Heart and cardiovascular diseases
Heart Attack
What is a Heart Attack?
Coronary arteries are the main blood vessels that surround the heart muscle in order to supply heart with oxygen-rich blood. When coronary arteries become blocked by blood clot, the blood flow to the heart muscle is been interrupted which causing injury to the heart muscle. The longer the blood supply stops the greater the damage occurs and even the muscle can be completely damaged and die which can be fatal.
Heart attack often felt like a sudden, crushing chest pain that takes a person by complete surprise. But before a person had the heart attach there are several early warning signs as heart attack is a result of other heart disease that builds up over time. Also in many cases people may confuse the symptoms of heart attack with a minor illness such as indigestion, back or neck pain which will cause delay to get the proper treatment at the proper time.
It is also called a myocardial infarction or acute myocardial infarction.
Causes of a Heart Attack
There are main two causes of heart attacks, coronary heart disease and coronary artery spasm.
Coronary Heart Disease
Most of the heart attacks occur due to coronary heart disease. Coronary heart disease is a condition when a fatty waxy substance called plaque builds up in the coronary arteries which are the main blood vessels to supply oxygen to the heart.
The plaque buildup causes the arteries to get narrow resulting less blood flow to the heart. Sometime an area of plaque can rupture and in the process of healing the arteries, blood will clot over the surface of plaque. If the plaque is big enough it can also block the blood flow completely. When the blood supply is entirely cut off, it can cause a heart attack. If the blockage isn’t treated quickly the muscle which deprive from blood flow starts to die and eventually replaced by scar tissue. This change can be not obvious or can be fatal.
Coronary Artery Spasm
Some of the heart attacks occur due to coronary artery spasm. The sever spasm (tightening) of a coronary artery can cuts off the blood flow through the artery which also can occur in those coronary arteries which are not been blocked by plaque buildup. Till the cause of coronary artery spasm is not very clear but though that they may be related to few risk factors such as consumption of illegal drugs like cocaine, stress or emotional pain, smoking or exposure to extreme cold condition or due to tumor.
Symptoms of aHeart Attack
The sign and symptom of heart attack vary from people to people. Also not all people who have heart attacks experience them to same degree. The heart attack symptoms are not always as dramatic as it has been in shows on TV or in movies. Many heart attack starts slowly as a mild chest pain or discomfort. However in some cases there are no any symptoms at all this kind of heart attack without any symptoms or very mild one to be distinguished are called silent heart attack.
Heart attack can occur anytime. In some cases heart attack has been a sudden one but in many cases the heart attack have warning signs and symptoms hours, days or even week before. Know the warning signs of a heart attack and act fast because sooner the treatment less the damage to the heart.
Some common symptoms of heart attack:
- Crushing pressure, a feeling of a squeezing pain or fullness in the center or left side of the chest which lasts for more that few minutes orthe pain goes away and comes back.
- Discomfort or pain extending to one or both arms, shoulder, back, neck, jaw and even teeth.
- Feels like indigestion or prolonged pain in the upper abdomen.
- Shortness of breath that can occur before or with the chest pain
- Nausea and feel like vomiting
- Breaking out in cold sweat
- Fainting
Some different signs and symptoms of heart attack in women may include:
- Heartburn or abdominal pain
- Light-headedness or sudden dizziness
- Fatigue(tiredness), or lack of energy
- Clammy(cold, moist and usually pale) skin
Who is at the risk of a Heart Attack?
There are various risk factors which can lead to cause coronary heart disease and develop heart attack. Some risk factors are nonmodifiable which cannot be changed and some risk factors are modifiable which can be controlled. However if the risk factors are been controlled then heart attack can be prevented.
Nonmodifiable Risk Factors:
There are certain factors which cannot be controlled or changed such as:
Ageing: Getting older increases the risk of damaging and narrowing the arteries.
Gender: Men tend to have more risk of heart attack than women. However women’s risk of cardiovascular disease increases after menopause.
Family history: A family history of cardiovascular disease increases with a higher risk of coronary artery disease which can lead to heart attack, especially if a close relative such as father or a brother was diagnosed with heart disease before age 55, or mother or a sister developed it before age 65.
Preeclampsia: This health condition can develop during the pregnancy. A rise in blood pressure and excess protein in the urine are the main two signs of the disease. It is one of the major risk factor to have lifetime heart diseases.
Modifiable Risk Factors:
There are certain factors which can be changed, controlled or treated such as:
Quit smoking: Smoking is the most preventable risk factor for cardiovascular disease and stroke. Nicotine constricts the blood vessels. Also when cigarette is smoked the carbon monoxide can damage their inner lining, making them more susceptible to atherosclerosis. The incidence of heart attack in women who smoke at least 20 cigarettes a day is six times that of women who have never smoked. For men who smoke, the incidence is triple that of nonsmokers.
Maintain the cholesterol level: Excessive amount of low-density lipoprotein (LDL), known as “bad” cholesterolcan increase the risk of plaque buildup. High-density lipoprotein (HDL), known as “good” cholesteroltakes the LDL cholesterol away from the arteries and back to the liver where it can be passed out of the body. High levels of HDL seem to protect against cardiovascular disease however a low level of HDL can promote atherosclerosis.
Control high blood pressure: Uncontrolled high blood pressure for long time can increase the workload of heart alsoharden and thicken the arteries, narrowing the channel through which blood can flow. This increases the risk of heart attack, heart failure, stroke and kidney diseases.
Control diabetes: diabetes is a condition when the pancreas is not able to produce insulin or the body is not able to use the insulin. This elevates the level of blood sugar. Diabetes especially in women have a higher risk of promoting cardiovascular diseases as it increase other risk factors.
Maintain a healthy weight: excess weight raises blood cholesterol, triglycerides and blood pressure. Also research has shown that being overweight contributes to the onset of cardiovascular disease.
Be physically active: Being physically activity helps to reduce so many other risk factors such as it lowers the blood pressure, lower the high cholesterol, reduce the stress, achieve and maintain a healthy body weight. Lack of exercise, lead to the risk of having coronary artery disease.
Follow a healthy diet: There are four major risk factor related with diet which are high blood pressure, high blood cholesterol, diabetes and obesity.Foods that are high in saturated and trans fats, cholesterol, sodium (salt), and sugar can worsen other risk factors for coronary heart diseases.
Diagnosis of a Heart Attack
The doctor will diagnose heart attack based on the sign and symptoms, medical and family history, a physical exam, and the results from tests.
If a person is having a heart attack or is suspected of having, the diagnosis is likely to happen in an emergency setting either it is in the hospital or home. The doctor will ask to describe the symptoms and the blood pressure; pulse and temperature will be checked. There are two vital tests to check heart attack. While asking the symptoms and the medical history to the patience, electrocardiogram (ECG) is been done which is a painless and first test that detects and records the heart’s electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular).
The second test is the blood test to measure the protein level in blood because during heart attack heart muscle cells die and release proteins into the bloodstream.
Medical and Family Histories
The doctor may ask series of question regarding the symptoms of coronary heart disease also may ask if patience is suffering from other health problems which can lead to coronary heart disease. Also may ask if the patience smoke or use alcohol or drugs, has stress and etc.
Further the doctor may ask regarding the background of patience’s family if any of the sibling or parents had a history of coronary heart disease, diabetes, high blood pressure etc.
Physical Examination
The doctor will check the skin and listen to the heart and take the pulse to listen the heart rate and rhythm.
Tests and Procedures
Some of the tests and procedures will be prescribed.
Laboratory Test
- Blood tests
ImagingTests
- Electrocardiogram (EKG/ECG)
- Chest x ray
- Echocardiography (ECHO)
- Stress test
- Cardiac computerized tomography (CT
- Magnetic resonance imaging (MRI)
Invasive Testing
- Cardiac catheterization
- Coronary angiography
Treatments of a Heart Attack
If a treatment for a heart attack is provided fast then we can prevent heart from damaging a lot. Acting fast, at the first symptoms of a heart attack, can save life.
A heart attack outside the medical environment
If a person is unconscious by a presumed heart attack outside the hospital first call for the paramedics then despite you are a trained or untrained,begin CPR with chest compressions.
At least 2 inches (5 centimeter) deep compression of chest with a rate of at least 100 per minute is acquired in an effort to create manual pumping of blood through the heart which helps to deliver oxygen to the body and brain.
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Rescuer |
Ways |
Remember |
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Untrained |
Provide hands-only CPR |
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Trained |
Remember C-A-B |
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A heart attack treatment at a hospital
Heart attack treatment varies depending on the severity of the patience’s condition and the amount of damage to the heart. The treatment can be only medication or need to undergo an invasive procedure or both.
Medicine
There are certain types of medicine used such as:
- Aspirin or other blood thinner
- Thrombolytics( also called clotbusters)
- Superaspirins
- Pain relievers
- Nitroglycerin
- Beta blocker
- Cholesterol-lowering medications
These medicines used are for:
- To reduce the clotting
- To prevent new clotting to form
- To dissolve the clotting
- To make blood less sticky
- To treat chest pain (angina)
- To opens arterial blood vesselstemporarily
- To lower the blood pressure
- To slow down the heart rate
- To lower levels of unwanted blood cholesterol
Medical Procedure
- Coronary angioplasty and stenting
SurgicalProcedure
- Coronary artery bypass grafting (CABG)