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It is caused by an acute disruption of blood supply to the heart muscle (myocardium), which is mostly due to a closure of education in one or more of the coronary arteries. Pathophysiology Dieursächliche mechanism of heart attack is the formation of Thrombi on the basis of a pre-existing atherosclerosis of the coronary arteries is usually. In atherosclerosis lipids, in particular, LDL‑cholesterol to accumulate in the arterial wall interior to form Plaques (vascular plaques). If such a Plaque becomes unstable and ruptures, it activates the coagulation system: It is a Thrombus (blood clot) that occludes the artery partially or completely formed. As a result, the oxygen supply to the connected to the heart muscle tissue is interrupted. Without adequate oxygen and nutrient supply to the tissue begins to die within a few minutes (necrotizing). Symptoms The typical symptoms of a heart attack include: fierce, radiate, pressing or burning pain behind the breastbone (Retrosterbralschmerzen), often to the left Arm, the shoulder, the neck, or jaw; Shortness of breath; profuse sweating (diaphoresis); Nausea and possibly vomiting; Feeling of anxiety and restlessness. It is important to note that the symptoms may extend, in particular in the case of women, the elderly and patients with Diabetes mellitus, atypical. In these cases, nonspecific complaints such as fatigue, shortness of breath without pain or gastrointestinal complaints in the fore often. Diagnostics The diagnosis of myocardial infarction is made by a combination of different methods of investigation: History and physical examination: assessment of the symptoms and risk factors. Electrocardiogram (ECG) Shows typical changes such as ST‑segment elevation (STEMI) or ST‑depression and T‑wave Inversion (NSTEMI). Laboratory diagnosis: detection of elevated cardiac muscle enzymes in the blood, in particular Troponin T or I, are specific to a damage of the myocardium. Imaging procedures: coronary angiography for the visualization of the closures in the heart arteries. Therapy The goal of the therapy is the quickest possible restoration of the blood circulation of the affected heart muscle region. The main measures are: Thrombolysis: Drug dissolution of the Thrombus (if early catheter intervention is not possible). Percutaneous coronary intervention (PCI): the use of a balloon catheter and possible stent implantation for the re-opening of the closed artery. Drug therapy: administration of anticoagulants (e.g., ACE, Clopidogrel), beta-blockers, ACE inhibitors, and statins to reduce risk and improve the prognosis. 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