Heart attack

 

A heart attack or a myocardial infarction means death of heart tissue due to lack of blood supply to the heart muscles. This can happen when there is an accumulation of fat or cholesterol narrowing the coronary arteries or when other substances like a blood clot are blocking the blood flow. This can damage or destroy a part of the heart muscle permanently.

 

 

Causes include:

1. Coronary heart disease: Most heart attacks arise when your coronary arteries narrow with deposition of fatty materials within their walls, i.e., atherosclerosis. If a piece of this fatty material comes off its place it may cause a blood clot. This clot blocks the artery and cuts the blood supply to the heart.

2. Spasm of coronary arteries: If a coronary artery goes into spasm, it cuts off blood supply to the heart. Use of cocaine drug is one such known cause of spasm of coronary arteries.

Risk factors include:

1. Age: Men above the age of 45 and women above the age of 55 are at a higher risk of suffering a heart attack.

2. Tobacco: Chronic smoking can tremendously increase the risk.

3. Hypertension: High blood pressure damages the arteries that can cause heart attack.

4. High cholesterol

5. Diabetes

6. Obesity

7. Family history of heart attack

8. Stress

 

 

Signs and symptoms include:

1. Severe pressure or squeezing sensation in your chest or arms that can spread to the neck, jaw or back.

2. Indigestion, acidity, and abdominal pain

3. Shortness of breath or difficulty in breathing

4. Rapid or irregular heartbeat

5. Excessive cold sweat breaking out

6. Exhaustion

7. Lightheadedness or dizziness

 

Diabetics typically do not experience pain to a large extent and theirs is often a ‘Silent attack’ which is fatal because prompt action is often not taken. 

 

 

This is usually a medical emergency where immediately your heart rate and blood pressure will be monitored. Electrocardiogram will be done immediately to confirm the diagnosis. Assessment of symptom history and past medical history will be done.

Blood tests will be conducted to check for certain enzymes which show heart damage, e.g., Troponin I and creatine phosphokinase-MB (CPK-MB). Other additional tests include chest x-ray, echocardiogram, angiogram or cardiac catheterization, and cardiac CT scan.

 

 

Treatment starts immediately as heart attack is a medical emergency.

A. Medical treatment: Drugs should be given immediately to decrease the amount of damage to the heart. Drugs used include:

1. Thrombolytic therapy to dissolve any blood clots

2. Aspirin and other blood thinners to prevent blood clotting that can aggravate another heart attack.

Other drugs include:

1. Antiplatelet agents -- to prevent formation of new clots.

2. Pain relievers

3. Nitroglycerin -- this medication helps the heart muscle to relax and improve blood flow to the heart.

B. Surgical procedures:

1. Coronary angioplasty and stenting where a metal mesh is placed inside the artery to keep it open.

2. Coronary artery bypass graft surgery (CABG) where a vein is used to create a new route for blood to flow to the affected region of the heart.

 

 

Damage to your heart can occur if not treated in time frame of 2 to 3 hours, and may lead to.:

1. Abnormal heart rhythm which can also be fatal.

2. Heart failure -- an attack can cause serious damage to the heart tissue that it fails to pump blood efficiently out of the heart.

3. Rupture of the heart -- parts of the heart muscle can rupture causing damage.

4. Heart valve problems -- they can get damaged and can also leak causing severe problems.