What is a Heart Attack?

 

What is a Heart Attack?

Heart attack signs and symptoms in men and women: Chest pain or discomfort; Shortness of breath; Pain or discomfort in the jaw, neck, back, arm, or shoulder; Feeling nauseous, light-headed, or unusually tired.

A heart attack is scary. If you’ve had one, or are close to someone who has, you’re not alone. Many people survive a heart attack and go on to enjoy productive lives.

As you work toward recovery, the frequently asked questions below can help you better understand what’s happened, and how your heart can heal. Knowledge is power. So use this information to live healthier and longer.

Your heart muscle needs oxygen to survive. A heart attack occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely.

 

Causes of a heart attack

·         Coronary heart disease (CHD) is the leading cause of heart attacks.

·         CHD is a condition in which the major blood vessels (coronary arteries) that supply the heart muscle become clogged by a build-up of deposits of fatty substances, known as plaques.

·         Before a heart attack, 1 of the plaques bursts (ruptures), causing a blood clot to develop at the site of the rupture.

·         The clot may block the supply of blood to the heart, triggering a heart attack.

Coronary artery disease causes most heart attacks. In coronary artery disease, one or more of the heart (coronary) arteries are blocked. This is usually due to cholesterol-containing deposits called plaques. Plaques can narrow the arteries, reducing blood flow to the heart.

If a plaque breaks open, it can cause a blood clot in the heart.

A heart attack may be caused by a complete or partial blockage of a heart (coronary) artery. One way to classify heart attacks is whether an electrocardiogram (ECG or EKG) shows some specific changes (ST elevation) that require emergency invasive treatment. Your health care provider may use electrocardiogram (ECG) results to describe these types of heart attacks.

• An acute complete blockage of a medium or large heart artery usually means you've had an ST elevation myocardial infarction (STEMI).
• A partial blockage often means you've had a non-ST elevation myocardial infarction (NSTEMI). However, some people with non-ST elevation myocardial infarction (NSTEMI) have a total blockage.

Not all heart attacks are caused by blocked arteries. Other causes include:

• Coronary artery spasm. This is a severe squeezing of a blood vessel that's not blocked. The artery generally has cholesterol plaques or there is early hardening of the vessel due to smoking or other risk factors. Other names for coronary artery spasms are Prinzmetal's angina, vasospastic angina or variant angina.
• Certain infections. COVID-19 and other viral infections may cause damage to the heart muscle.
• Spontaneous coronary artery dissection (SCAD). This life-threatening condition is caused by a tear inside a heart artery.

 

 

 

 

Symptoms of a heart attack

As heart attacks can be fatal, it is crucial to recognize the warnings as soon as possible and contact emergency services.

Symptoms include:

• a feeling of pressure, tightness, pain, squeezing, or aching in the chest
• pain that spreads to the arms, neck, jaw, or back
• a feeling of crushing or heaviness in the chest
• a feeling similar to heartburn or indigestion
• nausea and sometimes vomiting
• feeling clammy and sweaty
• shortness of breath
• feeling lightheaded or dizzy
• in some cases, anxiety that can feel similar to a panic attack
• coughing or wheezing, if fluid builds up in the lungs

The symptoms can vary in their order and duration — they may last several days or come and go suddenly.

The following may also develop:

• Hypoxemia: This involves low levels of oxygen in the blood.
• Pulmonary edema: This involves fluid accumulating  in and around the lungs.
• Cardiogenic shock: This involves blood pressure dropping suddenly because the heart cannot supply enough blood for the rest of the body to work adequately.

 

Diagnosis heart attack 

In the hospital, a doctor will ask about symptoms. When making a diagnosis and drawing up a treatment strategy, they will take into account the person’s:

• age
• overall health
• medical history 
• family history

They will also need to carry out tests  which include:

• imaging tests, such as X-rays, CT scans, and echocardiograms
• electrocardiography, to measure electrical activity in the heart
• blood tests, which can confirm that a heart attack has occurred
• cardiac catheterization, which enables a doctor to examine the inside of the heart

 

Treating heart attacks

While waiting for an ambulance, it may help to chew and then swallow a tablet of aspirin (ideally 300mg), as long as the person having a heart attack is not allergic to aspirin.

Aspirin helps to thin the blood and improves blood flow to the heart.

In hospital, treatment for a heart attack depends on the type of heart attack, and how serious it is.

The 2 main treatments are:

• using medicines to dissolve blood clots
• surgery to help restore blood to the heart

 

Treatment

Each minute after a heart attack, more heart tissue is damaged or dies. Urgent treatment is needed to fix blood flow and restore oxygen levels. Oxygen is given immediately. Specific heart attack treatment depends on whether there's a partial or complete blockage of blood flow.

Medications

Medications to treat a heart attack might include:

• Aspirin. Aspirin reduces blood clotting. It helps keep blood moving through a narrowed artery.
• Clot busters (thrombolytics or fibrinolytics). These drugs help break up any blood clots that are blocking blood flow to the heart. The earlier a thrombolytic drug is given after a heart attack, the less the heart is damaged and the greater the chance of survival.
• Other blood-thinning medications. A medicine called heparin may be given by or injection. Heparin makes the blood less sticky and less likely to form clots.
• Nitroglycerin. This medication widens the blood vessels. It helps improve blood flow to the heart. Nitroglycerin is used to treat sudden chest pain (angina). It's given as a pill under the tongue, as a pill to swallow or as an injection.
• Morphine. This medicine is given to relieve chest pain that doesn't go away with nitroglycerin.
• Beta blockers. These medications slow the heartbeat and decrease blood pressure. Beta blockers can limit the amount of heart muscle damage and prevent future heart attacks. They are given to most people who are having a heart attack.
• angiotensin-converting enzyme (ACE) inhibitors. These drugs lower blood pressure and reduce stress on the heart.
• Statins. These drugs help lower unhealthy cholesterol levels. Too much bad (low-density lipoprotein, or LDL) cholesterol can clog arteries.

Surgical and other procedures

If you've had a heart attack, a surgery or procedure may be done to open a blocked artery. Surgeries and procedures to treat a heart attack include:

• Coronary angioplasty and stenting. This procedure is done to open clogged heart arteries. It may also be called percutaneous coronary intervention (PCI). If you've had a heart attack, this procedure is often done during a procedure to find blockages (cardiac catheterization).

During angioplasty, a heart doctor (cardiologist) guides a thin, flexible tube (catheter) to the narrowed part of the heart artery. A tiny balloon is inflated to help widen the blocked artery and improve blood flow.

A small wire mesh tube (stent) may be placed in the artery during angioplasty. The stent helps keep the artery open. It lowers the risk of the artery narrowing again. Some stents are coated with a medication that helps keep the arteries open.

• Coronary artery bypass surgery (CABG). This is open-heart surgery. A surgeon takes a healthy blood vessel from another part of the body to create a new path for blood in the heart. The blood then goes around the blocked or narrowed coronary artery. coronary artery bypass surgery (CABG) may be done as an emergency surgery at the time of a heart attack. Sometimes it's done a few days later, after the heart has recovered a bit.

Cardiac rehabilitation

Cardiac rehabilitation is a personalized exercise and education program that teaches ways to improve heart health after heart surgery. It focuses on exercise, a heart-healthy diet, stress management and a gradual return to usual activities. Most hospitals offer cardiac rehabilitation starting in the hospital. The program typically continues for a few weeks or months after you return home.

People who attend cardiac rehab after a heart attack generally live longer and are less likely to have another heart attack or complications from the heart attack. If cardiac rehab is not recommended during your hospital stay, ask your provider about it.

 

Prevention heart attack 

It's never too late to take steps to prevent a heart attack — even if you've already had one. Here are ways to prevent a heart attack.

• Follow a healthy lifestyle. Don't smoke. Maintain a healthy weight with a heart-healthy diet. Get regular exercise and manage stress.
• Manage other health conditions.Certain conditions, such as high blood pressure and diabetes, can increase the risk of heart attacks. Ask your health care provider how often you need checkups.
• Take medications as directed. Your health care provider may prescribe drugs to protect and improve your heart health.

It's also a good idea to learn CPR properly so you can help someone who's having a heart attack. Consider taking an accredited first-aid training course, including CPR and how to use an automated external defibrillator (AED).