive bleeding.<a href="#cite_note-ATTaspirin2009-104">[104]</a><a href="#cite_note-105">[105]</a> Nevertheless, many <a href="/wiki/Clinical_practice_guideline" class="mw-redirect" title="Clinical practice guideline">clinical practice guidelines</a> continue to recommend aspirin for primary prevention,<a href="#cite_note-106">[106]</a> and some researchers feel that those with very high cardiovascular risk but low risk of bleeding should continue to receive aspirin.<a href="#cite_note-107">[107]</a> <div class="mw-heading mw-heading3"><h3 id="Secondary_prevention">Secondary prevention</h3></div> There is a large crossover between the lifestyle and activity recommendations to prevent a myocardial infarction, and those that may be adopted as <a href="/wiki/Secondary_prevention" class="mw-redirect" title="Secondary prevention">secondary prevention</a> after an initial myocardial infarct.<a href="#cite_note-Reed2017-72">[72]</a> Recommendations include <a href="/wiki/Smoking_cessation" title="Smoking cessation">stopping smoking</a>, a gradual return to exercise, eating a healthy <a href="/wiki/Diet_(nutrition)" title="Diet (nutrition)">diet</a>, low in <a href="/wiki/Saturated_fat" title="Saturated fat">saturated fat</a> and low in <a href="/wiki/Cholesterol" title="Cholesterol">cholesterol</a>, <a href="/wiki/Alcohol_consumption_recommendations" title="Alcohol consumption recommendations">drinking alcohol within recommended limits</a>, exercising, and trying to achieve a healthy weight.<a href="#cite_note-Reed2017-72">[72]</a><a href="#cite_note-NICE172-108">[108]</a> Exercise is both safe and effective even if people have had stents or heart failure,<a href="#cite_note-109">[109]</a> and is recommended to start gradually after 1–2 weeks.<a href="#cite_note-Reed2017-72">[72]</a> Counselling should be provided relating to medications used, and for warning signs of depression.<a href="#cite_note-Reed2017-72">[72]</a> Previous studies suggested a benefit from <a href="/wiki/Omega-3_fatty_acid" title="Omega-3 fatty acid">omega-3 fatty acid</a> supplementation but this has not been confirmed.<a href="#cite_note-NICE172-108">[108]</a> <div class="mw-heading mw-heading4"><h4 id="Medications">Medications</h4></div> Following a heart attack, nitrates, when taken for two days, and <a href="/wiki/ACE_inhibitor" title="ACE inhibitor">ACE-inhibitors</a> decrease the risk of death.<a href="#cite_note-110">[110]</a> Other medications include: <a href="/wiki/Aspirin" title="Aspirin">Aspirin</a> is continued indefinitely, as well as another antiplatelet agent such as clopidogrel or ticagrelor ("dual antiplatelet therapy" or DAPT) for up to twelve months.<a href="#cite_note-NICE172-108">[108]</a> If someone has another medical condition that requires anticoagulation (e.g. with <a href="/wiki/Warfarin" title="Warfarin">warfarin</a>) this may need to be adjusted based on risk of further cardiac events as well as bleeding risk.<a href="#cite_note-NICE172-108">[108]</a> In those who have had a stent, more than 12 months of clopidogrel plus aspirin does not affect the risk of death.<a href="#cite_note-111">[111]</a> <a href="/wiki/Beta_blocker" title="Beta blocker">Beta blocker</a> therapy such as <a href="/wiki/Metoprolol" title="Metoprolol">metoprolol</a> or <a href="/wiki/Carvedilol" title="Carvedilol">carvedilol</a> is recommended to be started within 24 hours, provided there is no acute heart failure or <a href="/wiki/Heart_block" title="Heart block">heart block</a>.<a href="#cite_note-AHA2013-19">[19]</a><a href="#cite_note-AHANSTEMI2014-85">[85]</a> The dose should be increased to the highest tolerated.<a href="#cite_note-NICE172-108">[108]</a> Contrary to most guidelines, the use of beta blockers does not appear to affect the risk of death,<a href="#cite_note-112">[112]</a><a href="#cite_note-113">[113]</a> possibly because other treatments for MI have improved. When beta blocker medication is given within the first 24–72 hours of a STEMI no lives are saved. However, 1 in 200 people were prevented from a repeat heart attack, and another 1 in 200 from having an abnormal heart rhythm. Additionally, for 1 in 91 the medication causes a <a href="/wiki/Cardiogenic_shock" title="Cardiogenic shock">temporary decrease in the heart's ability to pump blood</a>.<a href="#cite_note-BetaNNT2015-114">[114]</a> <a href="/wiki/ACE_inhibitor" title="ACE inhibitor">ACE inhibitor</a> therapy should be started within 24 hours and continued indefinitely at the highest tolerated dose. This is provided there is no evidence of worsening <a href="/wiki/Kidney_failure" title="Kidney failure">kidney failure</a>, <a href="/wiki/Hyperkalaemia" class="mw-redirect" title="Hyperkalaemia">high potassium</a>, low blood pressure, or known narrowing of the <a href="/wiki/Renal_artery" title="Renal artery">renal arteries</a>.<a href="#cite_note-Reed2017-72">[72]</a> Those who cannot tolerate ACE inhibitors may be treated with an <a href="/wiki/Angiotensin_II_receptor_antagonist" class="mw-redirect" title="Angiotensin II receptor antagonist">angiotensin II receptor antagonist</a>.<a href="#cite_note-NICE172-108">[108]</a> <a href="/wiki/Statin" title="Statin">Statin</a> therapy has been shown to reduce mortality and subsequent cardiac events and should be commenced to lower LDL cholesterol. Other medications, such as <a href="/wiki/Ezetimibe" title="Ezetimibe">ezetimibe</a>, may also be added with this goal in mind.<a href="#cite_note-Reed2017-72">[72]</a> <a href="/wiki/Aldosterone_antagonist" class="mw-redirect" title="Aldosterone antagonist">Aldosterone antagonists</a> (<a href="/wiki/Spironolactone" title="Spironolactone">spironolactone</a> or <a href="/wiki/Eplerenone" title="Eplerenone">eplerenone</a>) may be used if there is evidence of left ventricular dysfunction after an MI, ideally after beginning treatment with an ACE inhibitor.<a href="#cite_note-NICE172-108">[108]</a><a href="#cite_note-pmid26891235-115">[115]</a> <div class="mw-heading mw-heading4"><h4 id="Other_3">Other</h4></div> A <a href="/wiki/Defibrillator" class="mw-redirect" title="Defibrillator">defibrillator</a>, an electric device connected to the heart and surgically inserted under the skin, may be recommended. This is particularly if there are any ongoing signs of heart failure, with a low <a href="/wiki/LVEF" class="mw-redirect" title="LVEF">left ventricular ejection fraction</a> and a New York Heart Association grade II or III after 40 days of the infarction.<a href="#cite_note-Reed2017-72">[72]</a> Defibrillators detect potentially fatal arrhythmia and deliver an electrical shock to the person to depolarize a critical mass of the heart muscle.<a href="#cite_note-Hazinski2015-116">[116]</a> <div class="mw-heading mw-heading2"><h2 id="First_aid">First aid</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Management_of_acute_coronary_syndrome#Patient-dependent_initial_measures" title="Management of acute coronary syndrome">Management of acute coronary syndrome § Patient-dependent initial measures</a></div> Taking aspirin helps to reduce the risk of <a href="/wiki/Mortality_rate" title="Mortality rate">mortality</a> in people with myocardial infarction.<a href="#cite_note-reed-117">[117]</a> <div class="mw-heading mw-heading2"><h2 id="Management">Management</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Management_of_acute_coronary_syndrome" title="Management of acute coronary syndrome">Management of acute coronary syndrome</a></div> A myocardial infarction requires immediate medical attention. Treatment aims to preserve as much heart muscle as possible, and to prevent further complications.<a href="#cite_note-Harrisons2015-28">[28]</a> Treatment depends on whether the myocardial infarction is a STEMI or NSTEMI.<a href="#cite_note-Reed2017-72">[72]</a> Treatment in general aims to unblock blood vessels, reduce blood clot enlargement, reduce ischemia, and modify risk factors with the aim of preventing future MIs.<a href="#cite_note-Harrisons2015-28">[28]</a> In addition, the main treatment for myocardial infarctions with ECG evidence of ST elevation (STEMI) include <a href="/wiki/Thrombolysis" title="Thrombolysis">thrombolysis</a> or <a href="/wiki/Percutaneous_coronary_intervention" title="Percutaneous coronary intervention">percutaneous coronary intervention</a>, although PCI is also ideally conducted within 1–3 days for NSTEMI.<a href="#cite_note-Reed2017-72">[72]</a> In addition to <a href="/wiki/Clinical_judgement" class="mw-redirect" title="Clinical judgement">clinical judgement</a>, risk stratification may be used to guide treatment, such as with the <a href="/wiki/TIMI_Risk_Score" class="mw-redirect" title="TIMI Risk Score">TIMI</a> and <a href="/w/index.php?title=GRACE_Risk_Score&action=edit&redlink=1" class="new" title="GRACE Risk Score (page does not exist)">GRACE</a> scoring systems.<a href="#cite_note-Davidsons2010-16">[16]</a><a href="#cite_note-Reed2017-72">[72]</a><a href="#cite_note-118">[118]</a> <div class="mw-heading mw-heading3"><h3 id="Pain_2">Pain</h3></div> The pain associated with myocardial infarction is often treated with <a href="/wiki/Nitroglycerin_(medication)" title="Nitroglycerin (medication)">nitroglycerin</a>, a <a href="/wiki/Vasodilator" class="mw-redirect" title="Vasodilator">vasodilator</a>, or <a href="/wiki/Opioid" title="Opioid">opioid</a> medications such as <a href="/wiki/Morphine" title="Morphine">morphine</a>.<a href="#cite_note-Harrisons2015-28">[28]</a> Nitroglycerin (given <a href="/wiki/Sublingual_administration" title="Sublingual administration">under the tongue</a> or <a href="/wiki/Intravenous_therapy" title="Intravenous therapy">injected into a vein</a>) may improve blood supply to the heart.<a href="#cite_note-Harrisons2015-28">[28]</a> It is an important part of therapy for its pain relief effects, though there is no proven benefit to <a href="/wiki/Case_fatality_rate" title="Case fatality rate">mortality</a>.<a href="#cite_note-Harrisons2015-28">[28]</a><a href="#cite_note-119">[119]</a> Morphine or other opioid medications may also be used, and are effective for the pain associated with STEMI.<a href="#cite_note-Harrisons2015-28">[28]</a> There is poor evidence that morphine shows any benefit to <a href="/wiki/Outcome_measure" title="Outcome measure">overall outcomes</a>, and there is some evidence of potential harm.<a href="#cite_note-120">[120]</a><a href="#cite_note-121">[121]</a> <div class="mw-heading mw-heading3"><h3 id="Antithrombotics">Antithrombotics</h3></div> <a href="/wiki/Aspirin" title="Aspirin">Aspirin</a>, an <a href="/wiki/Antiplatelet_drug" title="Antiplatelet drug">antiplatelet drug</a>, is given as a <a href="/wiki/Loading_dose" title="Loading dose">loading dose</a> to reduce the clot size and reduce further clotting in the affected artery.<a href="#cite_note-Harrisons2015-28">[28]</a><a href="#cite_note-Reed2017-72">[72]</a> It is known to decrease mortality associated with acute myocardial infarction by at least 50%.<a href="#cite_note-Reed2017-72">[72]</a> <a href="/wiki/P2Y12_inhibitors" class="mw-redirect" title="P2Y12 inhibitors">P2Y12 inhibitors</a> such as <a href="/wiki/Clopidogrel" title="Clopidogrel">clopidogrel</a>, <a href="/wiki/Prasugrel" title="Prasugrel">prasugrel</a> and <a href="/wiki/Ticagrelor" title="Ticagrelor">ticagrelor</a> are given concurrently, also as a <a href="/wiki/Loading_dose" title="Loading dose">loading dose</a>, with the dose depending on whether further surgical management or fibrinolysis is planned.<a href="#cite_note-Reed2017-72">[72]</a> Prasugrel and ticagrelor are recommended in European and American guidelines, as they are active more quickly and consistently than clopidogrel.<a href="#cite_note-Reed2017-72">[72]</a> P2Y12 inhibitors are recommended in both NSTEMI and STEMI, including in PCI, with evidence also to suggest improved mortality.<a href="#cite_note-Reed2017-72">[72]</a> <a href="/wiki/Heparin" title="Heparin">Heparins</a>, particularly in the unfractionated form, act at several points in the <a href="/wiki/Clotting_cascade" class="mw-redirect" title="Clotting cascade">clotting cascade</a>, help to prevent the enlargement of a clot, and are also given in myocardial infarction, owing to evidence suggesting improved mortality rates.<a href="#cite_note-Reed2017-72">[72]</a> In very high-risk scenarios, <a href="/wiki/Glycoprotein_IIb/IIIa_inhibitors" title="Glycoprotein IIb/IIIa inhibitors">inhibitors of the platelet glycoprotein αIIbβ3a receptor</a> such as <a href="/wiki/Eptifibatide" title="Eptifibatide">eptifibatide</a> or <a href="/wiki/Tirofiban" title="Tirofiban">tirofiban</a> may be used.<a href="#cite_note-Reed2017-72">[72]</a> There is varying evidence on the mortality benefits in NSTEMI. A 2014 review of P2Y12 inhibitors such as <a href="/wiki/Clopidogrel" title="Clopidogrel">clopidogrel</a> found they do not change the risk of death when given to people with a suspected NSTEMI prior to PCI,<a href="#cite_note-BMJP2Y12-122">[122]</a> nor do heparins change the risk of death.<a href="#cite_note-And2014-123">[123]</a> They do decrease the risk of having a further myocardial infarction.<a href="#cite_note-Reed2017-72">[72]</a><a href="#cite_note-And2014-123">[123]</a> <div class="mw-heading mw-heading3"><h3 id="Angiogram">Angiogram</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Myocardial_infarction.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/ac/Myocardial_infarction.svg/220px-Myocardial_infarction.svg.png" decoding="async" width="220" height="145" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/ac/Myocardial_infarction.svg/330px-Myocardial_infarction.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/ac/Myocardial_infarction.svg/440px-Myocardial_infarction.svg.png 2x" data-file-width="815" data-file-height="538" /></a><figcaption>Inserting a stent to widen the artery.</figcaption></figure> Primary <a href="/wiki/Percutaneous_coronary_intervention" title="Percutaneous coronary intervention">percutaneous coronary intervention</a> (PCI) is the treatment of choice for STEMI if it can be performed in a timely manner, ideally within 90–120 minutes of contact with a medical provider.<a href="#cite_note-Reed2017-72">[72]</a><a href="#cite_note-Bagai2014-124">[124]</a> Some recommend it is also done in NSTEMI within 1–3 days, particularly when considered high-risk.<a href="#cite_note-Reed2017-72">[72]</a> A 2017 review, however, did not find a difference between early versus later PCI in NSTEMI.<a href="#cite_note-125">[125]</a> PCI involves small probes, inserted through peripheral blood vessels such as the <a href="/wiki/Femoral_artery" title="Femoral artery">femoral artery</a> or <a href="/wiki/Radial_artery" title="Radial artery">radial artery</a> into the blood vessels of the heart. The probes are then used to identify and clear blockages <a href="/wiki/Balloon_angioplasty" class="mw-redirect" title="Balloon angioplasty">using small balloons</a>, which are dragged through the blocked segment, <a href="/wiki/Aspiration_thrombectomy" class="mw-redirect" title="Aspiration thrombectomy">dragging away the clot</a>, or <a href="/wiki/Coronary_stenting" class="mw-redirect" title="Coronary stenting">the insertion of stents</a>.<a href="#cite_note-Harrisons2015-28">[28]</a><a href="#cite_note-Reed2017-72">[72]</a> <a href="/wiki/Coronary_artery_bypass_grafting" class="mw-redirect" title="Coronary artery bypass grafting">Coronary artery bypass grafting</a> is only considered when the affected area of heart muscle is large, and PCI is unsuitable, for example with difficult cardiac anatomy.<a href="#cite_note-126">[126]</a> After PCI, people are generally placed on <a href="/wiki/Aspirin" title="Aspirin">aspirin</a> indefinitely and on dual antiplatelet therapy (generally aspirin and <a href="/wiki/Clopidogrel" title="Clopidogrel">clopidogrel</a>) for at least a year.<a href="#cite_note-AHA2013-19">[19]</a><a href="#cite_note-Reed2017-72">[72]</a><a href="#cite_note-127">[127]</a> <div class="mw-heading mw-heading3"><h3 id="Fibrinolysis">Fibrinolysis</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Thrombolysis" title="Thrombolysis">Thrombolysis</a></div> If PCI cannot be performed within 90 to 120 minutes in STEMI then fibrinolysis, preferably within 30 minutes of arrival to hospital, is recommended.<a href="#cite_note-Reed2017-72">[72]</a><a href="#cite_note-128">[128]</a> If a person has had symptoms for 12 to 24 hours evidence for effectiveness of thrombolysis is less and if they have had symptoms for more than 24 hours it is not recommended.<a href="#cite_note-129">[129]</a> Thrombolysis involves the administration of medication that activates the <a href="/wiki/Fibrinolysis" title="Fibrinolysis">enzymes that normally dissolve blood clots</a>. These medications include <a href="/wiki/Tissue_plasminogen_activator" class="mw-redirect" title="Tissue plasminogen activator">tissue plasminogen activator</a>, <a href="/wiki/Reteplase" title="Reteplase">reteplase</a>, <a href="/wiki/Streptokinase" title="Streptokinase">streptokinase</a>, and <a href="/wiki/Tenecteplase" title="Tenecteplase">tenecteplase</a>.<a href="#cite_note-Harrisons2015-28">[28]</a> Thrombolysis is not recommended in a number of situations, particularly when associated with a high risk of bleeding or the potential for problematic bleeding, such as active bleeding, past <a href="/wiki/Stroke" title="Stroke">strokes</a> or bleeds into the brain, or severe <a href="/wiki/Hypertension" title="Hypertension">hypertension</a>. Situations in which thrombolysis may be considered, but with caution, include recent surgery, use of anticoagulants, pregnancy, and proclivity to bleeding.<a href="#cite_note-Harrisons2015-28">[28]</a> Major risks of thrombolysis are major bleeding and <a href="/wiki/Intracranial_bleed" class="mw-redirect" title="Intracranial bleed">intracranial bleeding</a>.<a href="#cite_note-Harrisons2015-28">[28]</a> Pre-hospital thrombolysis reduces time to thrombolytic treatment, based on studies conducted in higher income countries; however, it is unclear whether this has an impact on mortality rates.<a href="#cite_note-mccaul-130">[130]</a> <div class="mw-heading mw-heading3"><h3 id="Other_4">Other</h3></div> In the past, high flow oxygen was recommended for everyone with a possible myocardial infarction.<a href="#cite_note-AHANSTEMI2014-85">[85]</a> More recently, no evidence was found for routine use in those with normal oxygen levels and there is potential harm from the intervention.<a href="#cite_note-131">[131]</a><a href="#cite_note-132">[132]</a><a href="#cite_note-133">[133]</a><a href="#cite_note-134">[134]</a><a href="#cite_note-135">[135]</a> Therefore, oxygen is currently only recommended if oxygen levels are found to be low or if someone is in respiratory distress.<a href="#cite_note-Harrisons2015-28">[28]</a><a href="#cite_note-AHANSTEMI2014-85">[85]</a> If despite thrombolysis there is significant <a href="/wiki/Cardiogenic_shock" title="Cardiogenic shock">cardiogenic shock</a>, continued severe chest pain, or less than a 50% improvement in <a href="/wiki/ST_elevation" title="ST elevation">ST elevation</a> on the ECG recording after 90 minutes, then rescue PCI is indicated emergently.<a href="#cite_note-Wang2011-136">[136]</a><a href="#cite_note-137">[137]</a> Those who have had <a href="/wiki/Cardiac_arrest" title="Cardiac arrest">cardiac arrest</a> may benefit from <a href="/wiki/Targeted_temperature_management" title="Targeted temperature management">targeted temperature management</a> with evaluation for implementation of hypothermia protocols. Furthermore, those with cardiac arrest, and ST elevation at any time, should usually have angiography.<a href="#cite_note-AHA2013-19">[19]</a> <a href="/wiki/Aldosterone_antagonists" class="mw-redirect" title="Aldosterone antagonists">Aldosterone antagonists</a> appear to be useful in people who have had an STEMI and do not have heart failure.<a href="#cite_note-138">[138]</a> <div class="mw-heading mw-heading3"><h3 id="Rehabilitation_and_exercise">Rehabilitation and exercise</h3></div> <a href="/wiki/Cardiopulmonary_rehabilitation" class="mw-redirect" title="Cardiopulmonary rehabilitation">Cardiac rehabilitation</a> benefits many who have experienced myocardial infarction,<a href="#cite_note-Reed2017-72">[72]</a> even if there has been substantial heart damage and resultant <a href="/wiki/Left_ventricular_failure" class="mw-redirect" title="Left ventricular failure">left ventricular failure</a>. It should start soon after discharge from the hospital. The program may include lifestyle advice, exercise, social support, as well as recommendations about driving, flying, sports participation, stress management, and sexual intercourse.<a href="#cite_note-NICE172-108">[108]</a> Returning to sexual activity after myocardial infarction is a major concern for most patients, and is an important area to be discussed in the provision of holistic care.<a href="#cite_note-139">[139]</a><a href="#cite_note-pmid20168196-140">[140]</a> In the short-term, exercise-based cardiovascular rehabilitation programs may reduce the risk of a myocardial infarction, reduces a large number of hospitalizations from all causes, reduces hospital costs, improves <a href="/wiki/Health_related_quality_of_life" class="mw-redirect" title="Health related quality of life">health-related quality of life</a>, and has a small effect on <a href="/wiki/All-cause_mortality" class="mw-redirect" title="All-cause mortality">all-cause mortality</a>.<a href="#cite_note-141">[141]</a> Longer-term studies indicate that exercise-based cardiovascular rehabilitation programs may reduce cardiovascular mortality and myocardial infarction. <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2></div> The prognosis after myocardial infarction varies greatly depending on the extent and location of the affected heart muscle, and the development and management of complications.<a href="#cite_note-Davidsons2010-16">[16]</a> Prognosis is worse with older age and social isolation.<a href="#cite_note-Davidsons2010-16">[16]</a> Anterior infarcts, persistent ventricular tachycardia or fibrillation, development of <a href="/wiki/Heart_block" title="Heart block">heart blocks</a>, and left ventricular impairment are all associated with poorer prognosis.<a href="#cite_note-Davidsons2010-16">[16]</a> Without treatment, about a quarter of those affected by MI die within minutes and about forty percent within the first month.<a href="#cite_note-Davidsons2010-16">[16]</a> Morbidity and mortality from myocardial infarction has, however, improved over the years due to earlier and better treatment:<a href="#cite_note-Harrisons2015B-30">[30]</a> in those who have a STEMI in the United States, between 5 and 6 percent die before leaving the hospital and 7 to 18 percent die within a year.<a href="#cite_note-AHA2013-19">[19]</a> It is unusual for babies to experience a myocardial infarction, but when they do, about half die.<a href="#cite_note-:0-142">[142]</a> In the short-term, neonatal survivors seem to have a normal quality of life.<a href="#cite_note-:0-142">[142]</a> <div class="mw-heading mw-heading3"><h3 id="Complications">Complications</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Myocardial_infarction_complications" title="Myocardial infarction complications">Myocardial infarction complications</a></div> Complications may occur immediately following the myocardial infarction or may take time to develop. <a href="/wiki/Heart_arrhythmia" class="mw-redirect" title="Heart arrhythmia">Disturbances of heart rhythms</a>, including <a href="/wiki/Atrial_fibrillation" title="Atrial fibrillation">atrial fibrillation</a>, <a href="/wiki/Ventricular_tachycardia" title="Ventricular tachycardia">ventricular tachycardia</a> and <a href="/wiki/Ventricular_fibrillation" title="Ventricular fibrillation">fibrillation</a> and <a href="/wiki/Heart_block" title="Heart block">heart block</a> can arise as a result of ischemia, cardiac scarring, and infarct location.<a href="#cite_note-Davidsons2010-16">[16]</a><a href="#cite_note-Reed2017-72">[72]</a> <a href="/wiki/Stroke" title="Stroke">Stroke</a> is also a risk, either as a result of <a href="/wiki/Arterial_embolism" title="Arterial embolism">clots</a> transmitted from the heart during PCI, as a result of bleeding following anticoagulation, or as a result of disturbances in the heart's ability to pump effectively as a result of the infarction.<a href="#cite_note-Reed2017-72">[72]</a> <a href="/wiki/Mitral_regurgitation" title="Mitral regurgitation">Regurgitation of blood through the mitral valve</a> is possible, particularly if the infarction causes dysfunction of the papillary muscle.<a href="#cite_note-Reed2017-72">[72]</a> <a href="/wiki/Cardiogenic_shock" title="Cardiogenic shock">Cardiogenic shock</a> as a result of the heart being unable to adequately pump blood may develop, dependent on infarct size, and is most likely to occur within the days following an acute myocardial infarction. Cardiogenic shock is the largest cause of in-hospital mortality.<a href="#cite_note-Harrisons2015B-30">[30]</a><a href="#cite_note-Reed2017-72">[72]</a> Rupture of the ventricular dividing wall or left ventricular wall may occur within the initial weeks.<a href="#cite_note-Reed2017-72">[72]</a> <a href="/wiki/Dressler%27s_syndrome" class="mw-redirect" title="Dressler's syndrome">Dressler's syndrome</a>, a reaction following larger infarcts and a cause of <a href="/wiki/Pericarditis" title="Pericarditis">pericarditis</a> is also possible.<a href="#cite_note-Reed2017-72">[72]</a> <a href="/wiki/Heart_failure" title="Heart failure">Heart failure</a> may develop as a long-term consequence, with an impaired ability of heart muscle to pump, scarring, and an increase in the size of the existing muscle. <a href="/wiki/Ventricular_aneurysm" title="Ventricular aneurysm">Aneurysm of the left ventricle myocardium</a> develops in about 10% of MI and is itself a risk factor for heart failure, ventricular arrhythmia, and the development of <a href="/wiki/Embolism" title="Embolism">clots</a>.<a href="#cite_note-Davidsons2010-16">[16]</a> Risk factors for complications and death include age, <a href="/wiki/Hemodynamics" title="Hemodynamics">hemodynamic</a> parameters (such as <a href="/wiki/Heart_failure" title="Heart failure">heart failure</a>, <a href="/wiki/Cardiac_arrest" title="Cardiac arrest">cardiac arrest</a> on admission, <a href="/wiki/Systole_(medicine)" class="mw-redirect" title="Systole (medicine)">systolic</a> <a href="/wiki/Blood_pressure" title="Blood pressure">blood pressure</a>, or <a href="/wiki/Killip_class" title="Killip class">Killip class</a> of two or greater), ST-segment deviation, diabetes, serum <a href="/wiki/Creatinine" title="Creatinine">creatinine</a>, <a href="/wiki/Peripheral_artery_occlusive_disease" class="mw-redirect" title="Peripheral artery occlusive disease">peripheral vascular disease</a>, and elevation of cardiac markers.<a href="#cite_note-PEPA-143">[143]</a><a href="#cite_note-GRACE-144">[144]</a><a href="#cite_note-Weir-2006-145">[145]</a> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2></div> Myocardial infarction is a common presentation of <a href="/wiki/Coronary_artery_disease" title="Coronary artery disease">coronary artery disease</a>. The <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a> estimated in 2004, that 12.2% of worldwide deaths were from ischemic heart disease;<a href="#cite_note-WHO-2004-146">[146]</a> with it being the leading cause of death in high- or middle-income countries and second only to <a href="/wiki/Lower_respiratory_tract_infection" title="Lower respiratory tract infection">lower respiratory infections</a> in <a href="/wiki/Developing_country" title="Developing country">lower-income countries</a>.<a href="#cite_note-WHO-2004-146">[146]</a> Worldwide, more than 3 million people have STEMIs and 4 million have NSTEMIs a year.<a href="#cite_note-Lancet08-18">[18]</a> STEMIs occur about twice as often in men as women.<a href="#cite_note-AHA2013-19">[19]</a> Rates of death from ischemic heart disease (IHD) have slowed or declined in most high-income countries, although cardiovascular disease still accounted for one in three of all deaths in the US in 2008.<a href="#cite_note-147">[147]</a> For example, rates of death from cardiovascular disease have decreased almost a third between 2001 and 2011 in the United States.<a href="#cite_note-148">[148]</a> In contrast, IHD is becoming a more common cause of death in the developing world. For example, in <a href="/wiki/India" title="India">India</a>, IHD had become the leading cause of death by 2004, accounting for 1.46 million deaths (14% of total deaths) and deaths due to IHD were expected to double during 1985–2015.<a href="#cite_note-149">[149]</a> Globally, <a href="/wiki/Disability_adjusted_life_year" class="mw-redirect" title="Disability adjusted life year">disability adjusted life years</a> (DALYs) lost to ischemic heart disease are predicted to account for 5.5% of total DALYs in 2030, making it the second-most-important cause of disability (after <a href="/wiki/Major_depressive_disorder" title="Major depressive disorder">unipolar depressive disorder</a>), as well as the leading cause of death by this date.<a href="#cite_note-WHO-2004-146">[146]</a> <div class="mw-heading mw-heading2"><h2 id="Social_determinants_of_health">Social determinants of health</h2></div> <style data-mw-deduplicate="TemplateStyles:r1251242444">.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid #36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output .ambox-speedy{border-left:10px solid #b32424;background-color:#fee7e6}.mw-parser-output .ambox-delete{border-left:10px solid #b32424}.mw-parser-output .ambox-content{border-left:10px solid #f28500}.mw-parser-output .ambox-style{border-left:10px solid #fc3}.mw-parser-output .ambox-move{border-left:10px solid #9932cc}.mw-parser-output .ambox-protection{border-left:10px solid #a2a9b1}.mw-parser-output .ambox .mbox-text{border:none;padding:0.25em 0.5em;width:100%}.mw-parser-output .ambox .mbox-image{border:none;padding:2px 0 2px 0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}</style><table class="box-Globalize plainlinks metadata ambox ambox-content ambox-globalize" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><img alt="Globe icon." src="//upload.wikimedia.org/wikipedia/commons/thumb/b/bd/Ambox_globe_content.svg/48px-Ambox_globe_content.svg.png" decoding="async" width="48" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/bd/Ambox_globe_content.svg/73px-Ambox_globe_content.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/bd/Ambox_globe_content.svg/97px-Ambox_globe_content.svg.png 2x" data-file-width="350" data-file-height="290" /></div></td><td class="mbox-text"><div class="mbox-text-span">The examples and perspective in this section may not represent a <a href="/wiki/Wikipedia:WikiProject_Countering_systemic_bias" title="Wikipedia:WikiProject Countering systemic bias">worldwide view</a> of the subject. You may <a class="external text" href="https://en.wikipedia.org/w/index.php?title=Myocardial_infarction&action=edit">improve this section</a>, discuss the issue on the <a href="/wiki/Talk:Myocardial_infarction" title="Talk:Myocardial infarction">talk page</a>, or create a new section, as appropriate. (October 2024) (<a href="/wiki/Help:Maintenance_template_removal" title="Help:Maintenance template removal">Learn how and when to remove this message</a>)</div></td></tr></tbody></table> Social determinants such as <a href="/wiki/Neighbourhood" title="Neighbourhood">neighborhood</a> disadvantage, <a href="/wiki/Immigration" title="Immigration">immigration</a> status, lack of <a href="/wiki/Social_support" title="Social support">social support</a>, <a href="/wiki/Social_isolation" title="Social isolation">social isolation</a>, and access to <a href="/wiki/Health_care" title="Health care">health services</a> play an important role in myocardial infarction risk and survival.<a href="#cite_note-150">[150]</a><a href="#cite_note-151">[151]</a><a href="#cite_note-152">[152]</a><a href="#cite_note-153">[153]</a> Studies have shown that low <a href="/wiki/Socioeconomic_status" title="Socioeconomic status">socioeconomic status</a> is associated with an increased risk of poorer survival. There are well-documented disparities in myocardial infarction survival by <a href="/wiki/Socioeconomic_status" title="Socioeconomic status">socioeconomic status</a>, <a href="/wiki/Race_and_ethnicity_in_the_United_States" title="Race and ethnicity in the United States">race</a>, <a href="/wiki/Education" title="Education">education</a>, and census-tract-level <a href="/wiki/Poverty" title="Poverty">poverty</a>.<a href="#cite_note-154">[154]</a> Race: In the U.S. <a href="/wiki/African_Americans" title="African Americans">African Americans</a> have a greater burden of myocardial infarction and other cardiovascular events. On a population level, there is a higher overall <a href="/wiki/Prevalence" title="Prevalence">prevalence</a> of risk factors that are unrecognized and therefore not treated, which places these individuals at a greater likelihood of experiencing adverse outcomes and therefore potentially higher <a href="/wiki/Morbidity" class="mw-redirect" title="Morbidity">morbidity</a> and <a href="/wiki/Mortality_rate" title="Mortality rate">mortality</a>.<a href="#cite_note-155">[155]</a> Similarly, South Asians (including South Asians that have migrated to other countries around the world) experience higher rates of acute myocardial infarctions at younger ages, which can be largely explained by a higher prevalence of risk factors at younger ages.<a href="#cite_note-156">[156]</a> Socioeconomic status: Among individuals who live in the low-<a href="/wiki/Socioeconomic_status" title="Socioeconomic status">socioeconomic</a> (SES) areas, which is close to 25% of the US population, myocardial infarctions (MIs) occurred twice as often compared with people who lived in higher SES areas.<a href="#cite_note-157">[157]</a> Immigration status: In 2018 many lawfully present <a href="/wiki/Immigrant" class="mw-redirect" title="Immigrant">immigrants</a> who were eligible for coverage remained uninsured because immigrant families faced a range of enrollment barriers, including fear, confusion about eligibility policies, difficulty navigating the enrollment process, and <a href="/wiki/Language" title="Language">language</a> and <a href="/wiki/Literacy" title="Literacy">literacy</a> challenges. Uninsured <a href="/wiki/Undocumented_immigrants_(U.S.)" class="mw-redirect" title="Undocumented immigrants (U.S.)">undocumented immigrants</a> are ineligible for coverage options due to their immigration status.<a href="#cite_note-158">[158]</a> Health care access: Lack of <a href="/wiki/Health_insurance" title="Health insurance">health insurance</a> and financial concerns about accessing care were associated with delays in seeking emergency care for acute myocardial infarction which can have significant, adverse consequences on patient outcomes.<a href="#cite_note-159">[159]</a> Education: Researchers found that compared to people with <a href="/wiki/Graduate_degrees" class="mw-redirect" title="Graduate degrees">graduate degrees</a>, those with lower educational attainment appeared to have a higher <a href="/wiki/Risk" title="Risk">risk</a> of heart attack, dying from a <a href="/wiki/Cardiovascular" class="mw-redirect" title="Cardiovascular">cardiovascular</a> event, and overall death.<a href="#cite_note-160">[160]</a> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2></div> Depictions of heart attacks in popular media often include collapsing or loss of consciousness which are not common symptoms; these depictions contribute to widespread misunderstanding about the symptoms of myocardial infarctions, which in turn contributes to people not getting care when they should.<a href="#cite_note-161">[161]</a> <div class="mw-heading mw-heading3"><h3 id="Legal_implications">Legal implications</h3></div> At <a href="/wiki/Common_law" title="Common law">common law</a>, in general, a myocardial infarction is a <a href="/wiki/Disease" title="Disease">disease</a> but may sometimes be an <a href="/wiki/Injury" title="Injury">injury</a>. This can create coverage issues in the administration of no-fault insurance schemes such as <a href="/wiki/Workers%27_compensation" title="Workers' compensation">workers' compensation</a>. In general, a heart attack is not covered;<a href="#cite_note-prairieview-162">[162]</a> however, it may be a <a href="/wiki/Industrial_injury" class="mw-redirect" title="Industrial injury">work-related injury</a> if it results, for example, from unusual emotional stress or unusual exertion.<a href="#cite_note-biia-163">[163]</a> In addition, in some jurisdictions, heart attacks had by persons in particular occupations such as <a href="/wiki/Police_officer" title="Police officer">police officers</a> may be classified as line-of-duty injuries by statute or policy. In some countries or states, a person having had an MI may be prevented from participating in activity that puts other people's lives at risk, for example driving a car or flying an airplane.<a href="#cite_note-NovaScotia-DrivingRegulations-164">[164]</a> <div class="mw-heading mw-heading2"><h2 id="References">References</h2></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-HLB2014-1">^ <a href="#cite_ref-HLB2014_1-0">a</a> <a href="#cite_ref-HLB2014_1-1">b</a> <a href="#cite_ref-HLB2014_1-2">c</a> <a href="#cite_ref-HLB2014_1-3">d</a> <a href="#cite_ref-HLB2014_1-4">e</a> <style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20150224034615/http://www.nhlbi.nih.gov/health/health-topics/topics/cad/signs">"What Are the Signs and Symptoms of Coronary Heart Disease?"</a>. www.nhlbi.nih.gov. 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Oxford University Press. pp. 39–47. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-19-871702-7" title="Special:BookSources/978-0-19-871702-7"><bdi>978-0-19-871702-7</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Chest+pain%2C+breathlessness%2C+fatigue&rft.btitle=Oxford+Textbook+of+Medicine%3A+Cardiovascular+Disorders&rft.pages=%3Cspan+class%3D%22nowrap%22%3E39-%3C%2Fspan%3E47&rft.pub=Oxford+University+Press&rft.date=2016-06-16&rft.isbn=978-0-19-871702-7&rft.aulast=Dwight&rft.aufirst=J&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DYqJHDAAAQBAJ&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMyocardial+infarction" class="Z3988"></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFGazianoGaziano2016" class="citation book cs1">Gaziano TA, Gaziano JM (15 September 2016). "Global Evolving Epidemiology, Natural History, and Treatment Trends of Myocardial Infarction". In Morrow DA (ed.). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=0TzrjwEACAAJ">Myocardial Infarction: A Companion to Braunwald's Heart Disease</a>. Elsevier. pp. 11–21. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-323-35943-6" title="Special:BookSources/978-0-323-35943-6"><bdi>978-0-323-35943-6</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Global+Evolving+Epidemiology%2C+Natural+History%2C+and+Treatment+Trends+of+Myocardial+Infarction&rft.btitle=Myocardial+Infarction%3A+A+Companion+to+Braunwald%27s+Heart+Disease&rft.pages=%3Cspan+class%3D%22nowrap%22%3E11-%3C%2Fspan%3E21&rft.pub=Elsevier&rft.date=2016-09-15&rft.isbn=978-0-323-35943-6&rft.aulast=Gaziano&rft.aufirst=TA&rft.au=Gaziano%2C+JM&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3D0TzrjwEACAAJ&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMyocardial+infarction" class="Z3988"></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMorrowBohula2016" class="citation book cs1">Morrow DA, Bohula EA (15 September 2016). "Heart Failure and Cardiogenic Shock After Myocardial Infarction". In Morrow DA (ed.). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=0TzrjwEACAAJ">Myocardial Infarction: A Companion to Braunwald's Heart Disease</a>. Elsevier. pp. 295–313. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-323-35943-6" title="Special:BookSources/978-0-323-35943-6"><bdi>978-0-323-35943-6</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Heart+Failure+and+Cardiogenic+Shock+After+Myocardial+Infarction&rft.btitle=Myocardial+Infarction%3A+A+Companion+to+Braunwald%27s+Heart+Disease&rft.pages=%3Cspan+class%3D%22nowrap%22%3E295-%3C%2Fspan%3E313&rft.pub=Elsevier&rft.date=2016-09-15&rft.isbn=978-0-323-35943-6&rft.aulast=Morrow&rft.aufirst=DA&rft.au=Bohula%2C+EA&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3D0TzrjwEACAAJ&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMyocardial+infarction" class="Z3988"></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMorrowBraunwald2016" class="citation book cs1">Morrow DA, Braunwald E (15 September 2016). "Classification and Diagnosis of Acute Coronary Syndromes". In Morrow DA (ed.). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=0TzrjwEACAAJ">Myocardial Infarction: A Companion to Braunwald's Heart Disease</a>. Elsevier. pp. 1–10. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-323-35943-6" title="Special:BookSources/978-0-323-35943-6"><bdi>978-0-323-35943-6</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Classification+and+Diagnosis+of+Acute+Coronary+Syndromes&rft.btitle=Myocardial+Infarction%3A+A+Companion+to+Braunwald%27s+Heart+Disease&rft.pages=%3Cspan+class%3D%22nowrap%22%3E1-%3C%2Fspan%3E10&rft.pub=Elsevier&rft.date=2016-09-15&rft.isbn=978-0-323-35943-6&rft.aulast=Morrow&rft.aufirst=DA&rft.au=Braunwald%2C+E&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3D0TzrjwEACAAJ&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMyocardial+infarction" class="Z3988"></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMorrow2016" class="citation book cs1">Morrow DA (15 September 2016). "Clinical Approach to Suspected Acute Myocardial Infarction". In Morrow DA (ed.). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=0TzrjwEACAAJ">Myocardial Infarction: A Companion to Braunwald's Heart Disease</a>. Elsevier. pp. 55–65. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-323-35943-6" title="Special:BookSources/978-0-323-35943-6"><bdi>978-0-323-35943-6</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Clinical+Approach+to+Suspected+Acute+Myocardial+Infarction&rft.btitle=Myocardial+Infarction%3A+A+Companion+to+Braunwald%27s+Heart+Disease&rft.pages=%3Cspan+class%3D%22nowrap%22%3E55-%3C%2Fspan%3E65&rft.pub=Elsevier&rft.date=2016-09-15&rft.isbn=978-0-323-35943-6&rft.aulast=Morrow&rft.aufirst=DA&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3D0TzrjwEACAAJ&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMyocardial+infarction" class="Z3988"></li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239549316"><div class="refbegin" style=""> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFLevineBatesBlankenshipBailey2016" class="citation journal cs1">Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, et al. (March 2016). <a rel="nofollow" class="external text" href="https://doi.org/10.1161%2FCIR.0000000000000336">"2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary Intervention for Patients With ST-Elevation Myocardial Infarction: An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention and the 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Society for Cardiovascular Angiography and Interventions"</a>. Circulation. 133 (11): 1135–47. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1161%2FCIR.0000000000000336">10.1161/CIR.0000000000000336</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26490017">26490017</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Circulation&rft.atitle=2015+ACC%2FAHA%2FSCAI+Focused+Update+on+Primary+Percutaneous+Coronary+Intervention+for+Patients+With+ST-Elevation+Myocardial+Infarction%3A+An+Update+of+the+2011+ACCF%2FAHA%2FSCAI+Guideline+for+Percutaneous+Coronary+Intervention+and+the+2013+ACCF%2FAHA+Guideline+for+the+Management+of+ST-Elevation+Myocardial+Infarction%3A+A+Report+of+the+American+College+of+Cardiology%2FAmerican+Heart+Association+Task+Force+on+Clinical+Practice+Guidelines+and+the+Society+for+Cardiovascular+Angiography+and+Interventions&rft.volume=133&rft.issue=11&rft.pages=%3Cspan+class%3D%22nowrap%22%3E1135-%3C%2Fspan%3E47&rft.date=2016-03&rft_id=info%3Adoi%2F10.1161%2FCIR.0000000000000336&rft_id=info%3Apmid%2F26490017&rft.aulast=Levine&rft.aufirst=GN&rft.au=Bates%2C+ER&rft.au=Blankenship%2C+JC&rft.au=Bailey%2C+SR&rft.au=Bittl%2C+JA&rft.au=Cercek%2C+B&rft.au=Chambers%2C+CE&rft.au=Ellis%2C+SG&rft.au=Guyton%2C+RA&rft.au=Hollenberg%2C+SM&rft.au=Khot%2C+UN&rft.au=Lange%2C+RA&rft.au=Mauri%2C+L&rft.au=Mehran%2C+R&rft.au=Moussa%2C+ID&rft.au=Mukherjee%2C+D&rft.au=Ting%2C+HH&rft.au=O%27Gara%2C+PT&rft.au=Kushner%2C+FG&rft.au=Ascheim%2C+DD&rft.au=Brindis%2C+RG&rft.au=Casey%2C+DE&rft.au=Chung%2C+MK&rft.au=de+Lemos%2C+JA&rft.au=Diercks%2C+DB&rft.au=Fang%2C+JC&rft.au=Franklin%2C+BA&rft.au=Granger%2C+CB&rft.au=Krumholz%2C+HM&rft.au=Linderbaum%2C+JA&rft.au=Morrow%2C+DA&rft.au=Newby%2C+LK&rft.au=Ornato%2C+JP&rft.au=Ou%2C+N&rft.au=Radford%2C+MJ&rft.au=Tamis-Holland%2C+JE&rft.au=Tommaso%2C+CL&rft.au=Tracy%2C+CM&rft.au=Woo%2C+YJ&rft.au=Zhao%2C+DX&rft_id=https%3A%2F%2Fdoi.org%2F10.1161%252FCIR.0000000000000336&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMyocardial+infarction" class="Z3988"></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMin_Cho2021" class="citation journal cs1">Min Cho S, et al. (2021). "Machine learning compared with conventional statistical models for predicting myocardial infarction readmission and mortality: a systematic review". Canadian Journal of Cardiology. 37 (8). Elsevier: 1207–1214. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.cjca.2021.02.020">10.1016/j.cjca.2021.02.020</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/33677098">33677098</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:232141652">232141652</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Canadian+Journal+of+Cardiology&rft.atitle=Machine+learning+compared+with+conventional+statistical+models+for+predicting+myocardial+infarction+readmission+and+mortality%3A+a+systematic+review&rft.volume=37&rft.issue=8&rft.pages=%3Cspan+class%3D%22nowrap%22%3E1207-%3C%2Fspan%3E1214&rft.date=2021&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A232141652%23id-name%3DS2CID&rft_id=info%3Apmid%2F33677098&rft_id=info%3Adoi%2F10.1016%2Fj.cjca.2021.02.020&rft.aulast=Min+Cho&rft.aufirst=S&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMyocardial+infarction" class="Z3988"></li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2></div> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 1em;line-height:1.5em;text-align:center}.mw-parser-output .navbox-group{white-space:nowrap;text-align:right}.mw-parser-output .navbox,.mw-parser-output .navbox-subgroup{background-color:#fdfdfd}.mw-parser-output .navbox-list{line-height:1.5em;border-color:#fdfdfd}.mw-parser-output .navbox-list-with-group{text-align:left;border-left-width:2px;border-left-style:solid}.mw-parser-output tr+tr>.navbox-abovebelow,.mw-parser-output tr+tr>.navbox-group,.mw-parser-output tr+tr>.navbox-image,.mw-parser-output tr+tr>.navbox-list{border-top:2px solid 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.navbox{display:none!important}}</style><style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output .hlist ul ol,.mw-parser-output .hlist ul ul{display:inline}.mw-parser-output .hlist .mw-empty-li{display:none}.mw-parser-output .hlist dt::after{content:": "}.mw-parser-output .hlist dd::after,.mw-parser-output .hlist li::after{content:" · ";font-weight:bold}.mw-parser-output .hlist dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox32" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q12152" class="extiw" title="d:Q12152">D</a></div><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/I21">I21</a>-<a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/I22">I22</a></li><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=410">410</a></li><li><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D009203">D009203</a></li><li><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb8664.htm">8664</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000195.htm">000195</a></li><li><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/med/1567-overview">med/1567</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/emerg/topic327.htm#">emerg/327</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/ped/topic2520.htm#">ped/2520</a></li><li><a href="/wiki/Patient_UK" title="Patient UK">Patient UK</a>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/acute-myocardial-infarction">Myocardial infarction</a></li></ul></div></div></td></tr></tbody></table></div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .side-box-abovebelow,.mw-parser-output .side-box-text{padding:0.25em 0.9em}.mw-parser-output .side-box-image{padding:2px 0 2px 0.9em;text-align:center}.mw-parser-output .side-box-imageright{padding:2px 0.9em 2px 0;text-align:center}@media(min-width:500px){.mw-parser-output .side-box-flex{display:flex;align-items:center}.mw-parser-output .side-box-text{flex:1;min-width:0}}@media(min-width:720px){.mw-parser-output .side-box{width:238px}.mw-parser-output .side-box-right{clear:right;float:right;margin-left:1em}.mw-parser-output .side-box-left{margin-right:1em}}</style><style data-mw-deduplicate="TemplateStyles:r1250146164">.mw-parser-output .sister-box .side-box-abovebelow{padding:0.75em 0;text-align:center}.mw-parser-output .sister-box .side-box-abovebelow>b{display:block}.mw-parser-output .sister-box .side-box-text>ul{border-top:1px solid #aaa;padding:0.75em 0;width:217px;margin:0 auto}.mw-parser-output .sister-box .side-box-text>ul>li{min-height:31px}.mw-parser-output .sister-logo{display:inline-block;width:31px;line-height:31px;vertical-align:middle;text-align:center}.mw-parser-output .sister-link{display:inline-block;margin-left:4px;width:182px;vertical-align:middle}@media print{body.ns-0 .mw-parser-output .sistersitebox{display:none!important}}@media screen{html.skin-theme-clientpref-night .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-v2.svg"]{background-color:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-v2.svg"]{background-color:white}}</style><div role="navigation" aria-labelledby="sister-projects" class="side-box metadata side-box-right sister-box sistersitebox plainlinks"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style> <div class="side-box-abovebelow"> Myocardial infarction at Wikipedia's <a href="/wiki/Wikipedia:Wikimedia_sister_projects" title="Wikipedia:Wikimedia sister projects">sister projects</a></div> <div class="side-box-flex"> <div class="side-box-text plainlist"><ul><li><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/0/06/Wiktionary-logo-v2.svg/27px-Wiktionary-logo-v2.svg.png" decoding="async" width="27" height="27" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/0/06/Wiktionary-logo-v2.svg/41px-Wiktionary-logo-v2.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/0/06/Wiktionary-logo-v2.svg/54px-Wiktionary-logo-v2.svg.png 2x" data-file-width="391" data-file-height="391" /><a href="https://en.wiktionary.org/wiki/Special:Search/Myocardial_infarction" class="extiw" title="wikt:Special:Search/Myocardial infarction">Definitions</a> from Wiktionary</li><li><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/20px-Commons-logo.svg.png" decoding="async" width="20" height="27" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/30px-Commons-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/40px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /><a href="https://commons.wikimedia.org/wiki/Category:Myocardial_infarction" class="extiw" title="c:Category:Myocardial infarction">Media</a> from Commons</li><li><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/2/24/Wikinews-logo.svg/27px-Wikinews-logo.svg.png" decoding="async" width="27" height="15" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/24/Wikinews-logo.svg/41px-Wikinews-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/24/Wikinews-logo.svg/54px-Wikinews-logo.svg.png 2x" data-file-width="759" data-file-height="415" /><a href="https://en.wikinews.org/wiki/Special:Search/Myocardial_infarction" class="extiw" title="n:Special:Search/Myocardial infarction">News</a> from Wikinews</li><li><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Wikiquote-logo.svg/23px-Wikiquote-logo.svg.png" decoding="async" width="23" height="27" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Wikiquote-logo.svg/35px-Wikiquote-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Wikiquote-logo.svg/46px-Wikiquote-logo.svg.png 2x" data-file-width="300" data-file-height="355" /><a href="https://en.wikiquote.org/wiki/Special:Search/Myocardial_infarction" class="extiw" title="q:Special:Search/Myocardial infarction">Quotations</a> from Wikiquote</li><li><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/26px-Wikisource-logo.svg.png" decoding="async" width="26" height="27" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/39px-Wikisource-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/51px-Wikisource-logo.svg.png 2x" data-file-width="410" data-file-height="430" /><a href="https://en.wikisource.org/wiki/Special:Search/Myocardial_infarction" class="extiw" title="s:Special:Search/Myocardial infarction">Texts</a> from Wikisource</li><li><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Wikibooks-logo.svg/27px-Wikibooks-logo.svg.png" decoding="async" width="27" height="27" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Wikibooks-logo.svg/41px-Wikibooks-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Wikibooks-logo.svg/54px-Wikibooks-logo.svg.png 2x" data-file-width="300" data-file-height="300" /><a href="https://en.wikibooks.org/wiki/Special:Search/Myocardial_infarction" class="extiw" title="b:Special:Search/Myocardial infarction">Textbooks</a> from Wikibooks</li><li><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/0/0b/Wikiversity_logo_2017.svg/27px-Wikiversity_logo_2017.svg.png" decoding="async" width="27" height="22" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/0b/Wikiversity_logo_2017.svg/41px-Wikiversity_logo_2017.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/0b/Wikiversity_logo_2017.svg/54px-Wikiversity_logo_2017.svg.png 2x" data-file-width="626" data-file-height="512" /><a href="https://en.wikiversity.org/wiki/Special:Search/Myocardial_infarction" class="extiw" title="v:Special:Search/Myocardial infarction">Resources</a> from Wikiversity</li></ul></div></div> </div> <ul><li><a rel="nofollow" class="external text" href="http://www.americanheart.org/heartattack">American Heart Association's Heart Attack web site</a> — Information and resources for preventing, recognizing, and treating a heart attack.</li> <li>TIMI Score for <a rel="nofollow" class="external text" href="http://www.mdcalc.com/timi-risk-score-for-uanstemi/">UA/NSTEMI</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20161105220551/http://www.mdcalc.com/timi-risk-score-for-uanstemi/">Archived</a> 2016-11-05 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a> and <a rel="nofollow" class="external text" href="http://www.mdcalc.com/timi-risk-score-for-stemi/">STEMI</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20090319073410/http://www.mdcalc.com/timi-risk-score-for-stemi">Archived</a> 2009-03-19 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a></li> <li><a rel="nofollow" class="external text" href="http://www.mdcalc.com/heart-score-for-major-cardiac-events/">HEART Score for Major Cardiac Events</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20161028004807/http://www.mdcalc.com/heart-score-for-major-cardiac-events/">Archived</a> 2016-10-28 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://medlineplus.gov/heartattack.html">"Heart Attack"</a>. MedlinePlus. U.S. National Library of Medicine.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=MedlinePlus&rft.atitle=Heart+Attack&rft_id=https%3A%2F%2Fmedlineplus.gov%2Fheartattack.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMyocardial+infarction" class="Z3988"></li></ul> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Cardiovascular_disease_(heart)135" style="padding:3px"><table class="nowraplinks hlist mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Heart_diseases" title="Template:Heart diseases"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Heart_diseases" title="Template talk:Heart diseases"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Heart_diseases" title="Special:EditPage/Template:Heart diseases"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Cardiovascular_disease_(heart)135" style="font-size:114%;margin:0 4em"><a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">Cardiovascular disease</a> (heart)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Ischemia" title="Ischemia">Ischemia</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Coronary disease</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Coronary_artery_disease" title="Coronary artery disease">Coronary artery disease</a> (CAD)</li> <li><a href="/wiki/Coronary_artery_aneurysm" title="Coronary artery aneurysm">Coronary artery aneurysm</a></li> <li><a href="/wiki/Spontaneous_coronary_artery_dissection" title="Spontaneous coronary artery dissection">Spontaneous coronary artery dissection</a> (SCAD)</li> <li><a href="/wiki/Coronary_thrombosis" title="Coronary thrombosis">Coronary thrombosis</a></li> <li><a href="/wiki/Coronary_vasospasm" title="Coronary vasospasm">Coronary vasospasm</a></li> <li><a href="/wiki/Myocardial_bridge" title="Myocardial bridge">Myocardial bridge</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Active ischemia</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Angina" title="Angina">Angina pectoris</a> <ul><li><a href="/wiki/Prinzmetal%27s_angina" class="mw-redirect" title="Prinzmetal's angina">Prinzmetal's angina</a></li> <li><a href="/wiki/Stable_angina" class="mw-redirect" title="Stable angina">Stable angina</a></li></ul></li> <li><a href="/wiki/Acute_coronary_syndrome" title="Acute coronary syndrome">Acute coronary syndrome</a> <ul><li><a class="mw-selflink selflink">Myocardial infarction</a></li> <li><a href="/wiki/Unstable_angina" title="Unstable angina">Unstable angina</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Myocardial_infarction_complications" title="Myocardial infarction complications">Sequelae</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>hours <ul><li><a href="/wiki/Hibernating_myocardium" title="Hibernating myocardium">Hibernating myocardium</a></li> <li><a href="/wiki/Myocardial_stunning" title="Myocardial stunning">Myocardial stunning</a></li></ul></li> <li>days <ul><li><a href="/wiki/Myocardial_rupture" title="Myocardial rupture">Myocardial rupture</a></li></ul></li> <li>weeks <ul><li><a href="/wiki/Ventricular_aneurysm" title="Ventricular aneurysm">Ventricular aneurysm</a></li> <li><a href="/wiki/Dressler_syndrome" title="Dressler syndrome">Dressler syndrome</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Layers</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pericardium" title="Pericardium">Pericardium</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pericarditis" title="Pericarditis">Pericarditis</a> <ul><li><a href="/wiki/Acute_pericarditis" title="Acute pericarditis">Acute</a></li> <li><a href="/wiki/Pericarditis#Acute_vs._chronic" title="Pericarditis">Chronic</a> / <a href="/wiki/Constrictive_pericarditis" title="Constrictive pericarditis">Constrictive</a></li></ul></li> <li><a href="/wiki/Pericardial_effusion" title="Pericardial effusion">Pericardial effusion</a> <ul><li><a href="/wiki/Cardiac_tamponade" title="Cardiac tamponade">Cardiac tamponade</a></li> <li><a href="/wiki/Hemopericardium" title="Hemopericardium">Hemopericardium</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cardiac_muscle" title="Cardiac muscle">Myocardium</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Myocarditis" title="Myocarditis">Myocarditis</a> <ul><li><a href="/wiki/Chagas_disease" title="Chagas disease">Chagas disease</a></li></ul></li> <li><a href="/wiki/Cardiomyopathy" title="Cardiomyopathy">Cardiomyopathy</a> <ul><li><a href="/wiki/Dilated_cardiomyopathy" title="Dilated cardiomyopathy">Dilated</a> <ul><li><a href="/wiki/Alcoholic_cardiomyopathy" title="Alcoholic cardiomyopathy">Alcoholic</a></li></ul></li> <li><a href="/wiki/Hypertrophic_cardiomyopathy" title="Hypertrophic cardiomyopathy">Hypertrophic</a></li> <li><a href="/wiki/Tachycardia-induced_cardiomyopathy" title="Tachycardia-induced cardiomyopathy">Tachycardia-induced</a></li> <li><a href="/wiki/Restrictive_cardiomyopathy" title="Restrictive cardiomyopathy">Restrictive</a></li> <li><a href="/wiki/Loeffler_endocarditis" title="Loeffler endocarditis">Loeffler endocarditis</a></li> <li><a href="/wiki/Amyloidosis" title="Amyloidosis">Cardiac amyloidosis</a></li> <li><a href="/wiki/Endocardial_fibroelastosis" title="Endocardial fibroelastosis">Endocardial fibroelastosis</a></li> <li><a href="/wiki/Viral_cardiomyopathy" title="Viral cardiomyopathy">Viral</a></li></ul></li> <li><a href="/wiki/Arrhythmogenic_right_ventricular_dysplasia" class="mw-redirect" title="Arrhythmogenic right ventricular dysplasia">Arrhythmogenic right ventricular dysplasia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Endocardium" title="Endocardium">Endocardium</a> / <a href="/wiki/Valvular_heart_disease" title="Valvular heart disease">valves</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Endocarditis" title="Endocarditis">Endocarditis</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Infective_endocarditis" title="Infective endocarditis">infective endocarditis</a> <ul><li><a href="/wiki/Subacute_bacterial_endocarditis" title="Subacute bacterial endocarditis">Subacute bacterial endocarditis</a></li></ul></li> <li><a href="/wiki/Endocarditis#Non-infective_endocarditis" title="Endocarditis">non-infective endocarditis</a> <ul><li><a href="/wiki/Libman%E2%80%93Sacks_endocarditis" title="Libman–Sacks endocarditis">Libman–Sacks endocarditis</a></li> <li><a href="/wiki/Nonbacterial_thrombotic_endocarditis" title="Nonbacterial thrombotic endocarditis">Nonbacterial thrombotic endocarditis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Valves</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Mitral_valve" title="Mitral valve">mitral</a> <ul><li><a href="/wiki/Mitral_valve_prolapse" title="Mitral valve prolapse">prolapse</a></li> <li><a href="/wiki/Mitral_valve_stenosis" class="mw-redirect" title="Mitral valve stenosis">stenosis</a></li> <li><a href="/wiki/Mitral_regurgitation" title="Mitral regurgitation">regurgitation</a></li></ul></li> <li><a href="/wiki/Aortic_valve" title="Aortic valve">aortic</a> <ul><li><a href="/wiki/Aortic_stenosis" title="Aortic stenosis">stenosis</a></li> <li><a href="/wiki/Aortic_regurgitation" title="Aortic regurgitation">regurgitation</a></li></ul></li> <li><a href="/wiki/Tricuspid_valve" title="Tricuspid valve">tricuspid</a> <ul><li><a href="/wiki/Tricuspid_valve_stenosis" title="Tricuspid valve stenosis">stenosis</a></li> <li><a href="/wiki/Tricuspid_regurgitation" title="Tricuspid regurgitation">regurgitation</a></li></ul></li> <li><a href="/wiki/Pulmonary_valve" title="Pulmonary valve">pulmonary</a> <ul><li><a href="/wiki/Pulmonary_valve_stenosis" title="Pulmonary valve stenosis">stenosis</a></li> <li><a href="/wiki/Pulmonary_regurgitation" title="Pulmonary regurgitation">regurgitation</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cardiac_conduction_system" title="Cardiac conduction system">Conduction</a> / <a href="/wiki/Arrhythmia" title="Arrhythmia">arrhythmia</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Bradycardia" title="Bradycardia">Bradycardia</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Sinus_bradycardia" title="Sinus bradycardia">Sinus bradycardia</a></li> <li><a href="/wiki/Sick_sinus_syndrome" class="mw-redirect" title="Sick sinus syndrome">Sick sinus syndrome</a></li> <li><a href="/wiki/Heart_block" title="Heart block">Heart block</a>: <a href="/wiki/Sinoatrial_block" title="Sinoatrial block">Sinoatrial</a></li> <li><a href="/wiki/Atrioventricular_block" title="Atrioventricular block">AV</a> <ul><li><a href="/wiki/First-degree_atrioventricular_block" title="First-degree atrioventricular block">1°</a></li> <li><a href="/wiki/Second-degree_atrioventricular_block" title="Second-degree atrioventricular block">2°</a></li> <li><a href="/wiki/Third-degree_atrioventricular_block" title="Third-degree atrioventricular block">3°</a></li></ul></li> <li><a href="/wiki/Intraventricular_block" title="Intraventricular block">Intraventricular</a></li> <li><a href="/wiki/Bundle_branch_block" title="Bundle branch block">Bundle branch block</a> <ul><li><a href="/wiki/Right_bundle_branch_block" title="Right bundle branch block">Right</a></li> <li><a href="/wiki/Left_bundle_branch_block" title="Left bundle branch block">Left</a></li> <li><a href="/wiki/Left_anterior_fascicular_block" title="Left anterior fascicular block">Left anterior fascicle</a></li> <li><a href="/wiki/Left_posterior_fascicular_block" title="Left posterior fascicular block">Left posterior fascicle</a></li> <li><a href="/wiki/Bifascicular_block" title="Bifascicular block">Bifascicular</a></li> <li><a href="/wiki/Trifascicular_block" title="Trifascicular block">Trifascicular</a></li></ul></li> <li><a href="/wiki/Adams%E2%80%93Stokes_syndrome" title="Adams–Stokes syndrome">Adams–Stokes syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Tachycardia" title="Tachycardia">Tachycardia</a> (<a href="/wiki/Paroxysmal_tachycardia" title="Paroxysmal tachycardia">paroxysmal</a> and <a href="/wiki/Sinus_tachycardia" title="Sinus tachycardia">sinus</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Supraventricular_tachycardia" title="Supraventricular tachycardia">Supraventricular</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Atrial_tachycardia" title="Atrial tachycardia">Atrial</a> <ul><li><a href="/wiki/Multifocal_atrial_tachycardia" title="Multifocal atrial tachycardia">Multifocal</a></li></ul></li> <li><a href="/wiki/Junctional_tachycardia" title="Junctional tachycardia">Junctional</a> <ul><li><a href="/wiki/AV_nodal_reentrant_tachycardia" title="AV nodal reentrant tachycardia">AV nodal reentrant</a></li> <li><a href="/wiki/Junctional_ectopic_tachycardia" title="Junctional ectopic tachycardia">Junctional ectopic</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Ventricular_tachycardia" title="Ventricular tachycardia">Ventricular</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Accelerated_idioventricular_rhythm" title="Accelerated idioventricular rhythm">Accelerated idioventricular rhythm</a></li> <li><a href="/wiki/Catecholaminergic_polymorphic_ventricular_tachycardia" title="Catecholaminergic polymorphic ventricular tachycardia">Catecholaminergic polymorphic</a></li> <li><a href="/wiki/Torsades_de_pointes" title="Torsades de pointes">Torsades de pointes</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Premature contraction</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Premature_atrial_contraction" title="Premature atrial contraction">Atrial</a></li> <li><a href="/wiki/Premature_junctional_contraction" title="Premature junctional contraction">Junctional</a></li> <li><a href="/wiki/Premature_ventricular_contraction" title="Premature ventricular contraction">Ventricular</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pre-excitation_syndrome" title="Pre-excitation syndrome">Pre-excitation syndrome</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Lown%E2%80%93Ganong%E2%80%93Levine_syndrome" title="Lown–Ganong–Levine syndrome">Lown–Ganong–Levine</a></li> <li><a href="/wiki/Wolff%E2%80%93Parkinson%E2%80%93White_syndrome" title="Wolff–Parkinson–White syndrome">Wolff–Parkinson–White</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Flutter / <a href="/wiki/Fibrillation" title="Fibrillation">fibrillation</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Atrial_flutter" title="Atrial flutter">Atrial flutter</a></li> <li><a href="/wiki/Ventricular_flutter" title="Ventricular flutter">Ventricular flutter</a></li> <li><a href="/wiki/Atrial_fibrillation" title="Atrial fibrillation">Atrial fibrillation</a> <ul><li><a href="/wiki/Familial_atrial_fibrillation" title="Familial atrial fibrillation">Familial</a></li></ul></li> <li><a href="/wiki/Ventricular_fibrillation" title="Ventricular fibrillation">Ventricular fibrillation</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Artificial_cardiac_pacemaker" class="mw-redirect" title="Artificial cardiac pacemaker">Pacemaker</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ectopic_pacemaker" title="Ectopic pacemaker">Ectopic pacemaker</a> / <a href="/wiki/Ectopic_beat" title="Ectopic beat">Ectopic beat</a></li> <li><a href="/wiki/Multifocal_atrial_tachycardia" title="Multifocal atrial tachycardia">Multifocal atrial tachycardia</a></li> <li><a href="/wiki/Pacemaker_syndrome" title="Pacemaker syndrome">Pacemaker syndrome</a></li> <li><a href="/wiki/Parasystole" title="Parasystole">Parasystole</a></li> <li><a href="/wiki/Wandering_atrial_pacemaker" title="Wandering atrial pacemaker">Wandering atrial pacemaker</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Long_QT_syndrome" title="Long QT syndrome">Long QT syndrome</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Andersen%E2%80%93Tawil_syndrome" title="Andersen–Tawil syndrome">Andersen–Tawil</a></li> <li><a href="/wiki/Jervell_and_Lange-Nielsen_syndrome" title="Jervell and Lange-Nielsen syndrome">Jervell and Lange-Nielsen</a></li> <li><a href="/wiki/Romano%E2%80%93Ward_syndrome" title="Romano–Ward syndrome">Romano–Ward</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cardiac_arrest" title="Cardiac arrest">Cardiac arrest</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cardiac_arrest" title="Cardiac arrest">Sudden cardiac death</a></li> <li><a href="/wiki/Asystole" title="Asystole">Asystole</a></li> <li><a href="/wiki/Pulseless_electrical_activity" title="Pulseless electrical activity">Pulseless electrical activity</a></li> <li><a href="/wiki/Sinoatrial_arrest" title="Sinoatrial arrest">Sinoatrial arrest</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other / ungrouped</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hexaxial_reference_system" title="Hexaxial reference system">hexaxial reference system</a> <ul><li><a href="/wiki/Right_axis_deviation" title="Right axis deviation">Right axis deviation</a></li> <li><a href="/wiki/Left_axis_deviation" title="Left axis deviation">Left axis deviation</a></li></ul></li> <li><a href="/wiki/QT_interval" title="QT interval">QT</a> <ul><li><a href="/wiki/Short_QT_syndrome" title="Short QT syndrome">Short QT syndrome</a></li></ul></li> <li><a href="/wiki/T_wave" title="T wave">T</a> <ul><li><a href="/wiki/T_wave_alternans" title="T wave alternans">T wave alternans</a></li></ul></li> <li><a href="/wiki/ST_segment" title="ST segment">ST</a> <ul><li><a href="/wiki/J_wave" title="J wave">J wave</a></li> <li><a href="/wiki/ST_elevation" title="ST elevation">ST elevation</a></li> <li><a href="/wiki/ST_depression" title="ST depression">ST depression</a></li></ul></li> <li><a href="/wiki/Strain_pattern" title="Strain pattern">Strain pattern</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cardiomegaly" title="Cardiomegaly">Cardiomegaly</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ventricular_hypertrophy" title="Ventricular hypertrophy">Ventricular hypertrophy</a> <ul><li><a href="/wiki/Left_ventricular_hypertrophy" title="Left ventricular hypertrophy">Left</a></li> <li><a href="/wiki/Right_ventricular_hypertrophy" title="Right ventricular hypertrophy">Right</a></li> <li><a href="/wiki/Pulmonary_heart_disease" title="Pulmonary heart disease">Pulmonary</a></li></ul></li> <li><a href="/wiki/Atrial_enlargement" title="Atrial enlargement">Atrial enlargement</a> <ul><li><a href="/wiki/Left_atrial_enlargement" title="Left atrial enlargement">Left</a></li> <li><a href="/wiki/Right_atrial_enlargement" title="Right atrial enlargement">Right</a></li></ul></li> <li><a href="/wiki/Athletic_heart_syndrome" title="Athletic heart syndrome">Athletic heart syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cardiac_fibrosis" title="Cardiac fibrosis">Cardiac fibrosis</a></li> <li><a href="/wiki/Heart_failure" title="Heart failure">Heart failure</a> <ul><li><a href="/wiki/Diastolic_heart_failure" class="mw-redirect" title="Diastolic heart failure">Diastolic heart failure</a></li> <li><a href="/wiki/Cardiac_asthma" title="Cardiac asthma">Cardiac asthma</a></li></ul></li> <li><a href="/wiki/Rheumatic_fever" title="Rheumatic fever">Rheumatic fever</a></li> <li><a href="/wiki/Obstructive_shock" title="Obstructive shock">Obstructive shock</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Ischaemia_and_infarction58" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Ischaemia_and_infarction" title="Template:Ischaemia and infarction"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Ischaemia_and_infarction" title="Template talk:Ischaemia and infarction"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Ischaemia_and_infarction" title="Special:EditPage/Template:Ischaemia and infarction"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Ischaemia_and_infarction58" style="font-size:114%;margin:0 4em"><a href="/wiki/Ischaemia" class="mw-redirect" title="Ischaemia">Ischaemia</a> and <a href="/wiki/Infarction" title="Infarction">infarction</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Ischemia" title="Ischemia">Ischemia</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Location <ul><li><a href="/wiki/Brain_ischemia" title="Brain ischemia">Brain</a></li> <li><a href="/wiki/Coronary_artery_disease" title="Coronary artery disease">Heart</a></li> <li><a href="/wiki/Ischemic_colitis" title="Ischemic colitis">Large intestine</a></li> <li><a href="/wiki/Mesenteric_ischemia" class="mw-redirect" title="Mesenteric ischemia">Small intestine</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Infarction" title="Infarction">Infarction</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Types <ul><li><a href="/wiki/Anemic_infarct" title="Anemic infarct">Anemic</a></li> <li><a href="/wiki/Hemorrhagic_infarct" title="Hemorrhagic infarct">Hemorrhagic</a></li></ul></li> <li>Location <ul><li><a class="mw-selflink selflink">Heart</a></li> <li><a href="/wiki/Cerebral_infarction" title="Cerebral infarction">Brain</a></li> <li><a href="/wiki/Splenic_infarction" title="Splenic infarction">Spleen</a></li> <li><a href="/wiki/Limb_infarction" title="Limb infarction">Limb</a></li></ul></li> <li><a href="/wiki/Gangrene" title="Gangrene">Gangrene</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r1038841319">.mw-parser-output .tooltip-dotted{border-bottom:1px dotted;cursor:help}</style></div><div role="navigation" class="navbox authority-control" aria-labelledby="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q12152#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata1247" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q12152#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata1247" style="font-size:114%;margin:0 4em"><a href="/wiki/Help:Authority_control" title="Help:Authority control">Authority control databases</a> <a href="https://www.wikidata.org/wiki/Q12152#identifiers" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" 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class="vector-user-links"> </div> </div> </div> </div> </div> <div class="vector-settings" id="p-dock-bottom"> <ul></ul> </div><script>(RLQ=window.RLQ||[]).push(function(){mw.config.set({"wgHostname":"mw-web.codfw.main-694c756cf9-hsjnb","wgBackendResponseTime":129,"wgPageParseReport":{"limitreport":{"cputime":"2.237","walltime":"2.654","ppvisitednodes":{"value":12018,"limit":1000000},"postexpandincludesize":{"value":553877,"limit":2097152},"templateargumentsize":{"value":5222,"limit":2097152},"expansiondepth":{"value":13,"limit":100},"expensivefunctioncount":{"value":21,"limit":500},"unstrip-depth":{"value":1,"limit":20},"unstrip-size":{"value":741288,"limit":5000000},"entityaccesscount":{"value":1,"limit":400},"timingprofile":["100.00% 2282.003 1 -total"," 48.96% 1117.320 1 Template:Reflist"," 30.26% 690.525 118 Template:Cite_journal"," 10.11% 230.727 21 Template:Cite_web"," 7.19% 164.171 8 Template:Navbox"," 7.05% 160.842 2 Template:Sfnm"," 5.39% 123.106 1 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