When the heart muscle is deprived off oxygenated blood either partially or fully the person gets an attack. Without oxygen the heart muscle cannot survive. This can occur when plaque like fat particles get deposited in the coronary arteries of the heart muscle which gradually becomes narrow. In some cases blood clot gets separated from the plaque like substance traveling to the heart major heart muscle thus blocking the blood flow. This process is known as ischemia and if death of heart muscle occurs due to this process it is known as heart attack.
Chest pain .Vs. Heart attack :
Not all the chest pain is heart attack. Chest pain can occur due to many reasons including gastric problem, increased blood pressure and heightened emotions. Angina is the medical term for the slight discomfort occurring in the heart muscle which lasts only for few minutes. Chest pain due to heart attack would not stop but it progresses rapidly causing more complications like shortness of breath, profuse sweating and pain would spread in the left shoulder and your back.
For every 43 seconds one person in the USA gets heart attack. Around 6 million die because of heart attack and related heart diseases. Each year 7.5 million people of America get a heart attack and out of these 5.25 million gets first attack and others it is the second heart attack.
Warning Signs Of Heart Attack :
In spite of repeated attempts for creating awareness on heart attack, only 27 out of 100 people surveyed know about all major symptoms and others are not. Cardiac deaths can considerably be prevented if the people act promptly on getting warning signs. It is reported about 48% of deaths due to heart attack occur outside the hospital.
Import warning signals of heart attack are :
- Persistent chest pain or discomfort
- Pain in the neck, arms, jaw and back region
- Shortness of breath
- Profuse sweating, nausea or feeling dizzy
Who Are At High Risk Of Getting A Heart Attack? :
Anyone can get an attack irrespective of race, religion and sex. But certain medical conditions like obesity, diabetes, sedentary lifestyle, physical inactivity and overuse of alcohol are prone to get a heart attack.
Difference Between Cardiac Arrest And Heart Attack :
As many people think, cardiac arrest is not the same as heart attack. Heart attack happens due to reduced/blocked blood flow to the major heart muscle. Here damage occurs to the heart muscle. Cardiac arrest occurs when there are abnormal electrical signals in the heart causing irregular rhythms in the heart (arrhythmias) leading to sudden cardiac death. Here the heart stops working all of a sudden causing death. Lower chamber of the heart (ventricles) starts producing abnormal beats not pumping enough blood to the heart. In this case, death occurs within seconds or few minutes. Immediate CPR therapy can save the life of the person restoring the normal rhythm of the heart.
Heart attack can be defined as partial/complete death of heart muscles due to sudden blockage/reduced blood flow. Coronary arteries get blocked with blood clot thus cutting off the blood supply to the heart. Heart muscles are damaged due to reduced blood flow causing chest pain and other symptoms. In most of the cases death of heart muscle can be prevented if blood flow is restored within 30 to 40 minutes. Often blood flow is blocked due to cholesterol or fat deposits which grow bigger in size gradually forming plaque inside the arteries. In medical terms, heart attack is known as Myocardial Infarction.
Common Symptoms Of Heart Attack :
- Heart attack begins with tightness in the chest region and pain. Intensity of pain can vary from mild to severe.
- Many people have described the feeling as squeezing sensation in the chest. Slowly the pain spreads to the neck, jaw and left shoulder, arm, and back.
- Heart attack can cause physiological changes like nausea, heartburn, sweating, shortness of breath and abdominal pain.
- Do not ignore the symptoms if you get chest pain along with sudden jaw pain or toothache.
- If a person gets a heart attack, symptoms will not subside but spreads to other parts like neck, shoulder, arm and back. Early diagnosis can save thousands of lives each day.
- Unfortunately heart attack can occur without any symptoms (asymptomatic). Delay in reaching the hospital can become fatal for many people.
- Asymptomatic attacks are common in women when compared with men. They often misunderstand the signs for fatigue or indigestion and do not seek prompt medical help.
What Should You Do If You Doubt An Attack?
- First and foremost seek emergency medical help. Find someone to drive you to hospital.
- Take aspirin before getting ready for hospital.
Heart Attack Causes :
Narrowing of coronary arteries and formation of blood clot in the major blood vessel that supplies blood to the heart is the medical cause for a heart attack. Cholesterol can build up inside the arteries thus blocking the normal blood flow partially/completely.
Some of the major causes of heart attack is discussed here.
- Atherosclerosis :
Build-up of cholesterol and fatty substances in the body gets accumulated gradually in the walls of arteries. As more and more substances gather inside the coronary artery it blocks the passage of blood flow thus narrowing the available space of the artery. This process can occur anywhere in the body like legs or hands and even on the major blood vessel of the brain causing death of brain tissue (vascular dementia) or stroke. Coronary artery disease (CAD) or atherosclerosis can occur due to persistent smoking, eating high fat foods, having hypertension or diabetes.
- Angina Pectoris :
Angina pectoris or simply angina is a strong warning signal of heart attack. When there is blockage in the normal oxygenated blood flow to the heart muscle it causes damage. Coronary arteries gets narrowed down slowly not able to supply enough blood during periods of high demand of oxygen. This in turn causes angina.
Angina can occur during exercise or at rest. Exertional angina is common in diabetic people wherein decreased blood flow may or may not cause any symptoms. Even if there is any symptoms like shortness of breath it is likely misunderstood for fatigue. Angina causes heavy pressure or squeezing pain in the chest which travels towards the neck, arms and back. Exertional angina may lasts for 15-20 minutes and the symptoms disappear when the person takes rest or takes nitroglycerin. Angina that occurs during rest is very dangerous. Coronary artery can develop spasm leading to heart attack or even cardiac arrest causing death.
Risk Factors :
- Atherosclerosis (buildup of fat molecules) can cause narrowing of coronary arteries.
- Diabetes (uncontrolled), high blood pressure, aging, high blood cholesterol, long-term use of tobacco, lack of physical activity, increasing stress and obesity are high risk factors for getting a heart attack.
- People having family history of heart attack are more prone to get an attack than others.
What Happens After A Heart Attack ?
Once the heart muscle gets damaged due to reduced blood supply amount of blood supply released from the heart gets drastically reduced. This in turn can seriously affect other organs like kidney and liver. Slowly the kidneys lose its function leading to kidney failure. The same thing happens with liver and other vital organs.
Ventricular Fibrillation :
Due to continued blockage in blood flow the heart muscle gets more and more damaged leading to severe injury. This in turn causes chaotic/irregular electrical activity in the heart forcing the heart to stop beating. Without heartbeat, blood supply to vital organs like brain gets disrupted leading to permanent brain damage. Majority of deaths from heart attack can occur due to ventricular fibrillation. Any victim who reaches the ER within half-an-hour has increased chance for survival since he/she will be given CPR (cardiopulmonary resuscitation) immediately. Unless major damage has already occurred to the heart muscle the blood flow can be restored thus saving the life.
ECG (Electrocardiogram) is the ideal test to diagnose an attack. Electrical activity of the heart is recorded in the machine in the form of printed paper. After a heart attack patient reaches the emergency room the nurses/doctors will be on action by connecting a monitor to record heartbeat. ECG will be taken simultaneously measuring the blood pressure and pulse. The patient will be put on supplementary oxygen and CPR will be started to restore the normal blood flow. All these will be done within minutes for saving the life of the patient.
If the condition of the patient is stable, ER doctor will order for blood tests to check leakage of heart enzymes. Further chest X-ray will be taken to check for fluid collection in the lungs. Echocardiogram will be taken to check any damage has been done to the heart and if so to what extent. If required MRI scan of the heart would be taken.
- The ultimate goal of the doctor and nurses in the hospital would be to prevent further damage to the heart muscle and restoring normal blood flow to the heart.
- CPR is the primary procedure to restore the heart’s function quickly.
- It is good to take aspirin pills before reaching the hospital since it is capable of reducing blood clot.
- After the patient becomes stable, medications are given to dissolve blood clot and prevent further damage.
- Medications given to treat a heart attack include thrombolytic drugs and antiplatelet agents to prevent further clot formation. Both these drugs serve as excellent clot-busters.
- Blood thinners like heparin are given to encourage free flow of blood. Nitroglycerin and other pain relieving drugs are given to get comfort.
Surgical Procedures :
Depending on the condition of the patient, team of doctors will decide about surgery as measure of treating heart attack.
- Angioplasty is the process in which a long thin tube is sent through the artery of the leg till it reaches the coronary artery to clear the blockage. The other end of tube holds a special balloon which is inflated to clear off the blockage. Further a metal stent is kept in the artery to keep it open and to prevent further narrowing of blood vessel.
- Bypass surgery is often performed on emergency basis which involves clearing the blockage in the arteries by sewing it at a safe distance and establishing fresh connection of blood flow to the heart through another artery.
Lifestyle Changes :
- After an attack you need to be very careful in following the instructions of your doctor. You need to take healthy diet and do regular exercises. Maintaining the blood sugar levels and blood pressure at optimal range is essential.
- Go for regular checkups and control your weight and cholesterol. Take necessary steps to reach a healthy weight. Manage stress by practicing yoga/meditation.
- Quit smoking and drinking.
- People who are overweight and with diabetes/hypertension should go for checkups regularly to eliminate any block in the heart.
- At least once in a year, checking the blood cholesterol can be helpful in preventing heart disease.
- By taking prescribed medications you can prevent further attacks if you already had one.