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Non-modifiable risk factors include age (men aged 45 and older and women aged 55 and older are more likely to have a heart attack), gender (men are at a greater risk than premenopausal women), and family history of heart disease [13, 14, 15] Myocardial infarction should not be mistaken for sudden cardiac arrest (SCA)

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Hydroxocobalamin 1mg is the standard UK formulation, typically administered every two to three months for maintenance therapy Self-administration requires GP prescription, competency training from practice nurses, and demonstration of proper injection technique Common injection sites include the thigh (vastus lateralis) for both intramuscular and subcutaneous administration with site rotation essential Serious side effects are rare but anaphylaxis requires immediate 999 call

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