Name	The Bronx
Official name	Bronx County
Settlement type	Borough of New York City
Total type
Motto	''"Ne cede malis"'' Do not give way to evil
Map caption	The Bronx is shown in yellow.
Pushpin map
Pushpin label position
Pushpin mapsize
Coordinates region	US-NY
Subdivision type	Country
Subdivision name	United States
Subdivision type1	State
Subdivision name1	New York
Subdivision type2	County
Subdivision name2	Bronx
Subdivision type3	City
Subdivision name3	New York City
Parts style
Parts
P2
Government type	Borough (New York City)
Leader title	Borough     President
Leader name	Ruben Diaz, Jr.— ''(Borough of the Bronx)''
Leader title1	District     Attorney
Leader name1	Robert T. Johnson— ''(Bronx County)''
Established title	Borough created
Established date	1898  (County in 1914)
Official flower	the Tiger Lily (Day Lily)
Area total sq mi	57
Area land sq mi	42
Area water sq mi	15
Area water percent
Elevation footnotes	http://www.peakbagger.com/peak.aspx?pid7110 "Bronx High Point" at Peakbagger.com
Elevation max ft	280
Elevation min ft
Population as of	April 1, 2010 U.S. Census
Population note	(2010 pop. as estimated in March 2011; density is July 2006 est. pop. on land area as of 2000 )
Population total	1400761
Population density sq mi	32393
Timezone	Eastern Standard Time (North America)
Utc offset	-5
Timezone dst	Eastern Daylight Time
Utc offset dst	-4
Postal code type	ZIP Code
Postal code	104 + two digits
Area code	347, 718, 917
Website	Official website of the Bronx Borough President
Footnotes	}}

The Bronx is the northernmost of the five boroughs of New York City. It is also known as Bronx County, the last of the 62 counties of New York State to be incorporated. Located north of Manhattan and Queens, and south of Westchester County, the Bronx is the only borough that is located primarily on the mainland (a very small portion of Manhattan is located on the mainland named Marble Hill). The Bronx's population is 1,400,761 according to the 2010 United States Census. The borough has a land area of , making it the fourth most populated of the five boroughs, the fourth-largest in land area, and the third-highest in density of population.

The Bronx is divided by the Bronx River into a hillier section in the west, closer to Manhattan, and the flatter East Bronx, closer to Long Island. The West Bronx was annexed to New York City (then largely confined to Manhattan) in 1874, and the areas east of the Bronx River in 1895. The Bronx first assumed a distinct legal identity when it became a borough of Greater New York in 1898. Bronx County, with the same boundaries as the borough, was separated from New York County (afterwards coextensive with the Borough of Manhattan) as of January 1, 1914. Although the Bronx is the third-most-densely-populated county in the U.S., about a quarter of its area is open space, including Woodlawn Cemetery, Van Cortlandt Park, Pelham Bay Park, the New York Botanical Garden and the Bronx Zoo in the borough's north and center, on land deliberately reserved in the late 19th century as urban development progressed northwards and eastwards from Manhattan with the building of roads, bridges and railways.

The Bronx River was named for Jonas Bronck, an early settler from Småland in Sweden whose land bordered the river on the east. The borough of the Bronx was named for the river that was "Bronck's River". The indigenous Lenape (Delaware) American Indians were progressively displaced after 1643 by settlers from the Netherlands and Great Britain. The Bronx received many Irish, German, Jewish and Italian immigrants as its once-rural population exploded between the mid-19th and mid-20th centuries. They were succeeded after 1945 by African Americans and Hispanic Americans from the Caribbean basin — especially Puerto Rico and the Dominican Republic, but also from Jamaica. In recent years, this cultural mix has made the Bronx a wellspring of both Latin music and hip hop.

The Bronx contains one of the five poorest Congressional Districts in the U.S., (the 16th), but its wide variety of neighborhoods also includes the affluent Riverdale and Country Club. The Bronx, particularly the South Bronx, saw a sharp decline in population, livable housing, and the quality of life in the late 1960s and the 1970s, culminating in a wave of arson, but has shown some signs of revival in recent years.

History

For generations a rural area of small farms supplying the city markets, the Bronx grew into a railroad suburb in the late 19th century. Faster transportation allowed for rapid population growth in the late 19th century, involving the move from horse-drawn street cars to elevated railways to the subway system, which linked to Manhattan in 1904. The great majority lived in rented apartments. The demographic history of the Bronx in the 20th century may be divided into four periods: a boom during 1900–29, with a population growth by a factor of six from 200,000 in 1900 to 1.3 million in 1930. The Great Depression and war years saw a slowing of growth. The 1950s were hard times, as the Bronx decayed 1950–79 from a predominantly middle-class to a predominantly lower-class area with high rates of crime and poverty. Finally the Bronx has enjoyed economic and demographic stabilization since 1980.

The South Bronx was for many years a manufacturing center, and in the early part of the 20th Century was noted as a center of piano manufacturing. In 1919, the Bronx was the site of 63 piano factories employing more than 5,000 workers.

At the end of World War I, the Bronx hosted the rather small 1918 World's Fair at 177th Street and DeVoe Avenue.

The Bronx underwent rapid growth after World War I. Extensions of the New York City Subway contributed to the increase in population as thousands of immigrants flooded The Bronx, resulting in a major boom in residential construction. Among these groups, many Irish Americans, Italian Americans and especially Jewish Americans settled here. In addition, French, German, and Polish immigrants moved into the borough. The Jewish population also increased notably during this time. In 1937, according to Jewish organizations, 592,185 Jews lived in The Bronx (43.9% of the borough's population), while only 45,000 Jews lived in the borough in 2002. Many synagogues still stand in the Bronx, but most have been converted to other uses.

In Prohibition days (1920–33), bootleggers and gangs were active in the Bronx. Irish, Italian and Polish gangs smuggled in most of the illegal whiskey.

After the 1930s, Irish Americans started moving further north, and German Americans followed suit in the 1940s, as did many Italian Americans in the 1950s and Jews in the 1960s. As the older generation retired, many moved to Florida. The migration has left an African American and Hispanic (mostly Puerto Rican and Dominican) population, along with some Caucasian communities in the far southeastern and northwestern parts of the county.

In the 1970s, the South Bronx became iconic of America's urban crisis of unemployment and poverty, as arson in the city's public housing was a persistent symbol of the problem. However, led by aggressive community leaders, many burned-out tenements were replaced by single- and multifamily housing during the late 1970s to the present. Thus, Co-op City began in 1968 as a subsidized, high-rise, middle-class housing project, whose tenants bought shares in the corporation that operated it. It succeeded because it delivered on its promise of economic affordability and controlled racial integration.

By 2000, the Bronx had a population of about 1.2 million, and its bridges, highways, and railroads were more heavily traveled than those of any other part of the United States.

Fighting decline

Starting in the mid-1960s to the mid-1970s, the Bronx went into an era of sharp decline in the residents' quality of life. Historians and social scientists have put forward many factors. They include the theory (elaborated in Robert Caro's biography ''The Power Broker'') that Robert Moses' Cross-Bronx Expressway destroyed existing residential neighborhoods. Another factor in the Bronx's decline may have been the development of high-rise housing projects. Yet another may have been a reduction in the real-estate listings and property-related financial services (such as mortgages or insurance policies) offered in some areas of the Bronx — a process known as redlining. Others have suggested a "planned shrinkage" of municipal services, such as fire-fighting. There was also much debate as to whether rent control laws had made it less profitable (or more costly) for landlords to maintain existing buildings with their existing tenants than to abandon or destroy those buildings.

In the 1970s, the Bronx was plagued by a wave of arson. The burning of buildings was mostly in the South Bronx and in West Farms. The most common explanation of what occurred was that landlords decided to burn their low property-value buildings and take the insurance money as profit. After the fiery destruction of many buildings in the borough, the arsons slowed by the turn of the decade, but the after-effects were still felt into the 1990s.

Since the mid-1980s, some residential development has occurred in the Bronx, stimulated by the city's "Ten-Year Housing Plan" and community members working to rebuild the social, economic and environmental infrastructure by creating affordable housing. Groups affiliated with churches in the South Bronx erected the Nehemiah Homes with about 1,000 units. The grass roots organization Nos Quedamos' endeavor known as Melrose Commons began to rebuild areas in the South Bronx. The ripple effects have been felt borough-wide. The IRT White Plains Road Line began to show an increase in riders. Chains such as Marshalls, Staples, and Target have opened stores in the Bronx. More bank branches have opened in the Bronx as a whole (rising from 106 in 1997 to 149 in 2007), although not primarily in poor or minority neighborhoods, while the Bronx still has fewer branches per person than other boroughs.

Although not actually a city, in 1997, the Bronx was designated an ''All America City'' by the National Civic League, signifying its comeback from the decline of the 1970s. In 2006, ''The New York Times'' reported that "construction cranes have become the borough's new visual metaphor, replacing the window decals of the 1980s in which pictures of potted plants and drawn curtains were placed in the windows of abandoned buildings." The borough has experienced substantial new building construction since 2002. Between 2002 and June 2007, 33,687 new units of housing were built or were under way and $4.8 billion has been invested in new housing. In the first six months of 2007 alone total investment in new residential development was $965 million and 5,187 residential units were scheduled to be completed. Much of the new development is springing up in formerly vacant lots across the South Bronx.

Geography

Adjacent counties

Westchester County – north

Queens County, New York (Queens) – south

New York County, New York (Manhattan) – southwest

Bergen County, New Jersey – west

Location and physical features

The Bronx is almost entirely situated on the North American mainland. The Hudson River separates the Bronx on the west from Alpine, Tenafly and Englewood Cliffs in Bergen County, New Jersey; the Harlem River separates it from the island of Manhattan to the southwest; the East River separates it from Queens to the southeast; and, to the east, Long Island Sound separates it from Nassau County in western Long Island. Directly north of the Bronx are (from west to east) the adjoining Westchester County communities of Yonkers, Mount Vernon, Pelham Manor and New Rochelle.

(There is also a short southern land boundary with Marble Hill in the Borough of Manhattan, over the filled-in former course of the Spuyten Duyvil Creek. Marble Hill's postal ZIP code, telephonic Area Code and fire service, however, are shared with the Bronx and not Manhattan.)

The New York Public Library maintains a ''Map Rectifier'' facility that reconciles old maps of the Bronx (and elsewhere) with current cartography.

The Bronx River flows south from Westchester County through the borough, emptying into the East River; it is the only entirely freshwater river in New York City. A smaller river, the Hutchinson River (named after the religious leader Anne Hutchinson, killed along its banks in 1641), passes through the East Bronx and empties into Eastchester Bay.

The Bronx also includes several small islands in the East River and Long Island Sound, such as City Island and Hart Island. Although it is part of the Bronx, Rikers Island in the East River, home to the large jail complex for the entire City, can be reached only by water, by air, or—since 1966—over the Francis Buono Bridge from Queens.

The Bronx's highest elevation , is in the northwest corner, west of Van Cortlandt Park and in the Chapel Farm area near the Riverdale Country School. The opposite (southeastern) side of the Bronx has four large low peninsulas or "necks" of low-lying land that jut into the waters of the East River and were once saltmarsh: Hunt's Point, Clason's Point, Screvin's Neck and Throg's Neck. Further up the coastline, Rodman's Neck lies between Pelham Bay Park in the northeast and City Island.

† (New York City's last freshwater marsh was in Van Cortlandt Park until displaced in the 1930s by the junction of the Mosholu and Henry Hudson Parkways.)

Almost 27%, of the Bronx's total area is water, and the irregular shoreline extends for .

Parks and open space

Although, in 2006, it was the third most densely populated county in the United States (after Manhattan and Brooklyn), about one-fifth of the Bronx's area, and one-quarter of its land area, is given over to park land: about .

Woodlawn Cemetery, one of the largest cemeteries in New York City, sits on the western bank of the Bronx River near Yonkers. It opened in 1863, at a time when the Bronx was still considered a rural area.

The northern side of the borough includes the largest park in New York City - Pelham Bay Park, which includes Orchard Beach - and the fourth largest, Van Cortlandt Park, which is west of Woodlawn Cemetery and borders Yonkers.

Nearer the borough's center, and along the Bronx River, is Bronx Park. Its northern end houses the New York Botanical Gardens, which preserve the last patch of the original hemlock forest that once covered the entire city, and its southern end the Bronx Zoo, the largest urban zoological gardens in the U.S.

Farther south is Crotona Park, home to a 3.3 acre (1.3 hectare) lake, 28 species of trees and a large swimming pool. The land for these parks, and many others, was bought by New York City in 1888, while land was still open and inexpensive, in anticipation of future needs and future pressures for development.

Some of the acquired land was set aside for the Grand Concourse and Pelham Parkway, the first of a series of boulevards and parkways (thoroughfares lined with trees, vegetation and greenery). Later projects included the Bronx River Parkway, which developed a road while restoring the riverbank and reducing pollution, Mosholu Parkway and the Henry Hudson Parkway.

Just south of Van Cortlandt Park is the Jerome Park Reservoir, surrounded by of stone walls and bordering several small parks in the Bedford Park neighborhood. The reservoir was built in the 1890s on the site of the former Jerome Park Racetrack.

In 2006, a five-year, $220-million program of capital improvements and natural restoration in 70 Bronx parks was begun (financed by water and sewer revenues) as part of an agreement that allowed a water filtration plant under Van Cortlandt Park's golf course. One major focus is on opening more of the Bronx River's banks and restoring them to a natural state.

Wave Hill, the former estate of George W. Perkins — known for a historic house, gardens, changing site-specific art installations and concerts — overlooks the New Jersey Palisades from a promontory on the Hudson in Riverdale.

Neighborhoods and commercial districts

The number, locations and boundaries of the Bronx's neighborhoods (many of them sitting on the sites of 19th-century villages) have become unclear with time and successive waves of newcomers. In 2006, Manny Fernandez of ''The New York Times'' wrote,

"According to a Department of City Planning map of the city's neighborhoods, the Bronx has 49. The map publisher Hagstrom identifies 69. The borough president, Adolfo Carrión Jr., says 61. The Mayor's Community Assistance Unit, in a listing of the borough's community boards, names 68. Wikipedia, the online encyclopedia, lists 44."

Notable Bronx neighborhoods include the South Bronx, Little Italy on Arthur Avenue in the Belmont section, and Riverdale.

East Bronx

(Bronx Community Boards 9 ''[south central]'', 10 ''[east]'', 11 ''[east central]'' and 12 ''[north central]'' )

East of the Bronx River, the borough is relatively flat, and includes four large low peninsulas, or 'necks,' of low-lying land which jut into the waters of the East River and were once saltmarsh: Hunts Point, Clason's Point, Screvin's Neck (Castle Hill Point) and Throgs Neck. The East Bronx has older tenement buildings, low income public housing complexes, and multifamily homes, as well as smaller and larger single family homes. It includes New York City's largest park: Pelham Bay Park along the Westchester-Bronx border.

Neighborhoods include: Clason's Point, Harding Park, Soundview, Castle Hill, Parkchester ''(under Board 9)'', Throgs Neck, Country Club, City Island, Pelham Bay, Co-op City ''(Board 10)'', Westchester Square, Van Nest, Pelham Parkway, Morris Park ''(Board 11)'', Williamsbridge, Eastchester, Baychester, Edenwald and Wakefield ''(Board 12)''.

City Island and Hart Island

thumb|right|The sea is a part of everyday life in [[City Island, Bronx|City Island]] (Bronx Community Board 10)

City Island is located east of Pelham Bay Park in Long Island Sound, and is known for its seafood restaurants and waterfront private homes. City Island's single shopping street, City Island Avenue, is reminiscent of a small New England town. It is connected to Rodman's Neck on the mainland by the City Island Bridge.

East of City Island is Hart Island which is uninhabited and not open to the public. It once served as a prison and now houses New York City's Potter's Field or pauper's graveyard for unclaimed bodies.

West Bronx

(Bronx Community Boards 1 to 8, progressing roughly from south to northwest)

The western parts of the Bronx are hillier and are dominated by a series of parallel ridges, running south to north. The West Bronx has older apartment buildings, low income public housing complexes, multifamily homes in its lower income areas as well as larger single family homes in more affluent areas such as Riverdale and Fieldston. It includes New York City's fourth largest park: Van Cortlandt Park along the Westchester-Bronx border. The Grand Concourse, a wide boulevard, runs through it, north to south.

Northwestern Bronx

(Bronx Community Boards 7 ''[between the Bronx and Harlem Rivers]'' and 8 ''[facing the Hudson River]'' — plus part of Board 12)

Neighborhoods include: Fordham-Bedford, Bedford Park, Norwood, Kingsbridge Heights ''(Board 7)'', Kingsbridge, Riverdale ''(Board 8)'', and Woodlawn ''(Board 12)''. (Marble Hill, Manhattan is now connected by land to the Bronx rather than Manhattan and is served by Bronx Community Board 8.)

South Bronx

(Bronx Community Boards 1 to 6 plus part of Board 7 —— ''progressing northwards, Boards 2, 3 and 6 border the Bronx River from its mouth to Bronx Park, while 1, 4, 5 and 7 face Manhattan across the Harlem River'')

Like other neighborhoods in New York City, the South Bronx has no official boundaries. The name has been used to represent poverty in the Bronx and applied to progressively more northern places so that by the 2000s Fordham Road was often used as a northern limit. The Bronx River more consistently forms an eastern boundary. The South Bronx has many high-density apartment buildings, low income public housing complexes, and multi-unit homes. The South Bronx is home to the Bronx County Courthouse, Borough Hall, and other government buildings, as well as Yankee Stadium. The Cross Bronx Expressway bisects it, east to west. The South Bronx has some of the poorest neighborhoods in the country, as well as very high crime areas.

Neighborhoods include: The Hub (a retail district at Third Avenue and East 149th Street), Port Morris, Mott Haven ''(Board 1)'', Melrose ''(Board 1 & Board 3)'', Morrisania, East Morrisania [also known as Crotona Park East] ''(Board 3)'', Hunts Point, Longwood ''(Board 2)'', Highbridge, Concourse ''(Board 4)'', West Farms, Belmont, East Tremont ''(Board 6)'', Tremont, Morris Heights ''(Board 5)'', University Heights, and Fordham ''(Board 5 & Board 7)''.

Shopping districts

Prominent shopping areas in the Bronx include Fordham Road, Bay Plaza (in Co-op City), The Hub, Riverdale/Kingsbridge Shopping center and Bruckner Boulevard. Shops are also concentrated on streets aligned underneath elevated railroad lines, including Westchester Avenue, White Plains Road, Jerome Avenue, Southern Boulevard and Broadway. The Gateway Center at Bronx Terminal Market contains several big-box stores, which opened in 2009 south of Yankee Stadium.

The Bronx Hub

The Hub–Third Avenue Business Improvement District (B.I.D.) is the retail heart of the South Bronx, located where four roads converge: East 149th Street, Willis, Melrose and Third Avenues. It is primarily located inside the neighborhood of Melrose but also lines the northern border of Mott Haven. The Hub has been called "the Broadway of the Bronx." It is the site of both maximum traffic and architectural density. In configuration, it resembles a miniature Times Square, a spatial "bow-tie" created by the geometry of the street. The area is part of Bronx Community Board 1.

Transportation

Roads and streets

The Bronx street grid is irregular. Like the northernmost part of upper Manhattan, the West Bronx's hilly terrain leaves a relatively free-style street grid. Much of the West Bronx's street numbering carries over from upper Manhattan, but does not match it exactly; East 132nd Street is the lowest numbered street in the Bronx. This dates from the mid-19th century when the southwestern area of Westchester County west of the Bronx River, was incorporated into New York City and known as the Northside.

The East Bronx is considerably flatter, and the street layout tends to be more regular. Only the Wakefield neighborhood picks up the street numbering, albeit at a disalignment due to Tremont Avenue's layout. At the same diagonal latitude, West 262nd Street in Riverdale matches East 237th Street in Wakefield.

Three major north-south thoroughfares run between Manhattan and the Bronx: Third Avenue, Park Avenue, and Broadway. Other major north-south roads include the Grand Concourse, Jerome Avenue, Sedgwick Avenue, Webster Avenue, and White Plains Road. Major east-west thoroughfares include Mosholu Parkway, Gun Hill Road, Fordham Road, Pelham Parkway, and Tremont Avenue.

Most east-west streets are prefixed with either ''East'' or ''West'', to indicate on which side of Jerome Avenue they lie (continuing the similar system in Manhattan, which uses Fifth Avenue as the dividing line).

The historic Boston Post Road, part of the long pre-revolutionary road connecting Boston with other northeastern cities, runs east-west in some places, and sometimes northeast-southwest.

Mosholu and Pelham Parkways, with Bronx Park between them, Van Cortlandt Park to the west and Pelham Bay Park to the east, are also linked by bridle paths.

Approximately 61.6% of all Bronx households do not have access to a car. Citywide, the percentage of autoless households is 55%.

Highways

Several major limited access highways traverse the Bronx. These include:

the Bronx River Parkway

the Bruckner Expressway (I-278/I-95)

the Cross-Bronx Expressway (I-95/I-295)

the New England Thruway (I-95)

the Henry Hudson Parkway (NY-9A)

the Hutchinson River Parkway

the Major Deegan Expressway (New York Thruway) (I-87)

Bridges and tunnels

Many bridges and tunnels connect the Bronx to Manhattan and Queens (3). These include, from west to east:

''To Manhattan:'' the Spuyten Duyvil Bridge, the Henry Hudson Bridge, the Broadway Bridge, the University Heights Bridge, the Washington Bridge, the Alexander Hamilton Bridge, the High Bridge, the Concourse Tunnel, the Macombs Dam Bridge, the 145th Street Bridge, the 149th Street Tunnel, the Madison Avenue Bridge, the Park Avenue Bridge, the Lexington Avenue Tunnel, the Third Avenue Bridge (southbound traffic only), and the Willis Avenue Bridge (northbound traffic only).

''To Manhattan or Queens:'' the Robert F. Kennedy Bridge (which opened as the Triborough Bridge).

''To Queens:'' the Bronx Whitestone Bridge and the Throgs Neck Bridge.

Mass transit

The Bronx is served by six lines of the New York City Subway with 70 stations in the Bronx: IND Concourse Line ( trains) IRT Broadway – Seventh Avenue Line ( train) IRT Dyre Avenue Line ( train) IRT Jerome Avenue Line ( train) IRT Pelham Line ( trains) IRT White Plains Road Line ( trains) Two Metro-North Railroad commuter rail lines (the Harlem Line and the Hudson Line) serve 11 stations in the Bronx. (Marble Hill, between the Spuyten Duyvil and University Heights stations, is actually in the only part of Manhattan connected to the mainland.) In addition, trains serving the New Haven Line stop at Fordham Road.

Postal service

The United States Postal Service operates post offices in the Bronx. The Bronx General Post Office is located at 558 Grand Concourse.

Demographics

Race, ethnicity, language, and immigration

According to the 2010 Census, 10.9% of the population was non-Hispanic White, 30.1% non-Hispanic Black or African American, 3.4% non-Hispanic Asian, 0.6% from some other race (non-Hispanic) and 1.2% of two or more races (non-Hispanic). 53.5% of Bronx's population was of Hispanic, Latino, or Spanish origin (they may be of any race)

The U.S. Census considers the Bronx to be the most diverse area in the country. There is an 89.7 percent chance that any two residents, chosen at random, would be of different race or ethnicity.

The Bronx is the only New York City borough with a Hispanic majority, many of whom are Puerto Ricans and Dominicans. In 2000, The Bronx had some of the nation's highest percentages of Puerto Ricans and Dominicans with 24.0% and 10.0%, respectively.

According to the 2009 American Community Survey, White Americans of both Hispanic and non-Hispanic origin represented over one-fifth (22.9%) of The Bronx's population. However, non-Hispanic whites formed under one-eighth (12.1%) of the population. Out of all five boroughs, The Bronx has the lowest number and percentage of white residents. 320,640 whites called the Bronx home, of which 168,570 were non-Hispanic whites. The majority of the non-Hispanic European American population is of Italian and Irish descent. People of Italian descent numbered over 55,000 individuals and made up 3.9% of the population. People of Irish descent numbered over 43,500 individuals and made up 3.1% of the population. German Americans and Polish Americans made up 1.4% and 0.8% of the population respectively.

At the 2009 American Community Survey, Black Americans made the second largest group in the Bronx after Hispanics and Latinos. Blacks of both Hispanic and non-Hispanic origin represented over one-third (35.4%) of the Bronx's population. Blacks of non-Hispanic origin made up 30.8% of the population. Over 495,200 blacks resided in the borough, of which 430,600 were non-Hispanic blacks. Over 61,000 people identified themselves as "Sub-Saharan African" in the survey, making up 4.4% of the population.

Native Americans are a very small minority in the borough. Only some 5,560 individuals (out of the borough's 1.4 million people) are Native American, which is equal to just 0.4% of the population. In addition, roughly 2,500 people are Native Americans of non-Hispanic origin.

Asian Americans are a small but sizable minority in the borough. Roughly 49,600 Asians make up 3.6% of the population. Roughly 13,600 Indians call The Bronx home, along with 9,800 Chinese, 6,540 Filipinos, 2,260 Vietnamese, 2,010 Koreans, and 1,100 Japanese.

Multiracial Americans are also a sizable minority in the Bronx. People of multiracial heritage number over 41,800 individuals and represent 3.0% of the population. People of mixed Caucasian and African American heritage number over 6,850 members and form 0.5% of the population. People of mixed Caucasian and Native American heritage number over 2,450 members and form 0.2% of the population. People of mixed Caucasian and Asian heritage number over 880 members and form 0.1% of the population. People of mixed African American and Native American heritage number over 1,220 members and form 0.1% of the population.

In 2009, Hispanic and Latino Americans represented 52.0% of the Bronx's population. Puerto Ricans represented 23.2% of the borough's population. Over 72,500 Mexicans lived in the Bronx, and they formed 5.2% of the population. Cubans numbered over 9,640 members and formed 0.7% of the population. In addition, over 319,000 people were of various Hispanic and Latino groups, such as Dominican, Salvadoran, and so on. These groups collectively represented 22.9% of the population. At the 2010 Census, 53.5% of Bronx's population was of Hispanic, Latino, or Spanish origin (they may be of any race).

Approximately 44.3% of the population over the age of 5 speak only English at home, which is roughly 570,000 people. The majority (55.7%) of the population speak non-English languages at home. Over 580,600 people (45.2% of the population) speak Spanish at home.

According to the 2005–2007 American Community Survey Estimates, the borough's population was 23.0% White (13.0% non-Hispanic White alone), 34.5% Black or African American (30.6% non-Hispanic Black or African American alone), 0.7% American Indian and Alaska Native, 3.8% Asian, 0.1% Native Hawaiian and Other Pacific Islander, 40.4% from some other race and 2.4% from two or more races. 50.7% of the total population were Hispanic or Latino of any race (23.3% of Bronx's population were Puerto Ricans). 31.7% of the population were foreign born and another 8.9% were born in Puerto Rico, U.S. Island areas, or born abroad to American parents. 55.6% spoke a language other than English at home and 16.4% had a Bachelor's degree or higher.

The Census of 1930 counted only 1.0% (12,930) of the Bronx's population as Negro (while making no distinct counts of Hispanic or Spanish-surname residents).

Immigrants from Ghana have clustered along the Grand Concourse.

Based on sample data from the 2000 census, the U.S. Census Bureau estimated that 47.3% of the population five and older spoke only English at home, while 43.7% spoke Spanish at home, either exclusively or along with English. Other languages or groups of languages spoken at home by more than 0.25% of the population of the Bronx include Italian (1.36%), Kru, Igbo, or Yoruba ''[West Africa]'' (0.72%) and French (0.54%).

   477,342 135,210 67,732 55,969 43,349 34,538 140,544

bgcolor="f0f0f0" align="center" colspan="6;"	Bronx residents born abroad or overseas, 1930 and 2000
	2000 United States Census
width="35%" align="center"	Total population of the Bronx
	|		''All born abroad or overseas'' ‡	524,410	''39.4%''
	|		Puerto Rico	126,649	''9.5%''
align="center"	''Foreign-born Whites''	|	''37.7%''	''All foreign-born''	385,827	''29.0%''
align="left"	White persons born in Russia	|	''10.7%''	Dominican Republic	124,032	''9.3%''
align="left"	White persons born in Italy	|	''5.4%''	Jamaica	51,120	''3.8%''
align="left"	White persons born in Poland	|	''4.4%''	Mexico	20,962	''1.6%''
align="left"	White persons born in Germany	|	''3.4%''	Guyana	14,868	''1.1%''
align="left"	White persons born in the Irish Free State †	|	''2.7%''	Ecuador	14,800	''1.1%''
Other foreign birthplaces of Whites	|	''11.1%''	Other foreign birthplaces	160,045		''12.0%''
	‡ beyond the 50 states & District of Columbia

Population and housing

At the 2010 Census, there were, 1,385,108 people living in Bronx, a 3.9% increase since 2000. As of the United States Census of 2000, there were 1,332,650 people, 463,212 households, and 314,984 families residing in the borough. The population density was 31,709.3 inhabitants per square mile (12,242.2/km²). There were 490,659 housing units at an average density of 11,674.8 per square mile (4,507.4/km²). There were 463,212 households out of which 38.1% had children under the age of 18 living with them, 31.4% were married couples living together, 30.4% had a female householder with no husband present, and 32.0% were non-families. 27.4% of all households were made up of individuals and 9.4% had someone living alone who was 65 years of age or older. The average household size was 2.78 and the average family size was 3.37.

The age distribution of the population in the Bronx was as follows: 29.8% under the age of 18, 10.6% from 18 to 24, 30.7% from 25 to 44, 18.8% from 45 to 64, and 10.1% 65 years of age or older. The median age was 31 years. For every 100 females there were 87.0 males.

Individual and household income

The 1999 median income for a household in the borough was $27,611, and the median income for a family was $30,682. Males had a median income of $31,178 versus $29,429 for females. The per capita income for the borough was $13,959. About 28.0% of families and 30.7% of the population were below the poverty line, including 41.5% of those under age 18 and 21.3% of those age 65 or over.

Government and politics

Local government

Since New York City's consolidation in 1898, the Bronx has been governed by the New York City Charter that provides for a mayor-council system. The centralized New York City government is responsible for all municipal functions.

The office of Borough President was created in the consolidation of 1898 with powers mostly derived from having a vote on the New York City Board of Estimate. The 1989 Board of Estimate of City of New York v. Morris case declared the Board unconstitutional, and since 1990 the Borough President has acted as an advocate for the borough at the mayoral agencies, the City Council, the New York state government, and corporations.

On February 18, 2009, U.S. President Barack Obama appointed the former Bronx Borough President, Adolfo Carrión, Jr., to the position of Director of the White House Office of Urban Affairs Policy.

On April 21, 2009, a special election was held to choose Carrión's successor. Democratic New York State Assembly member Rubén Díaz, Jr., running on the "Bronx Unity" ticket, won this election with 29,420 votes (86%) against 4,646 votes (14%) for the Republican Anthony Ribustello ("People First") and 11 votes for write-in candidates. On May 1, 2009, Assemblyman Diaz was sworn in as the 13th Borough President of the Bronx (For his predecessors, see the List of Bronx Borough Presidents.)

Every currently-elected public official in the Bronx has first won the Democratic nomination (whether or not also nominated by other parties). Local party platforms center on affordable housing, education and economic development. Controversial political issues in the Bronx include environmental issues, the cost of housing, and the alienation of parkland for new Yankee Stadium.

Since its separation from New York County on January 1, 1914, the Bronx, has had, like each of the other 61 counties of New York State, its own directly-elected District Attorney, the county's chief public prosecutor. Robert T. Johnson, a Democrat, has been the District Attorney of Bronx County since 1989. He was the first African-American District Attorney in New York State.

Eight members of the New York City Council represent districts wholly within the Bronx, while a ninth represents a Manhattan district (8) that also includes a small area of the Bronx. (All of them were Democrats in 2008.) One of those members, Joel Rivera (District 15), has been the Council's Majority Leader since 2002.

The Bronx also has 12 Community Boards, appointed bodies that field complaints and advise on land use and municipal facilities and services for local residents, businesses and institutions. (They are listed at Bronx Community Boards).

Legislative and Congressional representatives

In 2008, three Democrats represented almost all of the Bronx in the United States House of Representatives.

José M. Serrano (first elected in March 1990) represents New York's 16th congressional district, which covers much of the South Bronx. It was, in 2000, the poorest of the nation's 435 districts (42.8% below the poverty line); it was also the most Hispanic of New York state's 29 congressional districts (62.8%) and the youngest (34.5% under 18 years old; 6.7% over 65).

Eliot Engel (first elected in 1988) represents the 17th District which includes parts of the northwest Bronx as well as parts of Westchester and Rockland counties.

Joseph Crowley (first elected in 1998) represents the 7th District which spans the East Bronx and includes Co-op City, City Island, Pelham Bay, Morris Park, Pelham Parkway, Parkchester, Castle Hill and Throgs Neck, as well as parts of northwest Queens.

''(Riker's Island, the city's main jail complex, is included in the 15th District, which covers Upper Manhattan and utilities facilities in Astoria, Queens. It is represented by Charles B. Rangel, first elected in 1970. In 2006, the Congressional election returns in this district included no votes from the Bronx or Queens.)''

All of these Representatives won over 75% of their districts' respective votes in both 2004 and 2006. ''National Journal's'' neutral rating system placed all of their voting records in 2005 and 2006 somewhere between very liberal and extremely liberal.

11 out of 150 members of the New York State Assembly (the lower house of the state legislature) represent districts wholly within the Bronx. Six State Senators out of 62 represent Bronx districts, half of them wholly within the County, and half straddling other counties. All these legislators are Democrats who won between 65% and 100% of their districts' vote in 2006.

Votes for other offices

In the 2004 presidential election, Senator John F. Kerry (Democratic/Working Families) received 81.8% of the vote in the Bronx while President George W. Bush (Republican/Conservative) received 16.3%.

A year later, the Democratic former Bronx Borough President Fernando Ferrer won 59.8% of the borough's vote against 38.8% for Mayor Michael Bloomberg (Republican/Independence) who carried every other borough in his winning campaign for re-election. In 2009, the Bronx voted slightly more strongly against the successful re-election of Mayor Bloomberg, who received 37% of the Bronx vote (as an independent supported by the Republican and Independence Parties) against 61.2% for New York City Comptroller Bill Thompson (Democratic and Working Families).

In 2006, successfully-reelected Senator Hillary Clinton (Democratic, Working Families & Independence) won 89.5% of the Bronx's vote against 9.6% for Yonkers ex-Mayor John Spencer (Republican and Conservative), while Eliot Spitzer (Democratic, Working Families & Independence) received 88.8% of the Borough's vote in winning the Governorship against John Faso (Republican & Conservative), who received 9.7% of the Bronx's vote.

In the Presidential primary elections of February 5, 2008, Sen. Clinton won 61.2% of the Bronx's 148,636 Democratic votes against 37.8% for Barack Obama and 1.0% for the other four candidates combined. At the same time, John McCain won 54.4% of the borough's 5,643 Republican votes, Mitt Romney 20.8%, Mike Huckabee 8.2%, Ron Paul 7.4%, Rudy Giuliani 5.6%, and the other three candidates 3.6% between them.

In the Presidential general election of November 4, 2008, Sen. Obama won 87.8% of the Bronx's vote (338,261) on the Democratic and Working Families Party lines of the ballot, Sen. McCain won 10.8% (41,683) on the Republican, Independence and Conservative Party lines, and other candidates won 1.3% (1,342) between them. The Democratic candidate's percentage of the Presidential vote increased by 6% from 2004, while the Republican presidential candidate's percentage declined by 5.5%.

After becoming a separate county in 1914, the Bronx has supported only two Republican Presidential candidates. It voted heavily for the winning Republican Warren G. Harding in 1920, but much more narrowly on a split vote for his victorious Republican successor Calvin Coolidge in 1924 (Coolidge 79,562; John W. Davis, Dem., 72,834; Robert La Follette, 62,202 equally divided between the Progressive and Socialist lines).

Since then, the Bronx has always supported the Democratic Party's nominee for President, starting with a vote of 2–1 for the unsuccessful Al Smith in 1928, followed by four 2-1 votes for the successful Franklin D. Roosevelt. (Both had been Governors of New York, but the Bronx voted against two former Republican Governors who ran for President: Charles Evans Hughes in 1916 and Thomas E. Dewey in 1944 and 1948.)

The Bronx has often shown striking differences from other boroughs in elections for Mayor. The only Republican to carry the Bronx since 1914 was Fiorello La Guardia in 1933, 1937 and 1941 (and in the latter two elections, only because his 30–32% vote on the American Labor Party line was added to 22–23% as a Republican). The Bronx was thus the only borough not carried by the successful Republican re-election campaigns of Mayors Rudolph Giuliani in 1997 and Michael Bloomberg in 2005. The anti-war Socialist campaign of Morris Hillquit in the 1917 mayoral election won over 31% of the Bronx's vote, putting him second and well ahead of the 20% won by the incumbent pro-war Fusion Mayor John P. Mitchel, who outpolled Hillquit city-wide by 23.2% to 21.7%.

Education

Education in the Bronx is provided by a large number of public and private institutions, many of which draw students who live beyond the Bronx. The New York City Department of Education manages public noncharter schools in the borough. In 2000, public schools enrolled nearly 280,000 of the Bronx's residents over 3 years old (out of 333,100 enrolled in all pre-college schools). There are also several public charter schools. Private schools range from élite independent schools to religiously-affiliated schools run by the Roman Catholic Archdiocese of New York and Jewish organizations.

''Educational attainment:'' In 2000, according to the U.S. Census, out of the nearly 800,000 people in the Bronx who were then at least 25 years old, 62.3% had graduated from high school and 14.6% held a bachelor's or higher college degree. These percentages were lower than those for New York's other boroughs, which ranged from 68.8% (Brooklyn) to 82.6% (Staten Island) for high school graduates over 24, and from 21.8% (Brooklyn) to 49.4% (Manhattan) for college graduates. (The respective state and national percentages were ''[NY]'' 79.1% & 27.4% and ''[US]'' 80.4% & 24.4%.)

High schools

In the 2000 Census, 79,240 of the nearly 95,000 Bronx residents enrolled in high school attended public schools.

Many public high schools are located in the borough including the élite Bronx High School of Science, DeWitt Clinton High School, High School for Violin and Dance, Bronx Leadership Academy 2, Bronx International High School, the School for Excellence, the Morris Academy for Collaborative Study, Wings Academy for young adults, Validus Preparatory Academy, Bronx Expeditionary Learning High School, Herbert H. Lehman High School and High School of American Studies. The Bronx is also home to three of New York City's most prestigious private, secular schools: Fieldston, Horace Mann, and Riverdale Country School.

High schools linked to the Roman Catholic Church include: Saint Raymond's Academy for Girls, All Hallows High School, Fordham Preparatory School, Monsignor Scanlan High School, St. Raymond High School for Boys, Cardinal Hayes High School, Cardinal Spellman High School, The Academy of Mount Saint Ursula, Aquinas High School, Preston High School, St. Catharine Academy, Mount Saint Michael Academy, and St. Barnabas High School.

The SAR Academy and SAR High School are Modern Orthodox Jewish Yeshiva coeducational day schools in Riverdale, with roots in Manhattan's Lower East Side.

In the 1990s, New York City began closing the large, public high schools in the Bronx and replacing them with small high schools. Among the reasons cited for the changes were poor graduation rates and concerns about safety. Schools that have been closed or reduced in size include John F. Kennedy, James Monroe, Taft, Theodore Roosevelt, Adlai Stevenson, Evander Childs, Christopher Columbus, Morris, Walton, and South Bronx High Schools. More recently the City has started phasing out large middle schools, also replacing them with smaller schools.

Institutions of higher education

In 2000, 49,442 (57.5%) of the 86,014 Bronx residents seeking college, graduate or professional degrees attended public institutions.

Several colleges and universities are located in the Bronx.

Fordham University, was founded as St. John's College in 1841 by the Diocese of New York as the first Catholic institution of higher education in the northeast. It is now officially an independent institution, but strongly embraces its Jesuit heritage. The Bronx campus, known as Rose Hill, is the main campus of the university, and is among the largest within the city (other Fordham campuses are located in Manhattan and Westchester County).

Three campuses of the City University of New York are in the Bronx: Hostos Community College, Bronx Community College (occupying the former University Heights Campus of New York University) and Herbert H. Lehman College (formerly the uptown campus of Hunter College), which offers both undergraduate and graduate degrees.

The College of Mount Saint Vincent is a Catholic liberal arts college in Riverdale under the direction of the Sisters of Charity of New York. Founded in 1847 as a school for girls, the academy became a degree-granting college in 1911 and began admitting men in 1974. The school serves 1,600 students. Its campus is also home to the Academy for Jewish Religion, a transdenominational rabbinical and cantorial school.

Manhattan College is a Catholic college in Riverdale which offers undergraduate programs in the arts, business, education, engineering, and science. It also offers graduate programs in education and engineering.

Albert Einstein College of Medicine, part of Yeshiva University, is in Morris Park.

Two colleges based in Westchester County have Bronx campuses. The Catholic and nearly-all-female College of New Rochelle maintains satellite campuses at Co-op City and in The Hub. The coeducational and non-sectarian Mercy College in Dobbs Ferry, founded by the Catholic Sisters of Mercy in 1950, has a campus near Westchester Square.

By contrast, the private, proprietary Monroe College, focused on preparation for business and the professions, started in the Bronx in 1933 but now has a campus in New Rochelle (Westchester County) as well the Bronx's Fordham neighborhood.

The State University of New York Maritime College in Fort Schuyler (Throggs Neck)—at the far southeastern tip of the Bronx—is the national leader in maritime education and houses the Maritime Industry Museum. (Directly across Long Island Sound is Kings Point, Long Island, home of the United States Merchant Marine Academy and the American Merchant Marine Museum.)

Cultural life and institutions

Author Edgar Allan Poe spent the last years of his life (1846 to 1849) in the Bronx at Poe Cottage, now located at Kingsbridge Road and the Grand Concourse. A small wooden farmhouse built about 1812, the cottage once commanded unobstructed vistas over the rolling Bronx hills to the shores of Long Island.

The Bronx's evolution from a hot bed of Latin jazz to an incubator of hip hop was the subject of an award-winning documentary, produced by City Lore and broadcast on PBS in 2006, "From Mambo to Hip Hop: A South Bronx Tale". Hip Hop first emerged in the South Bronx in the early 1970s. ''The New York Times'' has identified 1520 Sedgwick Avenue "an otherwise unremarkable high-rise just north of the Cross Bronx Expressway and hard along the Major Deegan Expressway" as a starting point, where DJ Kool Herc presided over parties in the community room.

On August 11, 1973, DJ Kool Herc was a Dee Jay and Emcee at a party in the recreation room of 1520 Sedgewick Avenue in the Bronx adjacent to the Cross-Bronx Expressway. While it was not the actual "Birthplace of Hip Hop" – the genre developed slowly in several places in the 1970s – it was verified to be the place where ''one of'' the pivotal and formative events occurred. Specifically, DJ Kool Herc:

Beginning with the advent of beat match DJ'ing, in which Bronx DJs (Disc Jockeys) including Grandmaster Flash, Afrika Bambaataa and DJ Kool Herc extended the breaks of funk records, a major new musical genre emerged that sought to isolate the percussion breaks of hit funk, disco and soul songs. As hip hop's popularity grew, performers began speaking ("rapping") in sync with the beats, and became known as MCs or emcees. The Herculoids, made up of Herc, Coke La Rock, and DJ Clark Kent, were the earliest to gain major fame. The Bronx is referred to in hip-hop slang as "The Boogie Down Bronx", or just "The Boogie Down". This was hip-hop pioneer KRS-One's inspiration for his thought provoking group BDP, or Boogie Down Productions, which included DJ Scott La Rock. Newer hip hop artists from the Bronx include Lord Toriq and Peter Gunz, Camp Lo, Swizz Beatz, Drag-On, Fat Joe, Terror Squad and Corey Gunz.

Hush Hip Hop Tours has established a sightseeing tour of the Bronx showcasing the locations that helped shape hip hop culture and has the pioneers of hip hop as tour guides. The recent recognition of the Bronx as an important center of African-American culture, led Fordham University to establish the ongoing "Bronx African-American History Project (BAAHP)".

The Bronx is the home of the New York Yankees, one of the leading baseball franchises in sports history. The original Yankee Stadium opened in 1923 on 161st Street and River Avenue, a year which saw the Yankeees bring home their first of 27 World Series Championships. With the famous facade, the short right field porch and Monument Park, Yankee Stadium has played host to many of the greatest players ever to take the field including Babe Ruth, Lou Gehrig, Joe DiMaggio, Whitey Ford, Yogi Berra, Mickey Mantle, Reggie Jackson, Derek Jeter, Mariano Rivera and Alex Rodriguez. The Stadium, as referred to by locals, has witnessed of the most memorable moments in sports history such as Lou Gehrig's Farewell Speech in 1939, Joe DiMaggio's 56 game hitting streak in 1941, Don Larsen's perfect game in the 1956 World Series, Roger Maris' record breaking 61st home run in 1961, Reggie Jackson's 3 home runs to clinch Game 6 of the 1977 World Series and more recently the dynasty of the 1996-2000 Yankee club that captured 4 out of 5 World Series victories during that span. The original Yankee Stadium closed in 2008 to make way for a brand new stadium in which the Yankees started play in 2009 and capped off a memorable first year in their new home with a 27th World Series title, by beating the Philadelphia Phillies 4 games to 2 in the Fall Classic.

The Bronx is home to several Off-Off-Broadway theaters, many staging new works by immigrant playwrights from Latin America and Africa. The Pregones Theater, which produces Latin American work, opened a new 130-seat theater in 2005 on Walton Avenue in the South Bronx. Some artists from elsewhere in New York City have begun to converge on the area, and housing prices have nearly quadrupled in the area since 2002. However rising prices directly correlate to a housing shortage across the city and the entire metro area.

The Bronx Museum of the Arts, founded in 1971, exhibits 20th century and contemporary art through its central museum space and of galleries. Many of its exhibitions are on themes of special interest to the Bronx. Its permanent collection features more than 800 works of art, primarily by artists from Africa, Asia and Latin America, including paintings, photographs, prints, drawings, and mixed media. The museum was temporarily closed in 2006 while it underwent a major expansion designed by the architectural firm Arquitectonica.

The Bronx has also become home to a peculiar poetic tribute, in the form of the Heinrich Heine Memorial, better known as the Lorelei Fountain from one of Heine's best-known works (1838). After Heine's German birthplace of Düsseldorf had rejected, allegedly for anti-Semitic motives, a centennial monument to the radical German-Jewish poet (1797–1856), his incensed German-American admirers, including Carl Schurz, started a movement to place one instead in Midtown Manhattan, at Fifth Avenue and 59th Street. However, this intention was thwarted by a combination of ethnic antagonism, aesthetic controversy and political struggles over the institutional control of public art. In 1899, the memorial, by the Berlin sculptor Ernst Gustav Herter (1846–1917), finally came to rest, although subject to repeated vandalism, in the Bronx, at 164th Street and the Grand Concourse, or Joyce Kilmer Park near today's Yankee Stadium. (In 1999, it was moved to 161st Street and the Concourse.) In 2007, Christopher Gray of ''The New York Times'' described it as "a writhing composition in white Tyrolean marble depicting Lorelei, the mythical German figure, surrounded by mermaids, dolphins and seashells."

One national landmark in the Bronx is the Hall of Fame for Great Americans, overlooking the Harlem River and designed by the renowned architect Stanford White. The never–landmarked Yankee Stadium, the "House that Ruth Built" and home to the New York Yankees since 1923, has been replaced with a similar-looking ballpark just across 161st Street.

The peninsular borough's maritime heritage is acknowledged in several ways.The City Island Historical Society and Nautical Museum occupies a former public school designed by the New York City school system's turn-of-the-last-century master architect C. B. J. Snyder. The state's Maritime College in Fort Schuyler (on the southeastern shore) houses the Maritime Industry Museum. In addition, the Harlem River is reemerging as "Scullers' Row" due in large part to the efforts of the Bronx River Restoration Project , a joint public-private endeavor of the city's parks department. Canoeing and kayaking on the borough's namesake river have been promoted by the Bronx River Alliance. The river is also straddled by the New York Botanical Gardens, its neighbor, the Bronx Zoo, and a little further south, on the west shore, Bronx River Art Center.

The press and broadcasting

Newspapers The Bronx has several local newspapers, including ''The Bronx News'' , ''Parkchester News'', ''City News'', ''The Riverdale Press'', ''Riverdale Review'', ''The Bronx Times Reporter'', ''Inner City Press'' (which now has more of a focus on national issues) and ''Co-Op City Times''. Four non-profit news outlets, ''Norwood News'', ''Mount Hope Monitor'', ''Mott Haven Herald'' and ''The Hunts Point Express'' serve the borough's poorer communities. The editor and co-publisher of ''The Riverdale Press'', Bernard Stein, won the Pulitzer Prize for editorial writing for his editorials about Bronx and New York City issues in 1998. (Stein graduated from the Bronx High School of Science in 1959.)

The Bronx once had its own daily newspaper, ''The Bronx Home News'', which started publishing on January 20, 1907 and merged into the ''New York Post'' in 1948. It became a special section of the Post, sold only in the Bronx, and eventually disappeared from view.

Radio and television One of New York City's major non-commercial radio broadcasters is WFUV, an National Public Radio–affiliated 50,000-watt station broadcasting from Fordham University's Rose Hill campus in the Bronx. The radio station's antenna is atop an apartment building owned by Montefiore Medical Center.

The City of New York has an official television station run by the NYC Media Group and broadcasting from Bronx Community College, and Cablevision operates News 12 The Bronx, both of which feature programming based in the Bronx. Co-op City was the first area in the Bronx, and the first in New York beyond Manhattan, to have its own cable television provider. The local Public-access television station BronxNet provides Government-access television (GATV) public affairs programming in addition to programming produced by Bronx residents.

Screen, literature and song

On screen (film and television)

Middle 20th century movies set in the Bronx portrayed densely-settled, working-class, urban culture. Hollywood films such as ''From This Day Forward'' (1946), set in Highbridge, occasionally delved into Bronx life. Paddy Chayefsky's Academy Award-winning ''Marty'' was the most notable examination of working class Bronx life was also explored by Chayefsky in his 1956 film ''The Catered Affair'', and in the 1993 Robert De Niro/Chazz Palminteri film, ''A Bronx Tale'', Spike Lee's 1999 movie ''Summer of Sam'', centered in an Italian-American Bronx community, 1994's ''I Like It Like That'' that takes place in the predominately Puerto Rican neighborhood of the South Bronx, and ''Doughboys'', the story of two Italian-American brothers in danger of losing their bakery thanks to one brother's gambling debts.

The Bronx's gritty urban life had worked its way into the movies even earlier, with depictions of the "Bronx cheer", a loud flatulent-like sound of disapproval, allegedly first made by New York Yankees fans. The sound can be heard, for example, when Spike Jones sings "Der Fuehrer's Face" (from the 1942 Disney animated film of the same name), repeatedly lambasting Adolf Hitler with: "We'll Heil! (Bronx cheer) Heil! (Bronx cheer) Right in Der Fuehrer's Face!"

Other movies have also used the term ''Bronx'' for comic effect, such as "Bronx", the character on the Disney animated series ''Gargoyles''.

Starting in the 1970s, the Bronx often symbolized violence, decay, and urban ruin. The wave of arson in the South Bronx in the 1960s and 1970s inspired the observation that "The Bronx is burning": in 1974 it was the title of both a New York Times editorial and a BBC documentary film. The line entered the pop-consciousness with Game Two of the 1977 World Series, when a fire broke out near Yankee Stadium as the team was playing the Los Angeles Dodgers. Numerous fires had previously broken out in the Bronx prior to this fire. As the fire was captured on live television, announcer Howard Cosell stated, "There it is, ladies and gentlemen: the Bronx is burning". Historians of New York City frequently point to Cosell's remark as an acknowledgement of both the city and the borough's decline. A new feature-length documentary film by Edwin Pagan called ''Bronx Burning'' is in production in 2006, chronicling what led up to the numerous arson-for-insurance fraud fires of the 1970s in the borough.

Bronx gang life was depicted in the 1974 novel ''The Wanderers'' by Bronx native Richard Price and the 1979 movie of the same name. They are set in the heart of the Bronx, showing apartment life and the then-landmark Krums ice cream parlor. In the 1979 film ''The Warriors'', the eponymous gang go to a meeting in Van Cortlandt Park in the Bronx, and have to fight their way out of the borough and get back to Coney Island in Brooklyn. The 2005 video game adaptation features levels called Pelham, Tremont, and "Gunhill" (a play off the name Gun Hill Road).

This theme lends itself to the title of ''The Bronx Is Burning'', an eight-part ESPN TV mini-series (2007) about the New York Yankees' drive to winning baseball's 1977 World Series. The TV series emphasizes the boisterous nature of the team, led by manager Billy Martin, catcher Thurman Munson and outfielder Reggie Jackson, as well as the malaise of the Bronx and New York City in general during that time, such as the blackout, the city's serious financial woes and near bankruptcy, the arson for insurance payments, and the election of Ed Koch as mayor.

The 1981 film ''Fort Apache, The Bronx'' is another film that used the Bronx's gritty image for its storyline. The movie's title is from the nickname for the 41st Police Precinct in the South Bronx which was nicknamed "Fort Apache". Also from 1981 is the horror film ''Wolfen'' making use of the rubble of the Bronx as a home for werewolf type creatures. ''Knights of the South Bronx'', a true story of a teacher who worked with disadvantaged children, is another film also set in the Bronx released in 2005.

The Bronx was the setting for the 1983 film ''Fuga dal Bronx'', also known as ''Bronx Warriors 2'' and ''Escape 2000'', an Italian B-movie best known for its appearance on the television series Mystery Science Theatre 3000. The plot revolves around a sinister construction corporation's plans to depopulate, destroy and redevelop the Bronx, and a band of rebels who are out to expose the corporation's murderous ways and save their homes. The film is memorable for its almost incessant use of the phrase, "Leave the Bronx!" Many of the movie's scenes were filmed in Queens, substituting as the Bronx.

Bronx born and reared Nancy Savoca's 1989 comedy ''True Love'', explores two Italian-American Bronx sweethearts in the days before their wedding. The film, which debuted Annabella Sciorra and Ron Eldard as the betrothed couple, won the Grand Jury Prize at that year's Sundance Film Festival.

The CBS television sitcom ''Becker'', 1998–2004, was more ambiguous. The show starred Ted Danson as Dr. John Becker, a doctor who operated a small practice and was constantly annoyed by his patients, co-workers, friends, and practically everything and everybody else in his world. It showed his everyday life as a doctor working in a small clinic in the Bronx.

Penny Marshall's 1990 film ''Awakenings'', which was nominated for several Oscars, is based on neurologist Oliver Sacks' 1973 account of his psychiatric patients at Beth Abraham Hospital in the Bronx who were paralyzed by a form of encephalitis but briefly responded to the drug L-dopa. Robin Williams played the physician; Robert De Niro was one of the patients who emerged from a catatonic (frozen) state. The home of Williams' character was shot not far from Sacks' actual City Island residence. A 1973 Yorkshire Television documentary and "A Kind of Alaska", a 1985 play by Harold Pinter, were also based on Sacks' book.

Gus Van Sant's 2000 ''Finding Forrester'' was quickly billed "Good Will Hunting in the Hood." Sean Connery is in the title role of a reclusive old man who 50 years earlier wrote a single novel that garnered the Pulitzer Prize. He meets 16 year old Jamal – actor Rob Brown – a gifted, Bronx reared basketball player and aspiring writer, and becomes his mentor. The movie includes stock footage of Bronx housing projects from 1990, as well as some other scenes shot in Manhattan and Brooklyn.

In literature

The Bronx has been featured significantly in fiction literature. All of the characters in Herman Wouk's City Boy: The Adventures of Herbie Bookbinder (1948) live in the Bronx, and about half of the action is set there. Kate Simon's ''Bronx Primitive: Portraits of a Childhood'' is directly autobiographical, a warm account of a Polish-Jewish girl in an immigrant family growing up before World War II, and living near Arthur Avenue and Tremont Avenue. In Jacob M. Appel's short story, "The Grand Concourse" (2007), a woman who grew up the in the iconic Lewis Morris Building returns to the Morrisania neighborhood with her adult daughter. Similarly, in Avery Corman's book ''The Old Neighborhood'' (1980), an upper-middle class white protagonist returns to his birth neighborhood (Fordham Road and the Grand Concourse), and learns that even though the folks are poor, Hispanic and African-American, they are good people.

By contrast, Tom Wolfe's ''Bonfire of the Vanities'' (1987) portrays a wealthy, white protagonist, Sherman McCoy, getting lost off the Major Deegan Expressway in the South Bronx and having an altercation with locals. A substantial piece of the last part of the book is set in the resulting riotous trial at the Bronx County Court House. However, times change, and in 2007, the ''New York Times'' reported that "the Bronx neighborhoods near the site of Sherman's accident are now dotted with townhouses and apartments." In the same article, the Reverend Al Sharpton (whose fictional analogue in the novel is "Reverend Bacon") asserts that "twenty years later, the cynicism of ''The Bonfire of the Vanities'' is as out of style as Tom Wolfe's wardrobe."

Don DeLillo's ''Underworld'' (1997) is also set in the Bronx and offers a perspective on the decline of the area from the 1950s onwards. John Patrick Shanley's "Savage in Limbo" is set in a 1980s Bronx bar called 'Scales' where the frustrated characters feel they are unable to move.

In poetry, the Bronx has been immortalized by one of the world's shortest couplets: : The Bronx : No Thonx :: Ogden Nash, ''The New Yorker'', 1931

Nash repented 33 years after his calumny, penning in 1964 the following prose poem to the Dean of Bronx Community College: :I can't seem to escape :the sins of my smart-alec youth; :Here are my amends. :I wrote those lines, "The Bronx? :No thonx"; :I shudder to confess them. :Now I'm an older, wiser man :I cry, "The Bronx? God :bless them!"

In song

''Passing through:'' The theme song to the 1960s U.S. television comedy series ''Car 54, Where Are You?'' begins "There's a holdup in the Bronx." And the song "New York, New York" (by Betty Comden and Adolph Green from the 1940s musical comedy and film, "On the Town") explains that "The Bronx is up and the Battery's down." Another song, "Manhattan" (by Richard Rodgers and Lorenz Hart for the 1925 musical "Garrick Gaieties"), declares "We'll have Manhattan,/The Bronx and Staten/Island too./It's lovely going through/the zoo."

''Bronx Local:'' While hundreds of songs about New York City, Manhattan and Brooklyn can be found in Wikipedia's List of songs about New York City and also in Marc Ferris's 5-page, 15-column list of "Songs and Compositions Inspired by New York City" in ''The Encyclopedia of New York City'' (1995), only a handful refer to the Bronx.

Ferris's extensive but selective 1995 list mentions only four songs referring specifically to the Bronx:

"On the Banks of the Bronx" (1919), William LeBaron, Victor Jacobi

"Bronx Express" (1922), Creamer and Layton

"The Tremont Avenue Cruisewear Fashion Show" (1973), Jerry Livingston, Mark David

"I Love the New York Yankees" (1987), Paula Lindstrom

But Wikipedia's own list also currently mentions:

"Alfie From The Bronx" by The Toy Dolls

"Back To The Bronx" by 2 Live Crew

"Boogie Down Bronx" by JVC Force

"Bronx" by Kurtis Blow

"The Bronx" by Regina Spektor

"Bronx Backyard" by The Johnny Seven Band

"The Bronx Is Beautiful" by Robert Klein

"Bronx Keeps Creating It" by Fat Joe

"Bronx Tale" by Fat Joe

"Bronx War Stories" by A.I.G.

"Cousin in The Bronx" by Kaiser Chiefs

"Cross Bronx Expressway" by Lord Tariq and Peter Gunz

"Deja Vu (Uptown Baby)" by Lord Tariq & Peter Gunz

"Ha Ya Doin? Yankees" – The Haya Doin'? Boys

"Here Come the Yankees", by Bob Bundin and Lou Stallman

"Jenny From The Block" by Jennifer Lopez featuring Styles P & Jadakiss

"On The Streets Of The Bronx" by The Moonglows

"Our Lady of the Bronx" by Black 47

"Rockin' the Bronx" by Black 47

"South Bronx" by Boogie Down Productions

See also

Bronx gangs (1950s-1960s)

Bronx cheer (gesture)

Bronx Bombers

Joseph P. Day, early land auctioneer

List of people from the Bronx

List of counties in New York

National Register of Historic Places listings in Bronx County, New York

References

Further reading

Barrows, Edward, and Mike Wallace. ''Gotham: A History of New York City to 1898'' (1999)

Baver, Sherrie L. "Development of New York's Puerto Rican Community", ''Bronx County Historical Society Journal'' 1988 25(1): 1–9

Briggs, Xavier de Souza, Anita Miller and John Shapiro. 1996. "CCRP in the South Bronx." Planners' Casebook, Winter.

de Kadt, Maarten. ''The Bronx River: An Environmental and Social History.'' The History Press (2011)

DiBrino, Nicholas. ''The History of the Morris Park Racecourse and the Morris Family'' (1977)

Federal Writers' Project. ''New York City Guide: A Comprehensive Guide to the Five Boroughs of the Metropolis: Manhattan, Brooklyn, the Bronx, Queens, and Richmond'' (1939) online edition

Gonzalez, Evelyn. ''The Bronx''. (Columbia University Press, 2004. 263 ISBN 0–231-12114-8), scholarly history focused on the slums of the South Bronx online edition

Goodman, Sam. "The Golden Ghetto: The Grand Concourse in the Twentieth Century", ''Bronx County Historical Society Journal'' 2004 41(1): 4–18 and 2005 42(2): 80–99

Jackson, Kenneth T., ed. ''The Encyclopedia of New York City'', (Yale University Press and The New-York Historical Society, (1995) ISBN 0-300-05536-6), has entries, maps, illustrations, statistics and bibliographic references on almost all of the significant topics in this article, from the entire borough to individual neighborhoods, people, events and artistic works.

Jonnes, Jull. ''South Bronx Rising: The Rise, Fall, and Resurrection of an American City'' (2002) online edition

McNamara, John ''History In Asphalt: The Origin of Bronx Street and Place Names'' (1993) ISBN 0941980162

McNamara, John ''McNamara's Old Bronx'' (1989) ISBN 0941980251

Olmsted, Robert A. "A History of Transportation in the Bronx", ''Bronx County Historical Society Journal'' 1989 26(2): 68–91

Olmsted, Robert A. "Transportation Made the Bronx", ''Bronx County Historical Society Journal'' 1998 35(2): 166–180

Rodríguez, Clara E. ''Puerto Ricans: Born in the U.S.A'' (1991) online edition

Samtur, Stephen M. and Martin A. Jackson. ''The Bronx: Lost, Found, and Remembered, 1935–1975'' (1999) online review, nostalgia

Twomey, Bill and Casey, Thomas ''Images of America Series: Northwest Bronx'' (2011)

Twomey, Bill and McNamara, John. ''Throggs Neck Memories'' (1993)

Twomey, Bill and McNamara, John. ''Images of America Series: Throggs Neck-Pelham Bay'' (1998)

Twomey, Bill and Moussot, Peter. ''Throggs Neck'' (1983), pictorial

Twomey, Bill. ''Images of America Series: East Bronx'' (1999)

Twomey, Bill. ''Images of America Series: South Bronx'' (2002)

Twomey, Bill. ''The Bronx in Bits and Pieces'' (2007)

Ultan, Lloyd. ''The Northern Borough: A History Of The Bronx'' (2009), popular general history

Ultan, Lloyd. ''The Bronx in the frontier era: from the beginning to 1696'' (1994)

Ultan, Lloyd. ''The Beautiful Bronx (1920–1950)'' (1979), heavily illustrated

Ultan, Lloyd. ''The Birth of the Bronx, 1609–1900'' (2000), popular

Ultan, Lloyd. ''The Bronx in the Innocent years, 1890–1925'' (1985), popular

Ultan, Lloyd. ''The Bronx: It Was Only Yesterday, "The Bronx: It Was Only Yesterday 1935–1965'' (1992), heavily illustrated popular history

External links

General links

Bronx Borough President's Office

The Bronx Times

Weekly Bronx Report from Inner City Press

The Bronx River Alliance

Bronx Council for Environmental Quality

Bronx Business Directory

Places in the Bronx

The Bronx Museum of the Arts

The Bronx Zoo

The New York Botanical Garden

Bronx River Art Center

Wave Hill: New York Public Garden and Cultural Center

Walking tour of the Grand Concourse Boulevard-Cross Bronx Expressway area

Walk in the Bronx

Yankee Stadium

Bronx history

East Bronx History Forum

Museum of Bronx History

The Bronx County Historical Society

The Bronx: A Swedish Connection

Report of the Bronx Parkway Commission, December 31, 1918, retrieved on July 24, 2008

Remembrance of Synagogues Past: The Lost Civilization of the Jewish South Bronx by Seymour Perlin, retrieved on August 10, 2008

Forgotten New York: Relics of a Rich History in the Everyday Life of New York City

Bronx Nostalgia, photos, narratives, personal accounts, school alumni, videos

The Bronx today

The South Bronx Overall Economic Development Corporation, retrieved on August 15, 2008

Melancholy in the Bronx, but Not Because of the Stadium by David Gonzales, ''The New York Times'', published and retrieved on September 19, 2008

Category:County seats in New York Category:Boroughs of New York City Category:Populated places established in 1639 Category:Populated places in the United States with Hispanic majority populations Category:West Indian communities in the United States

ar:برونكس bn:ব্রঙ্ক্‌স zh-min-nan:Bronx be:Бронкс bs:The Bronx bg:Бронкс ca:Bronx cs:Bronx da:Bronx de:Bronx et:Bronx el:Μπρονξ es:Bronx eo:Bronkso eu:Bronx fa:برانکس fr:Bronx fy:Bronx ga:An Bronx gl:Bronx ko:브롱크스 hr:Bronx, New York bpy:ব্রঙ্কস কাউন্টি, নিউ ইয়র্ক id:Bronx is:Bronx it:Bronx he:הברונקס ka:ბრონქსი sw:The Bronx la:Bronx lv:Bronksa lt:Bronksas hu:Bronx mr:द ब्राँक्स na:The Bronx nl:The Bronx ja:ブロンクス区 no:The Bronx pnb:برونکس کاؤنٹی nds:Bronx County pl:Bronx pt:Bronx ro:The Bronx ru:Бронкс sq:Bronx simple:The Bronx sk:Bronx sl:Bronx sr:Бронкс sh:Bronx fi:Bronx sv:Bronx tl:The Bronx th:เดอะบร็องซ์ uk:Бронкс vi:The Bronx war:An Bronx yi:בראנקס zh:布朗克斯

name	Myocardial infarction
diseasesdb	8664
icd10	-
icd9
medlineplus	000195
emedicinesubj	med
emedicinetopic	1567
emedicine mult
meshid	D009203 }}

Myocardial infarction (MI) or acute myocardial infarction (AMI), commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die. This is most commonly due to occlusion (blockage) of a coronary artery following the rupture of a vulnerable atherosclerotic plaque, which is an unstable collection of lipids (cholesterol and fatty acids) and white blood cells (especially macrophages) in the wall of an artery. The resulting ischemia (restriction in blood supply) and ensuing oxygen shortage, if left untreated for a sufficient period of time, can cause damage or death (''infarction'') of heart muscle tissue (''myocardium'').

Classical symptoms of acute myocardial infarction include sudden chest pain (typically radiating to the left arm or left side of the neck), shortness of breath, nausea, vomiting, palpitations, sweating, and anxiety (often described as a sense of impending doom). Women may experience fewer typical symptoms than men, most commonly shortness of breath, weakness, a feeling of indigestion, and fatigue. Approximately one-quarter of all myocardial infarctions are "silent", that is without chest pain or other symptoms.

Among the diagnostic tests available to detect heart muscle damage are an electrocardiogram (ECG), echocardiography, cardiac MRI and various blood tests. The most often used blood markers are the creatine kinase-MB (CK-MB) fraction and the troponin levels. Immediate treatment for suspected acute myocardial infarction includes oxygen, aspirin, and sublingual nitroglycerin.

Most cases of STEMI (ST elevation MI) are treated with thrombolysis or percutaneous coronary intervention (PCI). NSTEMI (non-ST elevation MI) should be managed with medication, although PCI is often performed during hospital admission. In people who have multiple blockages and who are relatively stable, or in a few emergency cases, bypass surgery may be an option, especially in diabetics.

Ischemic heart disease (which includes myocardial infarction, angina pectoris and heart failure when preceded by myocardial infarction) was the leading cause of death for both men and women worldwide in 2004. Important risk factors are previous cardiovascular disease, older age, tobacco smoking, high blood levels of certain lipids (triglycerides, low-density lipoprotein) and low levels of high density lipoprotein (HDL), diabetes, high blood pressure, obesity, chronic kidney disease, heart failure, excessive alcohol consumption, the abuse of certain drugs (such as cocaine and methamphetamine), and chronic high stress levels.

Classification

There are two basic types of acute myocardial infarction: Transmural: associated with atherosclerosis involving major coronary artery. It can be subclassified into anterior, posterior, inferior, lateral or septal. Transmural infarcts extend through the whole thickness of the heart muscle and are usually a result of complete occlusion of the area's blood supply. Subendocardial: involving a small area in the subendocardial wall of the left ventricle, ventricular septum, or papillary muscles. The subendocardial area is particularly susceptible to ischemia.

In the clinical context, a myocardial infarction can be further subclassified into a ST elevation MI (STEMI) versus a non-ST elevation MI (non-STEMI) based on ECG changes.

The phrase ''heart attack'' is sometimes used incorrectly to describe sudden cardiac death, which may or may not be the result of acute myocardial infarction. A heart attack is different from, but can be the cause of cardiac arrest, which is the stopping of the heartbeat, and cardiac arrhythmia, an abnormal heartbeat. It is also distinct from heart failure, in which the pumping action of the heart is impaired; however severe myocardial infarction may lead to heart failure.

A 2007 consensus document classifies myocardial infarction into five main types:

Type 1 – Spontaneous myocardial infarction related to ischaemia due to a primary coronary event such as plaque erosion and/or rupture, fissuring, or dissection

Type 2 – Myocardial infarction secondary to ischaemia due to either increased oxygen demand or decreased supply, e.g. coronary artery spasm, coronary embolism, anaemia, arrhythmias, hypertension, or hypotension

Type 3 – Sudden unexpected cardiac death, including cardiac arrest, often with symptoms suggestive of myocardial ischaemia, accompanied by new ST elevation, or new LBBB, or evidence of fresh thrombus in a coronary artery by angiography and/or at autopsy, but death occurring before blood samples could be obtained, or at a time before the appearance of cardiac biomarkers in the blood

Type 4 – Associated with coronary angioplasty or stents:

* Type 4a – Myocardial infarction associated with PCI

* Type 4b – Myocardial infarction associated with stent thrombosis as documented by angiography or at autopsy

Type 5 – Myocardial infarction associated with CABG

Signs and symptoms

The onset of symptoms in myocardial infarction (MI) is usually gradual, over several minutes, and rarely instantaneous. Chest pain is the most common symptom of acute myocardial infarction and is often described as a sensation of tightness, pressure, or squeezing. Chest pain due to ischemia (a lack of blood and hence oxygen supply) of the heart muscle is termed angina pectoris. Pain radiates most often to the left arm, but may also radiate to the lower jaw, neck, right arm, back, and epigastrium, where it may mimic heartburn. Levine's sign, in which the patient localizes the chest pain by clenching their fist over the sternum, has classically been thought to be predictive of cardiac chest pain, although a prospective observational study showed that it had a poor positive predictive value.

Shortness of breath (dyspnea) occurs when the damage to the heart limits the output of the left ventricle, causing left ventricular failure and consequent pulmonary edema. Other symptoms include diaphoresis (an excessive form of sweating), weakness, light-headedness, nausea, vomiting, and palpitations. These symptoms are likely induced by a massive surge of catecholamines from the sympathetic nervous system which occurs in response to pain and the hemodynamic abnormalities that result from cardiac dysfunction. Loss of consciousness (due to inadequate cerebral perfusion and cardiogenic shock) and sudden death (frequently due to the development of ventricular fibrillation) can occur in myocardial infarctions.

Women and older patients report atypical symptoms more frequently than their male and younger counterparts. Women also report more numerous symptoms compared with men (2.6 on average vs 1.8 symptoms in men). The most common symptoms of MI in women include dyspnea (shortness of breath), weakness, and fatigue. Fatigue, sleep disturbances, and dyspnea have been reported as frequently occurring symptoms that may manifest as long as one month before the actual clinically manifested ischemic event. In women, chest pain may be less predictive of coronary ischemia than in men.

Approximately one-fourth of all myocardial infarctions are silent, without chest pain or other symptoms. These cases can be discovered later on electrocardiograms, using blood enzyme tests or at autopsy without a prior history of related complaints. A silent course is more common in the elderly, in patients with diabetes mellitus and after heart transplantation, probably because the donor heart is not fully innervated by the nervous system of the recipient. In diabetics, differences in pain threshold, autonomic neuropathy, and psychological factors have been cited as possible explanations for the lack of symptoms.

Any group of symptoms compatible with a sudden interruption of the blood flow to the heart are called an acute coronary syndrome.

The differential diagnosis includes other catastrophic causes of chest pain, such as pulmonary embolism, aortic dissection, pericardial effusion causing cardiac tamponade, tension pneumothorax, and esophageal rupture. Other non-catastrophic differentials include gastroesophageal reflux and Tietze's syndrome.

Causes

Heart attack rates are higher in association with intense exertion, be it psychological stress or physical exertion, especially if the exertion is more intense than the individual usually performs. The period of intense exercise and subsequent recovery is associated with about a 6-fold higher myocardial infarction rate (compared with other more relaxed time frames) for people who are physically very fit. For those in poor physical condition, the rate differential is over 35-fold higher. One observed mechanism for this phenomenon is the increased arterial pulse pressure stretching and relaxation of arteries with each heart beat, which, as has been observed with intravascular ultrasound, increases mechanical "shear stress" on atheromas and the likelihood of plaque rupture.

Acute severe infection, such as pneumonia, can trigger myocardial infarction. A more controversial link is that between ''Chlamydophila pneumoniae'' infection and atherosclerosis. While this intracellular organism has been demonstrated in atherosclerotic plaques, evidence is inconclusive as to whether it can be considered a causative factor. Treatment with antibiotics in patients with proven atherosclerosis has not demonstrated a decreased risk of heart attacks or other coronary vascular diseases.

There is an association of an increased incidence of a heart attack in the morning hours, more specifically around 9 a.m. Some investigators have noticed that the ability of platelets to aggregate varies according to a circadian rhythm, although they have not proven causation.

Risk factors

In general, risk factors for atherosclerosis are risk factors for myocardial infarction:

Age — Men acquire an independent risk factor at age 45, Women acquire an independent risk factor at age 55; in addition, individuals acquire another independent risk factor if they have a first-degree male relative (brother, father) who suffered a coronary vascular event at or before age 55. Another independent risk factor is acquired if one has a first-degree female relative (mother, sister) who suffered a coronary vascular event at age 65 or younger.

Males are more at risk than females.

Diabetes (with or without insulin resistance)

High blood pressure

Dyslipidemia/hypercholesterolemia (abnormal levels of lipoproteins in the blood), particularly high low-density lipoprotein, low high-density lipoprotein and high Triglycerides

Tobacco smoking including secondhand smoke

Air pollution

Family history of ischaemic heart disease (IHD)

Obesity (defined by a body mass index of more than 30 kg/m², or alternatively by waist circumference or waist-hip ratio).

Hyperhomocysteinemia (high homocysteine)

Stress — Occupations with high stress index are known to have susceptibility for atherosclerosis

Alcohol — Studies show that prolonged exposure to high quantities of alcohol can increase the risk of heart attack

Many of these risk factors are modifiable, so many heart attacks can be prevented by maintaining a healthier lifestyle. Physical activity, for example, is associated with a lower risk profile. Non-modifiable risk factors include age, sex, and family history of an early heart attack (before the age of 60), which is thought of as reflecting a genetic predisposition.

Socioeconomic factors such as a shorter education and lower income (particularly in women), and unmarried cohabitation are also correlated with a higher risk of MI. To understand epidemiological study results, it is important to note that many factors associated with MI mediate their risk via other factors. For example, the effect of education is partially based on its effect on income and marital status.

Women who use combined oral contraceptive pills have a modestly increased risk of myocardial infarction, especially in the presence of other risk factors, such as smoking.

Inflammation is known to be an important step in the process of atherosclerotic plaque formation. C-reactive protein (CRP) is a sensitive but non-specific marker for inflammation. Elevated CRP blood levels, especially measured with high-sensitivity assays, can predict the risk of MI, as well as stroke and development of diabetes. Moreover, some drugs for MI might also reduce CRP levels. The use of high-sensitivity CRP assays as a means of screening the general population is advised against, but it may be used optionally at the physician's discretion in patients who already present with other risk factors or known coronary artery disease. Whether CRP plays a direct role in atherosclerosis remains uncertain.

Inflammation in periodontal disease may be linked to coronary heart disease, and, since periodontitis is very common, this could have great consequences for public health. Serological studies measuring antibody levels against typical periodontitis-causing bacteria found that such antibodies were more present in subjects with coronary heart disease. Periodontitis tends to increase blood levels of CRP, fibrinogen and cytokines; thus, periodontitis may mediate its effect on MI risk via other risk factors. Preclinical research suggests that periodontal bacteria can promote aggregation of platelets and promote the formation of foam cells. A role for specific periodontal bacteria has been suggested but remains to be established. There is some evidence that influenza may trigger an acute myocardial infarction.

Baldness, hair greying, a diagonal earlobe crease (Frank's sign) and possibly other skin features have been suggested as independent risk factors for MI. Their role remains controversial; a common denominator of these signs and the risk of MI is supposed, possibly genetic.

Calcium deposition is another part of atherosclerotic plaque formation. Calcium deposits in the coronary arteries can be detected with CT scans. Several studies have shown that coronary calcium can provide predictive information beyond that of classical risk factors.

The European Society of Cardiology and the European Association for Cardiovascular Prevention and Rehabilitation have developed an interactive tool for prediction and managing the risk of heart attack and stroke in Europe. HeartScore is aimed at supporting clinicians in optimising individual cardiovascular risk reduction. The Heartscore Programme is available in 12 languages and offers web-based or PC version.

Pathophysiology

Acute myocardial infarction refers to two subtypes of acute coronary syndrome, namely non-ST-elevated myocardial infarction and ST-elevated myocardial infarction, which are most frequently (but not always) a manifestation of coronary artery disease. The most common triggering event is the disruption of an atherosclerotic plaque in an epicardial coronary artery, which leads to a clotting cascade, sometimes resulting in total occlusion of the artery. Atherosclerosis is the gradual buildup of cholesterol and fibrous tissue in plaques in the wall of arteries (in this case, the coronary arteries), typically over decades. Blood stream column irregularities visible on angiography reflect artery lumen narrowing as a result of decades of advancing atherosclerosis. Plaques can become unstable, rupture, and additionally promote a thrombus (blood clot) that occludes the artery; this can occur in minutes. When a severe enough plaque rupture occurs in the coronary vasculature, it leads to myocardial infarction (necrosis of downstream myocardium).

If impaired blood flow to the heart lasts long enough, it triggers a process called the ischemic cascade; the heart cells in the territory of the occluded coronary artery die (chiefly through necrosis) and do not grow back. A collagen scar forms in its place. Recent studies indicate that another form of cell death called apoptosis also plays a role in the process of tissue damage subsequent to myocardial infarction. As a result, the patient's heart will be permanently damaged. This myocardial scarring also puts the patient at risk for potentially life threatening arrhythmias, and may result in the formation of a ventricular aneurysm that can rupture with catastrophic consequences.

Injured heart tissue conducts electrical impulses more slowly than normal heart tissue. The difference in conduction velocity between injured and uninjured tissue can trigger re-entry or a feedback loop that is believed to be the cause of many lethal arrhythmias. The most serious of these arrhythmias is ventricular fibrillation (''V-Fib''/VF), an extremely fast and chaotic heart rhythm that is the leading cause of sudden cardiac death. Another life-threatening arrhythmia is ventricular tachycardia (''V-Tach''/VT), which may or may not cause sudden cardiac death. However, ventricular tachycardia usually results in rapid heart rates that prevent the heart from pumping blood effectively. Cardiac output and blood pressure may fall to dangerous levels, which can lead to further coronary ischemia and extension of the infarct.

The cardiac defibrillator is a device that was specifically designed to terminate these potentially fatal arrhythmias. The device works by delivering an electrical shock to the patient in order to depolarize a critical mass of the heart muscle, in effect "rebooting" the heart. This therapy is time dependent, and the odds of successful defibrillation decline rapidly after the onset of cardiopulmonary arrest.

Diagnosis

The diagnosis of myocardial infarction can be made after assessing patient's complaints and physical status. ECG changes, coronary angiogram and levels of cardiac markers help to confirm the diagnosis. ECG gives valuable clues to identify the site of myocardial damage while coronary angiogram allows visualization of narrowing or obstructions in the heart vessels. At autopsy, a pathologist can diagnose a myocardial infarction based on anatomopathological findings.

A chest radiograph and routine blood tests may indicate complications or precipitating causes and are often performed upon arrival to an emergency department. New regional wall motion abnormalities on an echocardiogram are also suggestive of a myocardial infarction. Echo may be performed in equivocal cases by the on-call cardiologist. In stable patients whose symptoms have resolved by the time of evaluation, Technetium (99mTc) sestamibi (i.e. a "MIBI scan") or thallium-201 chloride can be used in nuclear medicine to visualize areas of reduced blood flow in conjunction with physiologic or pharmocologic stress. Thallium may also be used to determine viability of tissue, distinguishing whether non-functional myocardium is actually dead or merely in a state of hibernation or of being stunned.

WHO criteria formulated in 1979 have classically been used to diagnose MI; a patient is diagnosed with myocardial infarction if two (probable) or three (definite) of the following criteria are satisfied: # Clinical history of ischaemic type chest pain lasting for more than 20 minutes # Changes in serial ECG tracings # Rise and fall of serum cardiac biomarkers such as creatine kinase-MB fraction and troponin

The WHO criteria were refined in 2000 to give more prominence to cardiac biomarkers. According to the new guidelines, a cardiac troponin rise accompanied by either typical symptoms, pathological Q waves, ST elevation or depression, or coronary intervention is diagnostic of MI.

Prevention

The risk of a recurrent myocardial infarction decreases with strict blood pressure management and lifestyle changes, chiefly smoking cessation, regular exercise, a sensible diet for those with heart disease, and limitation of alcohol intake. People are usually commenced on several long-term medications post-MI, with the aim of preventing secondary cardiovascular events such as further myocardial infarctions, congestive heart failure or cerebrovascular accident (CVA). Unless contraindicated, such medications may include:

Antiplatelet drug therapy such as aspirin and/or clopidogrel should be continued to reduce the risk of plaque rupture and recurrent myocardial infarction. Aspirin is first-line, owing to its low cost and comparable efficacy, with clopidogrel reserved for patients intolerant of aspirin. The combination of clopidogrel and aspirin may further reduce risk of cardiovascular events, however the risk of hemorrhage is increased. Beta blocker therapy such as metoprolol or carvedilol should be commenced. These have been particularly beneficial in high-risk patients such as those with left ventricular dysfunction and/or continuing cardiac ischaemia. β-Blockers decrease mortality and morbidity. They also improve symptoms of cardiac ischemia in NSTEMI. ACE inhibitor therapy should be commenced 24–48 hours post-MI in hemodynamically-stable patients, particularly in patients with a history of MI, diabetes mellitus, hypertension, anterior location of infarct (as assessed by ECG), and/or evidence of left ventricular dysfunction. ACE inhibitors reduce mortality, the development of heart failure, and decrease ventricular remodelling post-MI. Statin therapy has been shown to reduce mortality and morbidity post-MI. The effects of statins may be more than their LDL lowering effects. The general consensus is that statins have plaque stabilization and multiple other ("pleiotropic") effects that may prevent myocardial infarction in addition to their effects on blood lipids. The aldosterone antagonist agent eplerenone has been shown to further reduce risk of cardiovascular death post-MI in patients with heart failure and left ventricular dysfunction, when used in conjunction with standard therapies above. Spironolactone is another option that is sometimes preferable to eplerenone due to cost. Evidence supports the consumption of polyunsaturated fats instead of saturated fats as a measure of decreasing coronary heart disease. Omega-3 fatty acids, commonly found in fish, have been shown to reduce mortality post-MI. While the mechanism by which these fatty acids decrease mortality is unknown, it has been postulated that the survival benefit is due to electrical stabilization and the prevention of ventricular fibrillation. However, further studies in a high-risk subset have not shown a clear-cut decrease in potentially fatal arrhythmias due to omega-3 fatty acids.

Blood donation may reduce the risk of heart disease for men, but the link has not been firmly established.

A Cochrane review found that giving heparin to people with heart conditions like unstable angina and some forms of heart attacks reduces the risk of having another heart attack. However, heparin also increases the chance of suffering from minor bleeding.

Management

An MI is a medical emergency that requires immediate medical attention. Treatment attempts to salvage as much myocardium as possible and to prevent further complications, hence the phrase "time is muscle". Oxygen, aspirin, and nitroglycerin may be administered. Morphine was classically used if nitroglycerin was not effective; however, it may increase mortality in the setting of NSTEMI. A 2009 and 2010 review of high flow oxygen in myocardial infarction found increased mortality and infarct size, calling into question the recommendation about its routine use. Other analgesics such as nitrous oxide are of unknown benefit. Percutaneous coronary intervention (PCI) or fibrinolysis are recommended in those with an STEMI.

Prognosis

The prognosis post myocardial infarction varies greatly, depending on a person's health, the extent of the heart damage and the treatment given. For the period 2005–2008 in the United States, the median mortality at 30 days was 16.6% with a range from 10.9% to 24.9% depending on the hospital. Using variables available in the emergency room, people with a higher risk of adverse outcome can be identified. One study found that 0.4% of patients with a low-risk profile died after 90 days, whereas in high-risk people it was 21.1%.

Some of the more reproduced risk-stratifying factors include: age, hemodynamic parameters (such as heart failure, cardiac arrest on admission, systolic blood pressure, or Killip class of two or greater), ST-segment deviation, diabetes, serum creatinine, peripheral vascular disease and elevation of cardiac markers. Assessment of left ventricular ejection fraction may increase the predictive power. The prognostic importance of Q-waves is debated. Prognosis is significantly worsened if a mechanical complication such as papillary muscle or myocardial free wall rupture occur. Morbidity and mortality from myocardial infarction has improved over the years due to better treatment.

Complications

Complications may occur immediately following the heart attack (in the acute phase), or may need time to develop (a chronic problem). Acute complications may include heart failure if the damaged heart is no longer able to adequately pump blood around the body; aneurysm or rupture of the myocardium; mitral regurgitation, in particular if the infarction causes dysfunction of the papillary muscle; and arrhythmias, such as ventricular fibrillation, ventricular tachycardia, atrial fibrillation and heart block. Longer-term complications include heart failure, atrial fibrillation, and the increased risk of a second myocardial infarction.

Epidemiology

Myocardial infarction is a common presentation of ischemic heart disease. The WHO estimated in 2002, that 12.6 percent of worldwide deaths were from ischemic heart disease with it the leading cause of death in developed countries, and third to AIDS and lower respiratory infections in developing countries. Worldwide more than 3 million people have STEMIs and 4 million have NSTEMIs a year.

Coronary heart disease is responsible for 1 in 5 deaths in the United States. It is becoming more common in the developing world such that, in India, cardiovascular disease (CVD) is the leading cause of death. The deaths due to CVD in India were 32% of all deaths in 2007 and are expected to rise from 1.17 million in 1990 and 1.59 million in 2000 to 2.03 million in 2010. Although a relatively new epidemic in India, it has quickly become a major health issue with deaths due to CVD expected to double during 1985–2015. Mortality estimates due to CVD vary widely by state, ranging from 10% in Meghalaya to 49% in Punjab (percentage of all deaths). Punjab (49%), Goa (42%), Tamil Nadu (36%) and Andhra Pradesh (31%) have the highest CVD related mortality estimates. State-wise differences are correlated with prevalence of specific dietary risk factors in the states. Moderate physical exercise is associated with reduced incidence of CVD in India (those that exercise have less than half the risk of those that do not).

Legal implications

At common law, in general a myocardial infarction is a disease, but may sometimes be an injury. This has implications for no-fault insurance schemes such as workers' compensation. In general, a heart attack is not covered; however, it may be a work-related injury if it results, for example, from unusual emotional stress or unusual exertion. In addition, in some jurisdictions, heart attacks suffered by persons in particular occupations such as police officers may be classified as line-of-duty injuries by statute or policy. In some countries or states, a person having suffered from a myocardial infarction may be prevented from participating in activity that puts other people's lives at risk, for example driving a car or flying an airplane.

Research

Patients who receive stem cell treatment by coronary artery injections of stem cells derived from their own bone marrow after a myocardial infarction (MI) show improvements in left ventricular ejection fraction and end-diastolic volume not seen with placebo. The larger the initial infarct size, the greater the effect of the infusion. Clinical trials of progenitor cell infusion as a treatment approach to ST elevation MI are proceeding.

There are currently 3 biomaterial and tissue engineering approaches for the treatment of MI, but these are in an even earlier stage of medical research, so many questions and issues must be addressed before they can be applied to patients. The first involves polymeric left ventricular restraints in the prevention of heart failure. The second utilizes ''in vitro'' engineered cardiac tissue, which is subsequently implanted ''in vivo''. The final approach entails injecting cells and/or a scaffold into the myocardium to create ''in situ'' engineered cardiac tissue.

References

External links

American Heart Association's Heart Attack web site – Information and resources for preventing, recognizing and treating heart attack.

Heart Attack – overview of resources from MedlinePlus

Category:Aging-associated diseases Category:Causes of death Category:Ischemic heart diseases Category:Medical emergencies

ar:احتشاء عضل القلب an:Infarcto de miocardio be:Востры інфаркт міякарда be-x-old:Востры інфаркт міякарда bs:Infarkt miokarda bg:Инфаркт на миокарда ca:Infart miocardíac ceb:Atake sa kasingkasing cs:Infarkt myokardu cy:Trawiad ar y galon da:Akut myokardieinfarkt de:Myokardinfarkt dv:ހާރޓް އެޓޭކް ޖެހުން et:Müokardi infarkt el:Έμφραγμα του μυοκαρδίου es:Infarto agudo de miocardio eo:Korinfarkto eu:Miokardio infartu akutu fa:سکته قلبی fr:Infarctus du myocarde gu:હૃદયરોગનો હુમલો ko:심근 경색 hi:हृदयाघात hr:Infarkt miokarda id:Serangan jantung is:Hjartaáfall it:Infarto miocardico acuto he:התקף לב kn:ಹೃದಯಾಘಾತ kk:Миокард инфарктысы ku:Mirina masûlkeyên dil la:Infarctus cordis lv:Miokarda infarkts lt:Miokardo infarktas hu:Szívinfarktus mk:Срцев напад ml:ഹൃദയാഘാതം mr:हृदयाघात mn:Зүрхний шигдээс nl:Hartinfarct ja:心筋梗塞 no:Hjerteinfarkt nn:Hjarteåtak oc:Infart miocardiac pnb:دل دا دورہ pl:Zawał mięśnia sercowego pt:Infarto agudo do miocárdio ro:Infarct miocardic qu:Sunqu p'itiy ru:Острый инфаркт миокарда sq:Infarkti miokardial si:හෘදයාබාධය simple:Myocardial infarction sl:Miokardni infarkt sr:Срчани удар sh:Srčani udar fi:Sydäninfarkti sv:Hjärtinfarkt ta:மாரடைப்பு te:గుండెపోటు th:กล้ามเนื้อหัวใจตายเหตุขาดเลือด tr:Kalp krizi uk:Гострий інфаркт міокарда ur:احتشاء عضل قلب vi:Nhồi máu cơ tim war:Atake ha kasingkasing yi:הארץ אטאקע zh:心肌梗死

''The Godson'' is a 1998 comedy directed by Bob Hoge, starring Rodney Dangerfield, Kevin McDonald and Dom DeLuise.The film is however a parody of The Godfather and Scarface.

Cast (partial)

Rodney Dangerfield - The Rodfather

Kevin McDonald - Guppy Calzone (credited as Kevin Hamilton McDonald)

Dom DeLuise - The Oddfather

Fabiana Udenio - Don Na

Lou Ferrigno - Bugsy/Alice

Paul Greenberg - Frito Calzone

Carol DeLuise - Mama Calzone (as Carol Arthur)

Barbara Crampton - Goldy

Bob Hoge .... Sunny Calzone (as Bob 'The Sicilian Salami' Hoge)

External links

Category:1998 films Category:1990s comedy films Category:American films Category:American comedy films Category:English-language films