When someone dies of a heart attack how do they know what the victim died of?

[Wrongn3mber]

Sorry just seen something on tv that made want to ask this. What signs are there in a dead heart that tells them it was a heart attack victim?

[Philtaz]

http://en.wikipedia.o...ction#Pathophysiology

[Wrongn3mber]

Philtaz I should've asked "In laymans terms"

[Buenchico]

. . .and when doctors write 'myocardial infarction' (a.k.a. 'a heart attack') on a death certificate without a post mortem taking place the chances are probably only 50/50 that they're right. Similarly, a large number of death certificates which should show 'myocardial infarction' actually attribute death to something else completely!
http://www.ncbi.nlm.nih.gov/pubmed/16866055

[Buenchico]

Here's the important bit from Phil's post:
http://en.wikipedia.o...t_wall_infarction.jpg
It's the presence of the damaged tissue, at the top of the picture, which reveals that the person suffered a heart attack.

Also (although I don't understand why or how) there are rapid changes to some hormone levels in the body when a heart attack takes place. I only know that because a colleague of mine suffered a heart attack which wasn't diagnosed by a first-aider (me!). She just appeared to have fainted and then, after a few minutes, she came round again. The following morning she suffered another heart attack which, again wasn't spotted by a first aider (who, this time, was also a qualified nurse). Again, she just seemed to have fainted but she was taken to hospital as a precautionary measure. The hospital staff also failed to realise that she'd had a heart attack but took routine blood samples anyway. It was only when they saw her hormone levels that she was suddenly whisked into the intensive care unit!

Chris

[Philtaz]

My best guess would be that the pathologist would remove the heart, study it for external signs of a heart attack and if certain signs are there would dissect it further and examine the coronary artery for a fatty-like matter, similar to furring/buildup seen in household piping.

Best I could do I'm afraid!

[sara3]

I believe the heart releases some kind of chemical into the blood stream, which is how they can tell if you've had the real thing, even if you survive.

[Wrongn3mber]

Okay thanks philtaz and buenchichris, at least my understanding is more than it was earlier :)

[Wrongn3mber]

And thanks sara3 :)

[sara3]

"How is a myocardial infarction diagnosed and assessed?

Many people develop chest pains that are not due to an MI. For example, you can have quite bad chest pains with heartburn, gallbladder problems or with pains from conditions of the muscles in the chest wall. However, tests can usually confirm MI. These are:

A heart tracing called an ECG (electrocardiograph). There are typical changes to the normal pattern of the heart tracing if you have an MI. Patterns that occur with an MI include things called pathological Q waves and ST elevation. However, it is possible to have a normal ECG even if you have had an MI.
Blood tests. A blood test that measures a chemical called troponin is the usual test that confirms an MI. This chemical is present in heart muscle cells. Damage to heart muscle cells releases troponin into the bloodstream. with an MI, the blood level of troponin increases within 3-12 hours from the onset of chest pain, peaks at 24-48 hours, and returns to a normal level over 5-14 days."

[sara3]

from here.. http://www.patient.co...28Heart-Attack%29.htm

[Sqad]

"Heart attack" is a common, non medical term for the sudden cessation of the heart to beat.

By far away, the commonest cause is a blockage (thrombus) in the main artery to the heart (coronary artery) which can be demonstrated at post mortem. They are other causes of sudden cessation of hear beat, but much, much, less common.

Blood tests (enzymes) can be used but mainly before death.

At post mortem, the heart muscle may look perfectly normal as it takes time to heart muscle to show changes to the naked eye.

[boxtops]

Sqad, do they use it as a catch- all sometimes? My dad had heart attack on his death cert, but we know (well, are pretty sure from other symptoms) that it was actually cirrhosis of the liver which took him away.

[Sqad]

Boxy.....Buenchico is right....sometimes "myocardial infarction" is often used to describe "death"

It is "sloppy" certification.

[emmie]

Sqad Perhaps its to save the families more pain?

[Sqad]

em 10 probably......but it makes a nonsense of medical statistics.

[WELSHYORKIE]

Probably the same reason they used the term seronegative hepatitis on Sylvias death cert - couldn't identify exactly what the cause was and used a general term.

[emmie]

sqad im sure it does. But thinking of many years ago, when cancer wasn't given as cause of death, but say pneumonia, or some other ailment, i have often heard it said why is cancer so much more prevalent nowadays, and i wondered whether it was that many doctors didn't know what the patient had, not talking say in the last 20/30 years, but before, when detection wasn't so high as it is now.