HEART ATTACK
What Is A Heart Attack? The medical term for "heart attack" is "myocardial infarction", which means death of heart muscle, usually due to a sudden reduction in blood supply to part of the heart. Most often, heart attacks occur in people with atherosclerosis (often loosely referred to as "heart disease"), a condition which causes fatty build-up and narrowing of the blood vessels. A diseased blood vessel can easily become blocked and deprive a segment of the heart of the oxygen and nutrients it constantly requires.
What Causes A Heart Attack? Almost all heart attacks occur in people with atherosclerosis. Over 90% of heart attacks occur when a fatty deposit in one of the heart's vessels causes a blood clot to form, and the clot blocks blood flow in the vessel. The major risk factors for atherosclerosis and heart attacks are smoking, high cholesterol, high blood pressure, diabetes, and a family history of heart disease, heart attacks, or stroke. Minor risk factors are older age, male gender, sedentary lifestyle, obesity, and "type A" personality.
What Are The Signs And Symptoms Of A Heart Attack? Two-thirds of people experience chest pain, shortness of breath, or fatigue in the weeks leading up to the heart attack. Typically, a person having a heart attack experiences severe crushing chest pain radiating to the neck, jaw, arms and/or back. The pain is usually accompanied by anxiety, sweating, and nausea or vomiting. Some people have only mild discomfort, however, and women often don't fit the usual picture. In addition, the skin may be pale, cool, and clammy. Fingertips and lips may be cold and bluish in colour.
With What Might A Heart Attack Be Confused? Chest pain and anxiety are common symptoms of several conditions. Only some are mentioned here. One of these is panic disorder; a panic attack is a short period of intense fear accompanied by sweating, trembling, nausea, and troubled breathing. Another is indigestion; heartburn, where stomach acid regurgitates into the esophagus, peptic ulcer disease, or any condition causing food to get stuck in the esophagus can cause intense chest pain. Third, angina may be confused with a heart attack; angina is chest pain caused by a decrease in blood supply to a portion of the heart that is not as severe as that which occurs during a heart attack.
What To Do? If you think you or someone around you is having a heart attack, call 911 immediately! Meanwhile, if the person has prescription nitroglycerine spray, use this to relieve the pain (repeat up to 3 times). Try to remain calm and make the person as comfortable as possible until the ambulance arrives.
What Next? First of all, the medical team will determine whether or not the person is having a heart attack. Doctors will want to know the details of what happened, as well as the person's past medical history. Electrodes will be placed on the chest to run an electrocardiogram (ECG); this is a quick and painless test that can reveal a lot about the heart's activity. Blood samples will be taken to test for chemicals that indicate whether a heart attack has occurred, and to examine cholesterol levels.
The goals of treatment for heart attack are to limit the extent of damage to the heart, reduce the heart's workload, and prevent or treat complications (below). The person will be given an Aspirin, and oxygen through the nostrils or a mask. Drugs will be given by intravenously (i.v.) to lower the heart rate and unclog the blocked blood vessel. Most heart attack patients remain in hospital for about a week.
After leaving the hospital, the person will keep taking anti-clot drugs (Heparin or Coumadin), and drugs to lower blood pressure and cholesterol, if necessary. A rehabilitation program involving education and exercise will probably be recommended.
Complications: When a portion of the heart muscle has died, it may render the heart unable to maintain a regular beat. Cardiac arrest, or cessation of the heart beat, is the most serious form of this problem. In addition, up to 2/3 of hospitalized heart attack patients enter heart failure, where the heart is not able to pump enough blood to meet the body's demand. The patient may go into shock as a result.
Survival: Approximately 90% of people will survive the first year following their heart attack. Depending on the severity of the heart attack and the presence of complications, people are classified as low or high risk. The medical team will conduct follow-up care and encourage preventive measures.
How Can I Prevent A Heart Attack? Modify your risk factors! Other than your family history and juvenile diabetes, you are in control of your risk for heart disease. Stop smoking. Cut down on fatty foods and eat more fruits, vegetables, and foods high in fibre. Be physically active: every bit helps. See your family doctor regularly to keep tabs on your blood pressure and cholesterol. Try to keep stress under control; take time to relax.
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