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Heart Attack

What is a heart attack?

A heart attack(Myocardial Infarction) is the death of heart muscle due to sudden blockage of a coronary artery by a blood clot. Coronary arteries supply the heart muscle with blood and oxygen. A blocked coronary artery deprives the heart muscle causes chest pain, discomfort and breathlessness. Blood flow needs to be restored within 20 to 40minutes; else irreversible death of the heart muscle begins to occur.

What causes a Heart Attack?

  • Atheroscderosis : Cholesterol deposition
  • Unstable plaque : Site for clot formation
  • Thrombosis : Clot formation

Atherosclerosis

The gradual process by which collections of cholesterol are deposited in the walls of arteries is called Atherosclerosis.

In many people, atherosclerosis can remain silent without causing any symptoms or health problems for many years.Atherosclerosis can begin even in the teenage years, but symptoms or healthe problems usually arise in adulthood when the arteries become severly narrow. Smoking, high blood pressure, high cholesterol, and diabetes mellitus can hasten atherosclerosis and lead to early symptoms and complications, especially in people who have a similar family history.

Angina

Angina is chest pain or pressure that occurs when the blood and oxygen supply to the heart muscle cannot keep up with the needs of the muscles. When coronary arteries are narrowed by more tha 50 to 70 percent, the arteries cannot increase the supply of blood to the heart muscle during exercise or other periods of high demand for oxygen. This inadequate supply of oxygen to the heart muscle causes angina. In some patients, especially diabetics, the progressive decrease in blood flow to the heart may occur without any pain or with just shortness of breath or early fatigue.

Unstable Plague

Sometimes the surface of a cholesterol plaque in a coronary artery may rupture or erode and a blood clot may form on the surface of the plaque. The clot blocks the flow of blood through the artery and results in a heart attack.

The heart muscle dies during a heart attack,which is a permanent loss. Though heart attacks can happen at any time, many heart attacks occur between 4:00 A.M and 10:00 A.M because of high levels of adrenaline in blood.

Symptoms of a Heart Attack

Although chest pain or burning sensation is the most common symptom of a heart attack, heart attack victims may experience a variety of symptoms including :

  • Pain, tightness, and/or squeezing sensation in the centre of the chest.
  • Upper back pain.
  • Shortness of breath.
  • Nausea, vomiting, and/or general eeqigastric(upper middle abdomen) discomfort.
  • Feeling of heartburn, gas and/or indigestion.
  • Excessive/unexplained sweating.
  • Arm pain(more commonly the left arm, but may be either arm).
  • Jaw pain, toothache, headache.
  • General malaise(vague feeling of illiness), Gabhrahat.
  • No symptoms(Around one quarter of all heart attacks are silent, without chest pain or new symptoms. Silent heart attacks are usually common among patients with diabetes mellitus).

Even though the symptoms of a heart attack at times can be vague and mild, remember that heart attacks producing no symptoms or only mild symptms can be just as serious and life-threatening as heart attacks that cause severe chest pain. Very often patients mistake heart attack symptoms to "indigestion," "fatigue," or "stress," and delay seeking prompt medical attention. Seeking prompt medical sttention in the presence of symptoms that suggest a heart attack is very important .Early diagnosis and treatment saves lives and reduces the extent of damage and disability. Delay in reaching medical assistance can prove fatal. Delay in medical attention can lead to permanently reduced function of the heart due to extensive a result of sudden onset of rhythm abnormalities(arrthythmlas) like ventricular fibrillation.

What are the risk factors for atheroscierosis and Heart Attack?

Factors that increase the risk of developing atheroscierosis and heart attacks include elevated blood cholesterol, high blood pressure,use of tobacco, diabetes mellitus, male gender, a family history of premature coronary heart disease, sedentary lifestyle, stress etc. While family history and male gender are genetically determined, the other risk factors can be modified through changes in lifestyle and medications.

The most common complications of a heart attack are heart failure, ventricular fibrillation and death. Heart attacks are diagnosed with electrocardiograms, echo tests and measurement of cardiac enzymes in blood. Early reopening of blocked coronary arteries reduces the amount of damage to the heart and improves the prognosis for a heart attack and outcomes.

Medical treatment for heart attacks may include anti-platelet, anti-coagulant, and clot dissolving drugs as well as anglotensin converting enzyme(ACE)inhibitors, beta blockers and oxygen. Interventional treatment for heart attacks may include coronar angiography(CAG) with percutaneous transluminal coronary angioplaty(PTCA),coronary artery stents, and coronary artery bypass grafting(CABG).

Patients suffering a heart attack are hospitalized for several days to detect heart rhythm disturbances, shortness of breath,and chest pain.

Preventive Measures

1.A healthy life style.

  • Low fat, high fibre diet.
  • Regular physical activity, atleast 45minutes brisk walk, 05 times a week.
  • Avoid tobacco and excess alcohol.
  • Good control of hypertension, diabetes and cholesterol abnormalities.
  • Avoid all types of stress.
  • Pass on good genes to children.
2.Adequate awareness of the disease.
3.Early recognition of symptoms and seeking prompt medical assistance.
4.Periodic check ups with the doctor.
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