Nearly one million Americans suffer from a heart attack each year. Four hundred thousand of them die as a result of their heart attack. There are an estimated 45 million patients of coronary artery (heart) disease in India. One fifth of the deaths in India are caused due to coronary heart disease. By 2020, heart diseases will account for one third of all deaths in India.
Rising public awareness about heart attacks and several lifestyle changes have eventually contributed to a considerable reduction in the occurrence of heart attacks in the last four decades. Today, the best treatment for someone encountering a heart attack is prompt identification of the diagnosis and transport to a hospital that can perform prompt catheterisation and PTCA or stenting within the first 90 minutes of the cardiac incidence.
What is a heart attack?
Myocardial infarction (MI), which literally means the death of the heart muscle, is the medical term for a heart attack. When two coronary arteries — that supply blood and oxygen to the heart — get blocked as a result of high cholesterol levels and other substances, it deprives the heart muscle of blood and oxygen, causing an injury. This condition is called ‘cardiac ischemia’.
If this condition lasts too long, the deprived heart tissue dies. This is what happens in a heart attack. Heart attacks cause irreversible death of the heart muscle. The heart muscle continues to die for six to eight hours at which time the heart attack usually is “complete”. The dead heart muscle is eventually replaced by a scar tissue.
Do you know your heart?
With these heart attack facts given by medical author Dr. Daniel Lee Kulick, MD, FACC, FSCAI, on Medicine.net you can keep a watch on your heart’s health!
Nearly 25% of all heart attacks occur without any previous warning signs.
In some cases, they are associated with a condition called ‘Silent Ischemia’, which causes sporadic interruptions of blood flow to the heart that are painless for unknown reasons, although they may damage the heart tissue. Silent ischemia is commonly seen in diabetic patients.
The most common symptoms of a heart attack include: Pressure, tightness, pain and aching sensation on the left side of chest or arms, spreading to neck, jaw and back, a feeling of fullness, nausea and heartburn, breathlessness, cold sweats, anxiety and fatigue, dizziness and an impending sense of doom or dying.
- The most commonly experienced symptom of heart attack is chest pain .
- Early reopening of blocked coronary arteries can reduce the amount of damage to the heart and improve the prognosis for a heart attack.
- Heart failure and ventricular fibrillation are the most common complications of a heart attack.
- The blood clot that causes the heart attack usually forms at the site of rupture of an atherosclerotic, cholesterol plaque on the inner wall of a coronary artery.
- Heart attacks are diagnosed with electrocardiograms and measurement of cardiac enzymes in blood.
- The risk factors for heart attack include high cholesterol levels, high blood pressure, tobacco use, diabetes, male gender, and a family history of heart attacks at an early age.
Causes and Risk factors
‘What you eat is what you are and how you live is how you shape’.
This holds true for the heart that beats life into human beings. Having said that, it is not surprising that the most common risk factors for coronary artery disease comprise lifestyle issues, eating habits, blood pressure and cholesterol levels, weight and stress issues, and diabetes.
But the underlying cause of most heart attacks is coronary artery disease. This is a result of a build-up (collectively called as plaques) of cholesterol and other substances in the artery. One of these plaques can rupture and spill out cholesterol and other substances into the bloodstream causing blood clots that block the coronary artery.
A spasm in the coronary artery that shuts down blood flow in the heart muscle is yet another cause of a heart attack. Drugs like cocaine can cause such a life-threatening spasm. A heart attack can also occur due to a tear in the heart artery (spontaneous coronary artery dissection). Coronary Embolism—a condition, in which small blood clots or tumours travel from other parts of the body to the artery—is an uncommon cause of heart attacks. Heart attacks can also occur if blood flow to the heart is severely decreased, in case of extremely low blood pressure (shock).
Diagnosis and tests
Ideally, during a regular medical check-up, your doctor should be able to tell you if you have any risk factors that can lead to a heart attack. Other procedures like Electrocardiogram (ECG), Echocardiogram, Angiogram (Coronary Catheterisation), Chest X-rays, Blood Tests, Cardiac computerised tomography (CT) or magnetic resonance imaging (MRI) and Exercise Stress tests help diagnose any coronary heart disorders.
Treatments and Drugs
If you or anybody you know encounters a heart attack, the best step to take is to get the patient to the nearest emergency room. Treatment of heart attacks in a hospital will include various tests, scans and medications. Depending on your condition, your doctor may advise antiplatelet, anticoagulant, clot-dissolving drugs and angiotensin-converting enzyme (ACE), inhibitors, beta blockers and oxygen.
Interventional treatments for heart attacks comprise coronary angiography with percutaneous transluminal coronary angioplasty (PTCA), coronary artery stents and coronary artery bypass grafting (CABG). Surgical procedures to treat heart attacks include Coronary Angioplasty and Stenting, and Coronary Artery Bypass Surgery.
Following a healthy lifestyle and the following steps can help you not only prevent but also recover from a heart attack.
- Don’t smoke
- Avoid passive smoke
- Check your blood pressure and cholesterol levels
- Get regular medical checkups
- Exercise regularly
- Maintain a healthy weight
- Eat a heart-healthy diet
- Manage diabetes
- Control stress
- If you drink alcohol, do so in moderation