A Heart’s Journey:
An interactive exploration of Myocardial Infarction
LETS START
Index
HOME
Abnormal Blood Flow
What is a Myocardial Infarction?
Atherosclerosis
Thrombosis
Did you know?
PLaque rupture
Epidemiology
INDEX
Ischemia
Lets Meet matt
prevention and treatment
what causes mi?
Pathogenesis
Conclusions
Virchow's Triad
Citations
WHAT IS MYOCARDIAL INFACTIONS (MI)?
Epidemiology
A myocardial infarction (MI), more commonly referred to as a heart attack, occurs when blood flow in a coronary artery is blocked long enough to cause permanent damage or death of heart muscle cells due to ischemia. MIs can be “silent,” going undetected, or they can present with symptoms such as chest pain.1
Did you know?
Lets meet at our case study patient:
Matt Smith
Matt Smith
On an early Monday morning, Matt Smith, a 45-year-old man from London, Ontario, feels a strong, heavy pain in his chest. The pain has spread to his left arm and jaw, and he is also experiencing shortness of breath, sweating, and nausea. His symptoms started suddenly and did not go away, prompting him to seek medical help. As a pathologist, your role is to help determine what is happening and guide his treatment.
Hover over to learn more about Matt
Hi, I'm Matt
Lets Go:
What leads to a Myocardial infraction?
Matt seems to be showing symptoms of a Mycardial infraction. Click to learn more about what can lead to this
ENVIRONMENTAL
GENETIC
These factors can contribute to the pathogenesis of myocardial infarction.
Genetic Factors
There are various genetic factors that can increase the risk of myocardial infarction. Here are some that Matt has mentioned run in his family:
1.
Genetic variants affecting LDL cholesterol metabolism are associated with an increased risk of myocardial infarction.6
2.
There is an increased risk of coronary artery disease in individuals who carry the ApoE E3/E4 genotype.7
3.
The strongest genetic effect on the risk of myocardial infarction is associated with a region on chromosome 9p21.3.6
Risk Factors
Lifestyle Behaviours
Matt’s sedentary lifestyle has begun to catch up with him. His lack of regular physical activity, combined with poor habits, has also affected his diet, leading him to rely on unhealthy food choices. 5 He also does not get enough sleep, further impacting his overall health. Over time, he has become overweight and is now considered prediabetic.5
Upon questioning by doctors, Matt admitted that he started smoking cigarettes when he was 18 and has continued to smoke about seven per day.5 Matt also mentioned that, due to his career, he tends to stay indoors most of the time and rarely exercises.5
Pathogenesis of myocardial infarctions
Now that we have seen what can lead to a heart attack, lets look at how they can develop. Click to learn more about each step!
Ischemia & Infarction
Thrombosis
Virchow's Triad
Treatment & Prevention
Atherosclerosis
Plaque Rupture
Hypercoagulability
Endothelial Damage
Abnormal Blood Flow
+ info
+ info
+ info
These 3 facotrs play an important role in both the development and complications of atherosclerosis
Stasis Flow
Turbulent Flow
Stasis
These can contribute significantly to thrombosis by disrupting normal circulation, often as a result of impaired venous return. This altered flow allows blood components to remain in prolonged contact with one another and with the vessel wall. 8 As a result, red blood cells, platelets, and clotting factors interact more frequently and for longer durations, promoting activation of the coagulation cascade and increasing the likelihood of clot formation. 8
and
turbulent
Flow
Atherosclerosis
Atherosclerosis is a systemic disease that affects medium- and large-sized arteries and is a major contributor to conditions such as myocardial infarction and stroke.9
What is it characterized by?
How does it develop?
Response to Injury Hypothesis
https://my.clevelandclinic.org/health/diseases/16753-atherosclerosis-arterial-disease
Thrombosis
Thrombosis is the pathological formation of a clot (thrombus) within a blood vessel, composed of platelets, fibrin, and blood cells. 9 This process is driven by Virchow’s triad. 9 As the thrombus grows, it can partially or completely occlude the vessel, reducing blood supply and leading to ischemia. 9
But how does this relate to Matt?
https://my.clevelandclinic.org/health/diseases/22242-thrombosis
Thrombosis question
https://www.istockphoto.com/photo/blood-clot-or-thrombus-blocking-the-red-blood-cells-stream-within-an-artery-or-a-gm1297034329-390279893
Plaque Rupture
What happens right after?
What does this result in?
https://pngfile.net/photo/2100/heart-disease-illustration-png
ISHCEMIA
Should Matt worry?
Ischemia is reduced blood flow to the heart muscle. When oxygen delivery to the myocardium is low, the affected tissue cannot function normally.8,10,11
Where does it occur?
Click on the buttons to learn more!
Is ischemia reversible? What if ischemia persists?
What causes it?
Signs & symptoms
Click on the heart to test your knowledge!
Time matters
Next
https://www.beaconhealthsystem.org/library/diseases-and-conditions/heart-attack/
VS
Myocardial Infarction
Ischemia
Myocardial infarction occurs when ischemia is severe or prolonged enough to cause irreversible cardiomyocyte necrosis. In other words, MI is the point at which reduced blood flow progresses from reversible injury to permanent myocardial cell death. 8,10,11
Myocardial ischemia is reduced blood flow to the heart muscle, causing decreased oxygen delivery and impaired function. At this stage, the injury may still be reversible if perfusion is restored promptly.8,10
Matt's Doctor's Visit
Help Matt understand the measures he can take to treat and prevent myocardial infarctions
1, Prevention
2. Acute Treatment
3. After MI
Explore lifestyle and medication options
Know how to act in the event an emergency
Learn how survivors manage complications prevention
+ info
+ info
+ info
A Healthy LifestylE
Small daily choices can strongly influence heart health.Smoking, poor diet, inactivity, obesity, high blood pressure, and diabetes all increase damage to the coronary arteries and make ischemia more likely. A healthier lifestyle helps protect the myocardium by reducing plaque buildup, improving blood flow, and lowering strain on the heart. 13,14
Click on each habit to learn more!
Weight Management 13,14
Smoking 13,14
Healthy Eating 13,14
Exercising 13,14
Other 13,14
Medication for high risk patients
Medication helps prevent myocardial infarction by lowering the chance of plaque progression, plaque rupture, and coronary artery blockage. 14In high-risk patients, these treatments target the main drivers of coronary artery disease. Together, they reduce the likelihood of ischemia progressing to infarction
Statins 14
Antihypertensives 14
Diabetes control 14
https://www.buzzrx.com/blog/medication-after-a-heart-attack-what-you-need-to-know
Matt's Recovery
Matt received urgent treatment, coronary blood flow was restored, and further myocardial damage was limited. Because MI was recognized and managed quickly, his chance of survival and recovery improved significantly! Recovery now depends on monitoring for complications, preventing recurrent ischemic events, and addressing long-term risk through medication, rehabilitation, and lifestyle change.
+ info
A Heart's Journey
Matt's story reminds us that a heart's journey is shaped by choice, care, knowledge and intervention; How quickly myocardial infarction can become life-threatening, yet how effective prevention, rapid diagnosis, and treatment can be.
CITATIONS
- Ojha N, Dhamoon AS. Myocardial infarction. In: StatPearls. StatPearls Publishing; 2026. Accessed April 9, 2026. http://www.ncbi.nlm.nih.gov/books/NBK537076/
- 10 facts you may not have known about heart attacks | columbia surgery. Accessed April 9, 2026. https://columbiasurgery.org/news/2014/07/28/10-facts-you-may-not-have-known-about-heart-attacks
- Cardiovascular diseases (Cvds). Accessed April 9, 2026. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
- CDC. Heart disease facts. Heart Disease. January 30, 2026. Accessed April 9, 2026. https://www.cdc.gov/heart-disease/data-research/facts-stats/index.html
- Szczepańska E, Białek-Dratwa A, Filipów K, Kowalski O. Lifestyle and the risk of acute coronary event: a retrospective study of patients after myocardial infarction. Front Nutr. 2023;10:1203841. doi:10.3389/fnut.2023.1203841
- Erdmann J, Linsel-Nitschke P, Schunkert H. Genetic causes of myocardial infarction. Deutsches Ärzteblatt international. Published online October 8, 2010. doi:10.3238/arztebl.2010.0694
- Xu M, Zhao J, Zhang Y, et al. Apolipoprotein e gene variants and risk of coronary heart disease: a meta-analysis. Biomed Res Int. 2016;2016:3912175. doi:10.1155/2016/3912175
- Kum J. Hemodynamic Disorders, Thromboembolisms & Shock [2]. October 6, 2025.
- Tugaleva E. Atherosclerosis and Its Sequelae. 2026:1-4.
Citations continued
CITATIONS
10. Buja LM. Pathobiology of myocardial ischemia and reperfusion injury. Diagnostics (Basel). 2022;12(8):1850. 11. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth universal definition of myocardial infarction (2018). Eur Heart J. 2019;40(3):237-269. Accessed April 9, 2026. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000617 12. Ogobuiro I, Gonzales J, Tuma F. Anatomy, thorax, heart coronary arteries. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: National Center for Biotechnology Information. 13. Public Health Agency of Canada. Heart disease in Canada [Internet]. Ottawa (ON): Government of Canada; 2022 Jul 28 [cited 2026 Apr 10]. Available from: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/heart-disease-canada.html 14. Rao SV, O’Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI guideline for the management of patients with acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2025;85(22):2135-2237. Accessed April 9, 2026. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001309
Epidemiology
Cardiovascular disease is the leading cause of death globally. 3 85% of cardiovascular disease cases are due to heart attacks and strokes.3 Every 40 seconds, someone has a heart attack in the United States. 4 About 1 in 5 individuals who experience heart attacks have silent heart attacks. 4
What might Matt feel? Ischemia may cause chest pain, chest pressure, or shortness of breath. Some people may also feel discomfort that spreads to the arm, shoulder, neck, or jaw.
Shortness of Breath
Chest Pain
Pressure
What might Matt feel? Ischemia may cause chest pain, chest pressure, or shortness of breath. Some people may also feel discomfort that spreads to the arm, shoulder, neck, or jaw. 10
Shortness of Breath
Chest Pain
Pressure
What is it characterized by?
It is characterized by the formation of atheromas, or fibrofatty plaques, within the arterial wall. 9 These plaques progressively narrow the vessel lumen, reducing blood flow and leading to ischemia and potential tissue damage or necrosis. 9
Here you can place a highlighted title
A cool title
A brilliant title
With this function... You can add additional content that excites your audience's brain: videos, images, links, interactivity... Whatever you want!
Did you know?
Most heart attacks happen on Monday mornings. 2 Negative emotions are risk factors for heart attacks. 2 A daily dose of aspirin may help prevent a second heart attack.2
Hypercoagulability refers to an abnormal tendency of the blood to clot more readily than normal, increasing the risk of thrombosis.
Secondary: acquired and may arise from factors such as prolonged immobility, malignancy, or certain medical conditions.
Primary: genetic in origin and results from inherited abnormalities in clotting factors.
https://www.texasheart.org/heart-health/heart-information-center/topics/hypercoagulable-states/
What happens right after?
When an atherosclerotic plaque ruptures, the fibrous cap is disrupted, exposing highly thrombogenic material within the plaque to the bloodstream. 9 This triggers rapid platelet adhesion and activation of the coagulation cascade, leading to the formation of a thrombus that can partially or completely occlude the vessel. 9
The pathogenesis of atherosclerosis is best explained by the “response to injury” hypothesis. 9 Endothelial damage triggers a chronic inflammatory response, allowing platelets and monocytes to adhere to the vessel wall. 9 Monocytes differentiate into macrophages, which ingest lipids and become foam cells, contributing to fatty streak formation. 9 At the same time, cytokines and growth factors stimulate the migration and proliferation of smooth muscle cells and fibroblasts, along with collagen deposition. This results in the development of a raised, fibrofatty plaque that narrows the artery and disrupts normal blood flow. 9
https://www.osmosis.org/blog/usmle-step-1-question-acute-chest-pain-with-diabetes-and-hypertension
What does it develop into?
The disease develops gradually, often beginning early in life with fatty streaks that can evolve into more complex and clinically significant plaques over time. 9
How much time does Matt have?
- Heart muscle begins to die within 20–30 minutes of severe ischemia. 10
- Early reperfusion saves the myocardium. Current ACS guidance emphasizes rapid restoration of blood flow. 10
- Symptoms that last more than a few minutes should be treated as urgent. 10
Prevention
Cardiovascular disease is the second leading cause of death worlwide. In Canada alone, more than 77,000 patients with acute MI are admitted annually with over 55,000 reported deaths in 2023. 11
In Canada, MI incidence is highest among men, at an average age of onset of 55-64. Women face higher mortality rates with later average onsets of 65-74. 11
Prioritize it and give visual weight to the main content.
Define secondary messages with interactivity.
What happens right after?
The resulting reduction in blood flow causes ischemia, which in the heart may present as severe, prolonged chest pain often described as crushing or radiating to the jaw or left arm, and may be accompanied by nausea and sweating. If the obstruction persists, it can lead to myocardial infarction, where heart muscle begins to die after prolonged ischemia. Complications can be severe and include arrhythmias, heart failure, or even sudden cardiac death due to impaired cardiac function and electrical instability
AFTER MI: PREVENTING COMPLICATIONS
After a myocardial infarction, the goal shifts to preventing reinfarction, limiting ventricular remodeling, reducing arrhythmia/heart failure risk, and improving long-term survival. Approximately 10% to 20% of myocardial infarction (MI) patients experience a recurrent heart attack within five years. Secondary prevention begins early and combines medication, rehabilitation, and strict control of ongoing cardiovascular risk factors. 14
Statin therapy 14
Dual antiplatelet therapy 14
Monitoring 14
Cardiac rehabilitation 14
Heart failure prevention 14
Should Matt worry?
Heart muscle requires a constant supply of oxygen to work properly. When oxygen levels fall, the affected tissue becomes stressed and begins to lose function.
Where can ischemia occur?
The location of ischemia or infarction depends on which coronary artery is blocked, as each artery supplies a different region of the heart.
- The left anterior descending artery (LAD) supplies the front of the left ventricle → blockage causes anterior ischemia. 9,14
- The left circumflex artery (LCx) supplies the side of the left ventricle → blockage causes lateral ischemia. 9,14
- The right coronary artery (RCA) supplies the back/inferior part of the left ventricle → blockage causes posterior or inferior ischemia. 9,14
How much time does Matt have?
- Heart muscle begins to die within 20–30 minutes of severe ischemia.
- Early reperfusion saves the myocardium. Current ACS guidance emphasizes rapid restoration of blood flow
- Symptoms that last more than a few minutes should be treated as urgent.
What if Matt waits too long? If ischemia is not relieved promptly, the myocardium progresses to irreversible cell injury. This results in myocardial infarction. 10 After 20 minutes, oxygen deprivation has caused critical ATP depletion, loss of membrane ion homeostasis, calcium overload, mitochondrial failure, and membrane disruptions. 10 Once these structural changes occur, cardiomyocytes undergo necrosis. Healing proceeds through inflammation and eventual scar formation rather than recovery of normal heart tissue and function. 10
Should Matt worry?
Heart muscle requires a constant supply of oxygen to work properly. When oxygen levels fall, the affected tissue becomes stressed and begins to lose function. 10
Why is Matt Ischemic? Matt is ischemic because blood flow through a coronary artery has been reduced, most likely by atherosclerotic narrowing or an acute thrombus. 10 As less blood reaches the myocardium, oxygen delivery falls and the affected heart muscle becomes deprived of the oxygen it needs to function. 10
Cool Title
Cool Title
Is Ischemia Reversible? Myocardial ischemia may still be reversible during the first ~15 minutes of severe oxygen deprivation.10 During this stage, ATP levels fall and contractile function becomes impaired, but irreversible necrosis has not yet developed. 10 The myocardium can still be salvaged if perfusion is restored promptly! 10
Role of Endothelial cells 8
What happens when endothelial damage occurs?8
what does endothelial damage result in?8
https://pdfs.semanticscholar.org/9409/26c87b03103f3be312976a81d8840e505a5e.pdf
How much time does Matt have?
- Heart muscle begins to die within 20–30 minutes of severe ischemia.
- Early reperfusion saves the myocardium. Current ACS guidance emphasizes rapid restoration of blood flow
- Symptoms that last more than a few minutes should be treated as urgent.
Where can ischemia occur?
The location of ischemia or infarction depends on which coronary artery is blocked, as each artery supplies a different region of the heart.
- The left anterior descending artery (LAD) supplies the front of the left ventricle → blockage causes anterior ischemia
- The left circumflex artery (LCx) supplies the side of the left ventricle → blockage causes lateral ischemia
- The right coronary artery (RCA) supplies the back/inferior part of the left ventricle → blockage causes posterior or inferior ischemia
Why is Matt Ischemic? Matt is ischemic because blood flow through a coronary artery has been reduced, most likely by atherosclerotic narrowing or an acute thrombus. As less blood reaches the myocardium, oxygen delivery falls and the affected heart muscle becomes deprived of the oxygen it needs to function.
Cool Title
Cool Title
Matt mentioned that he spent the last night playing on his PC with his friends for almost 5 hours straight! Would this result in stasis or turbulent flow?
Stasis!Why can this be dangerous?
ACUTE TREATMENT OF MYOCARDIAL INFARCTION
Acute treatment aims to restore coronary blood flow as fast as possible. Primary PCI is the preferred reperfusion strategy, while fibrinolysis is used when PCI is not available. 12,14
Immediate reperfusion 12,14 Antiplatelet therapy 12,14 Anticoagulation 12,14 Relief of ischemia 12,14 Additional early therapy 12,14
https://depositphotos.com/vectors/appelez-le-911.html
A Heart’s Journey:
Hafsa Rao
Created on March 7, 2026
Start designing with a free template
Discover more than 1500 professional designs like these:
View
Historical Presentation
View
Human Rights Presentation
View
Memphis Presentation
View
Blackboard Presentation
View
Florida Neon Presentation
View
Genial Storytale Presentation
View
Psychedelic Presentation
Explore all templates
Transcript
A Heart’s Journey:
An interactive exploration of Myocardial Infarction
LETS START
Index
HOME
Abnormal Blood Flow
What is a Myocardial Infarction?
Atherosclerosis
Thrombosis
Did you know?
PLaque rupture
Epidemiology
INDEX
Ischemia
Lets Meet matt
prevention and treatment
what causes mi?
Pathogenesis
Conclusions
Virchow's Triad
Citations
WHAT IS MYOCARDIAL INFACTIONS (MI)?
Epidemiology
A myocardial infarction (MI), more commonly referred to as a heart attack, occurs when blood flow in a coronary artery is blocked long enough to cause permanent damage or death of heart muscle cells due to ischemia. MIs can be “silent,” going undetected, or they can present with symptoms such as chest pain.1
Did you know?
Lets meet at our case study patient:
Matt Smith
Matt Smith
On an early Monday morning, Matt Smith, a 45-year-old man from London, Ontario, feels a strong, heavy pain in his chest. The pain has spread to his left arm and jaw, and he is also experiencing shortness of breath, sweating, and nausea. His symptoms started suddenly and did not go away, prompting him to seek medical help. As a pathologist, your role is to help determine what is happening and guide his treatment.
Hover over to learn more about Matt
Hi, I'm Matt
Lets Go:
What leads to a Myocardial infraction?
Matt seems to be showing symptoms of a Mycardial infraction. Click to learn more about what can lead to this
ENVIRONMENTAL
GENETIC
These factors can contribute to the pathogenesis of myocardial infarction.
Genetic Factors
There are various genetic factors that can increase the risk of myocardial infarction. Here are some that Matt has mentioned run in his family:
1.
Genetic variants affecting LDL cholesterol metabolism are associated with an increased risk of myocardial infarction.6
2.
There is an increased risk of coronary artery disease in individuals who carry the ApoE E3/E4 genotype.7
3.
The strongest genetic effect on the risk of myocardial infarction is associated with a region on chromosome 9p21.3.6
Risk Factors
Lifestyle Behaviours
Matt’s sedentary lifestyle has begun to catch up with him. His lack of regular physical activity, combined with poor habits, has also affected his diet, leading him to rely on unhealthy food choices. 5 He also does not get enough sleep, further impacting his overall health. Over time, he has become overweight and is now considered prediabetic.5
Upon questioning by doctors, Matt admitted that he started smoking cigarettes when he was 18 and has continued to smoke about seven per day.5 Matt also mentioned that, due to his career, he tends to stay indoors most of the time and rarely exercises.5
Pathogenesis of myocardial infarctions
Now that we have seen what can lead to a heart attack, lets look at how they can develop. Click to learn more about each step!
Ischemia & Infarction
Thrombosis
Virchow's Triad
Treatment & Prevention
Atherosclerosis
Plaque Rupture
Hypercoagulability
Endothelial Damage
Abnormal Blood Flow
+ info
+ info
+ info
These 3 facotrs play an important role in both the development and complications of atherosclerosis
Stasis Flow
Turbulent Flow
Stasis
These can contribute significantly to thrombosis by disrupting normal circulation, often as a result of impaired venous return. This altered flow allows blood components to remain in prolonged contact with one another and with the vessel wall. 8 As a result, red blood cells, platelets, and clotting factors interact more frequently and for longer durations, promoting activation of the coagulation cascade and increasing the likelihood of clot formation. 8
and
turbulent
Flow
Atherosclerosis
Atherosclerosis is a systemic disease that affects medium- and large-sized arteries and is a major contributor to conditions such as myocardial infarction and stroke.9
What is it characterized by?
How does it develop?
Response to Injury Hypothesis
https://my.clevelandclinic.org/health/diseases/16753-atherosclerosis-arterial-disease
Thrombosis
Thrombosis is the pathological formation of a clot (thrombus) within a blood vessel, composed of platelets, fibrin, and blood cells. 9 This process is driven by Virchow’s triad. 9 As the thrombus grows, it can partially or completely occlude the vessel, reducing blood supply and leading to ischemia. 9
But how does this relate to Matt?
https://my.clevelandclinic.org/health/diseases/22242-thrombosis
Thrombosis question
https://www.istockphoto.com/photo/blood-clot-or-thrombus-blocking-the-red-blood-cells-stream-within-an-artery-or-a-gm1297034329-390279893
Plaque Rupture
What happens right after?
What does this result in?
https://pngfile.net/photo/2100/heart-disease-illustration-png
ISHCEMIA
Should Matt worry?
Ischemia is reduced blood flow to the heart muscle. When oxygen delivery to the myocardium is low, the affected tissue cannot function normally.8,10,11
Where does it occur?
Click on the buttons to learn more!
Is ischemia reversible? What if ischemia persists?
What causes it?
Signs & symptoms
Click on the heart to test your knowledge!
Time matters
Next
https://www.beaconhealthsystem.org/library/diseases-and-conditions/heart-attack/
VS
Myocardial Infarction
Ischemia
Myocardial infarction occurs when ischemia is severe or prolonged enough to cause irreversible cardiomyocyte necrosis. In other words, MI is the point at which reduced blood flow progresses from reversible injury to permanent myocardial cell death. 8,10,11
Myocardial ischemia is reduced blood flow to the heart muscle, causing decreased oxygen delivery and impaired function. At this stage, the injury may still be reversible if perfusion is restored promptly.8,10
Matt's Doctor's Visit
Help Matt understand the measures he can take to treat and prevent myocardial infarctions
1, Prevention
2. Acute Treatment
3. After MI
Explore lifestyle and medication options
Know how to act in the event an emergency
Learn how survivors manage complications prevention
+ info
+ info
+ info
A Healthy LifestylE
Small daily choices can strongly influence heart health.Smoking, poor diet, inactivity, obesity, high blood pressure, and diabetes all increase damage to the coronary arteries and make ischemia more likely. A healthier lifestyle helps protect the myocardium by reducing plaque buildup, improving blood flow, and lowering strain on the heart. 13,14
Click on each habit to learn more!
Weight Management 13,14
Smoking 13,14
Healthy Eating 13,14
Exercising 13,14
Other 13,14
Medication for high risk patients
Medication helps prevent myocardial infarction by lowering the chance of plaque progression, plaque rupture, and coronary artery blockage. 14In high-risk patients, these treatments target the main drivers of coronary artery disease. Together, they reduce the likelihood of ischemia progressing to infarction
Statins 14
Antihypertensives 14
Diabetes control 14
https://www.buzzrx.com/blog/medication-after-a-heart-attack-what-you-need-to-know
Matt's Recovery
Matt received urgent treatment, coronary blood flow was restored, and further myocardial damage was limited. Because MI was recognized and managed quickly, his chance of survival and recovery improved significantly! Recovery now depends on monitoring for complications, preventing recurrent ischemic events, and addressing long-term risk through medication, rehabilitation, and lifestyle change.
+ info
A Heart's Journey
Matt's story reminds us that a heart's journey is shaped by choice, care, knowledge and intervention; How quickly myocardial infarction can become life-threatening, yet how effective prevention, rapid diagnosis, and treatment can be.
CITATIONS
Citations continued
CITATIONS
10. Buja LM. Pathobiology of myocardial ischemia and reperfusion injury. Diagnostics (Basel). 2022;12(8):1850. 11. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth universal definition of myocardial infarction (2018). Eur Heart J. 2019;40(3):237-269. Accessed April 9, 2026. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000617 12. Ogobuiro I, Gonzales J, Tuma F. Anatomy, thorax, heart coronary arteries. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: National Center for Biotechnology Information. 13. Public Health Agency of Canada. Heart disease in Canada [Internet]. Ottawa (ON): Government of Canada; 2022 Jul 28 [cited 2026 Apr 10]. Available from: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/heart-disease-canada.html 14. Rao SV, O’Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI guideline for the management of patients with acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2025;85(22):2135-2237. Accessed April 9, 2026. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001309
Epidemiology
Cardiovascular disease is the leading cause of death globally. 3 85% of cardiovascular disease cases are due to heart attacks and strokes.3 Every 40 seconds, someone has a heart attack in the United States. 4 About 1 in 5 individuals who experience heart attacks have silent heart attacks. 4
What might Matt feel? Ischemia may cause chest pain, chest pressure, or shortness of breath. Some people may also feel discomfort that spreads to the arm, shoulder, neck, or jaw.
Shortness of Breath
Chest Pain
Pressure
What might Matt feel? Ischemia may cause chest pain, chest pressure, or shortness of breath. Some people may also feel discomfort that spreads to the arm, shoulder, neck, or jaw. 10
Shortness of Breath
Chest Pain
Pressure
What is it characterized by?
It is characterized by the formation of atheromas, or fibrofatty plaques, within the arterial wall. 9 These plaques progressively narrow the vessel lumen, reducing blood flow and leading to ischemia and potential tissue damage or necrosis. 9
Here you can place a highlighted title
A cool title
A brilliant title
With this function... You can add additional content that excites your audience's brain: videos, images, links, interactivity... Whatever you want!
Did you know?
Most heart attacks happen on Monday mornings. 2 Negative emotions are risk factors for heart attacks. 2 A daily dose of aspirin may help prevent a second heart attack.2
Hypercoagulability refers to an abnormal tendency of the blood to clot more readily than normal, increasing the risk of thrombosis.
Secondary: acquired and may arise from factors such as prolonged immobility, malignancy, or certain medical conditions.
Primary: genetic in origin and results from inherited abnormalities in clotting factors.
https://www.texasheart.org/heart-health/heart-information-center/topics/hypercoagulable-states/
What happens right after?
When an atherosclerotic plaque ruptures, the fibrous cap is disrupted, exposing highly thrombogenic material within the plaque to the bloodstream. 9 This triggers rapid platelet adhesion and activation of the coagulation cascade, leading to the formation of a thrombus that can partially or completely occlude the vessel. 9
The pathogenesis of atherosclerosis is best explained by the “response to injury” hypothesis. 9 Endothelial damage triggers a chronic inflammatory response, allowing platelets and monocytes to adhere to the vessel wall. 9 Monocytes differentiate into macrophages, which ingest lipids and become foam cells, contributing to fatty streak formation. 9 At the same time, cytokines and growth factors stimulate the migration and proliferation of smooth muscle cells and fibroblasts, along with collagen deposition. This results in the development of a raised, fibrofatty plaque that narrows the artery and disrupts normal blood flow. 9
https://www.osmosis.org/blog/usmle-step-1-question-acute-chest-pain-with-diabetes-and-hypertension
What does it develop into?
The disease develops gradually, often beginning early in life with fatty streaks that can evolve into more complex and clinically significant plaques over time. 9
How much time does Matt have?
Prevention
Cardiovascular disease is the second leading cause of death worlwide. In Canada alone, more than 77,000 patients with acute MI are admitted annually with over 55,000 reported deaths in 2023. 11
In Canada, MI incidence is highest among men, at an average age of onset of 55-64. Women face higher mortality rates with later average onsets of 65-74. 11
Prioritize it and give visual weight to the main content.
Define secondary messages with interactivity.
What happens right after?
The resulting reduction in blood flow causes ischemia, which in the heart may present as severe, prolonged chest pain often described as crushing or radiating to the jaw or left arm, and may be accompanied by nausea and sweating. If the obstruction persists, it can lead to myocardial infarction, where heart muscle begins to die after prolonged ischemia. Complications can be severe and include arrhythmias, heart failure, or even sudden cardiac death due to impaired cardiac function and electrical instability
AFTER MI: PREVENTING COMPLICATIONS
After a myocardial infarction, the goal shifts to preventing reinfarction, limiting ventricular remodeling, reducing arrhythmia/heart failure risk, and improving long-term survival. Approximately 10% to 20% of myocardial infarction (MI) patients experience a recurrent heart attack within five years. Secondary prevention begins early and combines medication, rehabilitation, and strict control of ongoing cardiovascular risk factors. 14
Statin therapy 14
Dual antiplatelet therapy 14
Monitoring 14
Cardiac rehabilitation 14
Heart failure prevention 14
Should Matt worry?
Heart muscle requires a constant supply of oxygen to work properly. When oxygen levels fall, the affected tissue becomes stressed and begins to lose function.
Where can ischemia occur?
The location of ischemia or infarction depends on which coronary artery is blocked, as each artery supplies a different region of the heart.
How much time does Matt have?
What if Matt waits too long? If ischemia is not relieved promptly, the myocardium progresses to irreversible cell injury. This results in myocardial infarction. 10 After 20 minutes, oxygen deprivation has caused critical ATP depletion, loss of membrane ion homeostasis, calcium overload, mitochondrial failure, and membrane disruptions. 10 Once these structural changes occur, cardiomyocytes undergo necrosis. Healing proceeds through inflammation and eventual scar formation rather than recovery of normal heart tissue and function. 10
Should Matt worry?
Heart muscle requires a constant supply of oxygen to work properly. When oxygen levels fall, the affected tissue becomes stressed and begins to lose function. 10
Why is Matt Ischemic? Matt is ischemic because blood flow through a coronary artery has been reduced, most likely by atherosclerotic narrowing or an acute thrombus. 10 As less blood reaches the myocardium, oxygen delivery falls and the affected heart muscle becomes deprived of the oxygen it needs to function. 10
Cool Title
Cool Title
Is Ischemia Reversible? Myocardial ischemia may still be reversible during the first ~15 minutes of severe oxygen deprivation.10 During this stage, ATP levels fall and contractile function becomes impaired, but irreversible necrosis has not yet developed. 10 The myocardium can still be salvaged if perfusion is restored promptly! 10
Role of Endothelial cells 8
What happens when endothelial damage occurs?8
what does endothelial damage result in?8
https://pdfs.semanticscholar.org/9409/26c87b03103f3be312976a81d8840e505a5e.pdf
How much time does Matt have?
Where can ischemia occur?
The location of ischemia or infarction depends on which coronary artery is blocked, as each artery supplies a different region of the heart.
Why is Matt Ischemic? Matt is ischemic because blood flow through a coronary artery has been reduced, most likely by atherosclerotic narrowing or an acute thrombus. As less blood reaches the myocardium, oxygen delivery falls and the affected heart muscle becomes deprived of the oxygen it needs to function.
Cool Title
Cool Title
Matt mentioned that he spent the last night playing on his PC with his friends for almost 5 hours straight! Would this result in stasis or turbulent flow?
Stasis!Why can this be dangerous?
ACUTE TREATMENT OF MYOCARDIAL INFARCTION
Acute treatment aims to restore coronary blood flow as fast as possible. Primary PCI is the preferred reperfusion strategy, while fibrinolysis is used when PCI is not available. 12,14
Immediate reperfusion 12,14 Antiplatelet therapy 12,14 Anticoagulation 12,14 Relief of ischemia 12,14 Additional early therapy 12,14
https://depositphotos.com/vectors/appelez-le-911.html