Preface

**Section 5 Myocardial Infarction in Specific Patient Groups 99**

Meki Bilici, Mehmet Ture and Hasan Balik

Chapter 6 **Myocardial Infarction in Children 101**

**VI** Contents

Atherosclerosis is an inflammatory disease. Atherosclerotic cardiovascular diseases and my‐ ocardial infarction are still the most common cause of death among adults and their preva‐ lence are increasing in the developing countries. Diabetes mellitus, systemic hypertension, dyslipidemia, cigarette smoking, increased emotional stress, physical inactivity and obesity are known risk factors for atherosclerotic vascular diseases. We are living in an era where deaths from metabolic disorders, including over nutrition, obesity, diabetes and hypercho‐ lesterolemia are more prominent than deaths from a shortage of food.

Myocardial infarction is one of the clinical presentations of atherosclerotic coronary artery disease. Silent ischemia, sudden cardiac death, and stable and unstable angina are other clinical forms. However, myocardial infarction is the dominant form and it requires quick diagnosis and accurate treatment. In recent years, there have been important advances in both diagnostic and therapeutic strategies of myocardial infarction. Today we have a very strong armamentarium when compared to the 1980s. A few decades ago, we were using only aspirin and nitrates for the treatment of acute myocardial infarction. There was no in‐ terventional therapy and immediate revascularization nor strong medicines (anti-aggre‐ gants, anticoagulants, beta blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, statins and more). Today we have a wide spectrum of medical and inter‐ ventional therapy and thus a better prevention strategy. Since the majority of deaths occur because of ventricular fibrillation in patients experiencing a myocardial infarction today, we have automated external defibrillators at several airports, airplanes, metro-train stations, and in crowded places. It is even possible to send an AED with a drone to a place of need. Emergency medical services are also organized in order to more quickly reach the patients and to bring them to medical centres where primary percutaneous interventions can be per‐ formed as soon as possible.

In this book, we aimed to provide, at the beginning, epidemiological data on myocardial infarction and atherosclerotic cardiovascular diseases. Then in the following chapters, we aimed to overview current diagnostic biochemical tools. Current management strategies and interventional therapies are also addressed. And finally we aimed to provide information on 'how to manage myocardial infarction in a specific patient group; the children'.

Today, despite all advances in the management of myocardial infarction, the morbidity and mortality from atherosclerotic cardiovascular diseases and especially myocardial infarction are still high. Recent developments in interventional therapies established an important de‐ crease in morbidity and mortality from myocardial infarction. I think that more can be ach‐ ieved by the prevention of atherosclerotic processes and efforts should be focused on the early stages of the disease since it may be very late for some of the patients experiencing myocardial infarction.

I hope this book attracts the attention of the readers in a different way to myocardial infarc‐ tion and finally I would like to acknowledge all contributing authors and our author service manager Ms. Romina Skomersic for their contributions to the project.

**Burak PAMUKCU, MD**

**Introductory Section**

**Section 1**

Consultant Cardiologist & Associate Professor of Cardiology Acibadem Kozyatagi Hospital Acibadem Healthcare Group Istanbul, Turkey

**Section 1**

**Introductory Section**

I hope this book attracts the attention of the readers in a different way to myocardial infarc‐ tion and finally I would like to acknowledge all contributing authors and our author service

**Burak PAMUKCU, MD**

Istanbul, Turkey

Acibadem Kozyatagi Hospital Acibadem Healthcare Group

Consultant Cardiologist & Associate Professor of Cardiology

manager Ms. Romina Skomersic for their contributions to the project.

VIII Preface

**Chapter 1**

**Provisional chapter**

**Introductory Chapter: Atherosclerotic Cardiovascular**

**Introductory Chapter: Atherosclerotic Cardiovascular** 

Atherosclerotic cardiovascular disease is still the most common cause of death among adults [1]. Its prevalence is increasing in developing countries and despite all advances in both diagnostic tools and treatment modalities, it is still very common in the developed world. The nutritional and metabolic problems especially obesity, diabetes mellitus, hypercholesterolemia and also overuse of dietary salt play a pivotal role in increased cardiovascular morbidity

The atherosclerotic cardiovascular disease has got a wide clinical spectrum from silent ischemia to sudden cardiac death [3]. Myocardial infarction (MI) is at the center of this clinical spectrum, and a majority of current clinical efforts are mainly focused on the diagnosis and treatment of myocardial infarction. There are still scientific efforts to provide more comprehensive and realistic definition for myocardial infarction. The latest expert consensus document including experts from the main cardiovascular societies including European Society of Cardiology (ESC), American College of Cardiology (ACC), American Heart Association (AHA) and World Heart Federation (WHF) established the most comprehensive definition and classification of myocardial infarction to date [4]. Five major types of MI include type 1 MI—MI associated with occlusive or nonocclusive athero-thrombotic coronary lesions, type 2 MI—MI associated with mismatch between oxygen supply and demand, type 3 MI—MI in patients with ischemia-associated cardiac death, type 4a, 4b, and 4c—MI associated with percutaneous coronary intervention (PCI),

From the very beginning of human life in earth, three major issues including contagious diseases, shortage of food, and wars diminished human population for several years. To date, for the first time in history, modern medicine is providing us great success against contagious

and type 5 MI—MI associated with coronary artery bypass grafting surgery [4].

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

DOI: 10.5772/intechopen.81697

**Disease**

**Disease**

Burak Pamukcu

**1. Introduction**

and mortality worldwide [1, 2].

Additional information is available at the end of the chapter

Burak PamukcuAdditional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.81697

#### **Introductory Chapter: Atherosclerotic Cardiovascular Disease Introductory Chapter: Atherosclerotic Cardiovascular Disease**

DOI: 10.5772/intechopen.81697
