Heart Attack

Heart Attack

A heart attack is the death of a segment of heart muscle caused by a loss of blood supply. The blood is usually cut off when an artery supplying the heart muscle is blocked by a blood clot. A heart attack occurs when the flow of blood to the heart is blocked. The blockage is most often a build-up of fat, cholesterol and other substances, which form a plaque in the arteries that feed the heart (coronary arteries) .The plaque eventually, breaks away and forms a clot. The interrupted blood flow can damage or destroy part of the heart muscle.

A heart attack, also called a myocardial infarction, can be fatal, but treatment has improved dramatically over the years. It’s crucial to call 911 or emergency medical help if you think you might be having a heart attack.

Coronary heart disease (CHD) currently looms as the greatest health threat to Americans. The rise of coronary heart disease to the top of our medical “to-do list” is relatively recent. In 1900, pneumonia was the leading cause of death in the United States, and the average life expectancy was only 47. During the first half of the 20th century, doctors and scientists focused on treating infectious diseases — for example, developing new drugs to cure pneumonia and virtually eradicate tuberculosis. These dramatic advances enabled people to live longer — and inadvertently opened the door to coronary heart disease.

By 1930, average life expectancy in America had risen to about 60, and heart disease had become the number one cause of death. These statistics reflect an important feature of CHD: the incidence of the disease increases strikingly with age. Longer life means more time for arterial plaques to develop and cause problems. The risk of an 85-year-old man having a heart attack is 25 times that of a 45-year-old.

Longer life does not by itself cause CHD, but the combination of longer life and damaging lifestyles increases the risk of developing coronary heart disease. Contemporary lifestyles have created a minefield of risk factors for CHD. Liberated from the grip of infectious diseases, too many of us fill our extra years of life with smoking, eating, and many excuses not to exercise.

A heart attack happens when there is a sudden complete blockage of an artery that supplies blood to an area of your heart. A heart is a muscle, and it needs a good blood supply to keep it healthy.As we get older, the smooth inner walls of the arteries that supply the blood to the heart can become damaged and narrow due to the build up of fatty materials, called plaque.

When an area of plaque breaks, blood cells and other parts of the blood stick to the damaged area and form blood clots. A heart attack occurs when a blood clot completely blocks the flow of blood and seriously reduces blood flow to the heart muscle. This also results in patients experiencing chest pain.

As a result, some of the heart muscle starts to die.

The longer the blockage is left untreated, the more the heart muscle is damaged. If the blood flow is not restored quickly, the damage to the heart muscle is permanent.A heart attack is sometimes called a myocardial infarction (MI), acute myocardial infarction, coronary occlusion or coronary thrombosis.

The heart muscle requires a constant supply of oxygen-rich blood to nourish it. The coronary arteries provide the heart with this critical blood supply. If you have coronary artery disease, those arteries become narrow and blood cannot flow as well as they should. Fatty matter, calcium, proteins, and inflammatory cells build up within the arteries to form plaquesof different sizes. The plaque deposits are hard on the outside and soft and mushy on the inside.

When the plaque is hard, the outer shell cracks (plaque rupture), platelets (disc-shaped particles in the blood that aid clotting) come to the area, and blood clots form around the plaque. If a blood clot totally blocks the artery, the heart muscle becomes “starved” for oxygen. Within a short time, death of heart muscle cells occurs, causing permanent damage. This is a heart attack.

Some are the fast facts of heart attack:

• During a heart attack, the heart muscle loses blood supply and is damaged.
• Chest discomfort and pain are common symptoms.
• The risk of a heart attack increases when a man is over 45 and a woman is over 55.
• Smoking and obesity are big factors, particularly in the at-risk age range.

How to find heart attack?  So there are symptoms of heart attack  that can easily understand by Cardiology doctors.

There are clear symptoms of a heart attack that require immediate medical attention.

A feeling of pressure, tightness, pain, squeezing, or aching in the chest or arms that spreads to the neck, jaw, or back can be a sign that a person is having a heart attack.

The following are other possible signs and symptoms of a heart attack occurring:

• coughing
• nausea
• vomiting
• crushing chest pain
• dizziness
• shortness of breath called dyspepsia
• face seeming gray in color
• a feeling of terror that life is ending
• feeling awful, generally
• restlessness
• feeling clammy and sweaty
• shortness of breath

Changing position does not alleviate the pain of a heart attack. The pain a person feels is normally constant, although it may sometimes come and go.

Warning signs of heart attack that an attack is occur in any time, so that you should actively know and go to hospital.

As heart attacks can be fatal, it is vital to recognize the warning signs that an attack is occurring.

While the symptoms listed above are all linked to heart attacks, there are four warning signs listed by the American Heart Association (AHA) as being crucial signs of an attack. These include:

• discomfort, pressure, squeezing, or fullness in the chest that lasts several minutes or resolves then returns
• pain or discomfort in the arms, neck, back, stomach, or jaw
• sudden shortness of breath

Other signs can include a cold sweat, a sick or nauseous feeling, or being lightheaded.

When a person has these symptoms, the emergency services should be called immediately.

Some complications happen during heart attack. There two types of complications. The first one is Immediate complications and the second is complications that can occur later.

Immediate complications

• Arrhythmias: the heart beats irregularly, either too fast or too slowly.
• Cardiogenic shock: a person’s blood pressure drops suddenly and the heart cannot supply enough blood for the body to work adequately.
• Hypoxemia: levels of oxygen in the blood become too low.
• Pulmonary edema: fluid accumulates in and around the lungs.
• DVT or deep vein thrombosis: the deep veins of the legs and pelvis develop blood clots that either block or interrupt the flow of blood in the vein.
• Myocardial rupture: the heart attack damages the wall of the heart, meaning an increased risk of a heart wall rupture.
• Ventricular aneurysm: a heart chamber, known as a ventricle, forms a bulge.

Complications that can occur later

• Aneurysm: scar tissue builds up on the damaged heart wall, leading to blood clots, low blood pressure, and abnormal heart rhythms.
• Angina: not enough oxygen reaches the heart, causing chest pain.
• Congestive heart failure: the heart can only beat very weakly, leaving a person feeling exhausted and breathless.
• Edema: fluid accumulates in the ankles and legs, causing them to swell.
• Loss of erectile function: erectile dysfunction is generally caused by a vascular problem. However, it can also be the result of depression.
• Loss of libido: a loss of sexual drive can happen, especially in the case of men.
• Pericarditis: the lining of the heart becomes inflamed, causing serious chest pain.

It is important that a doctor monitors a person for several months after they have had a heart attack to check for any of these complications that may occur.

There are some causes of heart attack:

The following factors are associated with increased risk of a heart attack:

• Age: Heart attacks are more likely when a man is over 45, and when a woman is over 55.
• Angina: This causes chest pain due to lack of oxygen or blood supply to the heart.
• High cholesterol levels: These can increase the chance of blood clots in the arteries.
• Diabetes: This can increase heart attack risk.
• Diet: For example, consuming large quantities of saturated fats can increase the likelihood of a heart attack.
• Genetics: A person can inherit a higher risk of heart attack.
• Heart surgery: This can lead to a heart attack later on.
• Hypertension: High blood pressure can put unnecessary strain on the heart.
• Obesity: Being significantly overweight can put pressure on the heart.
• Previous heart attack.
• Smoking: Smokers are at much higher risk than non-smokers.
• HIV: People who are HIV-positive have a 50 percent higher risk.
• Work stress: Those who are shift workers or have stressful jobs can face a higher heart attack risk.

Physical inactivity is a factor in heart attack risk, and the more active people are, the lower their risk of having a heart attack.

Often, when it occurs, a heart attack is caused by a combination of factors, rather than a single one

How tom diagnose a heart attack?

Any doctor, nurse, or healthcare professional will send someone straight to hospital if they suspect they may be having a heart attack. Once there, several tests may be done, including:

• ECG or electrocardiograph
• cardiac enzyme tests
• chest X-ray

Some are the treatments during a heart attack

The quicker someone is treated when having a heart attack, the greater the chances of success. These days, most heart attacks can be dealt with effectively.

However, it is crucial to remember that a person’s survival depends largely on how quickly they reach the hospital.

If a person has a history of heart attacks, they should speak to a doctor about treatment plans.

Sometimes, a person who is having a heart attack will stop breathing. In this case, cardio-pulmonary resuscitation, or CPR, should be started immediately. This process involves:

• manual chest compressions
• a defibrillator

Most people will need several kinds of medications or treatments after a heart attack.

 The aim of these measures is to prevent future heart attacks occurring. They may include:

Aspirin and other antiplatelets

Beta blockers

ACE (angiotensin converting enzyme) inhibitors

Statins

Angioplasty

CABG or coronary artery bypasses graft

Preventions about heart attack:

The best way of preventing a heart attack is to have a healthy lifestyle. Measures for healthy living include the following:

• not smoking
• eating a balanced, healthful diet
• getting plenty of exercise
• getting plenty of good quality sleep
• keeping diabetes under control
• keeping alcohol intake down
• maintaining blood cholesterol at optimum levels
• keeping blood pressure at a safe level
• maintaining a healthy body weight
• avoiding stress where possible
• learning how to manage stress

It may be helpful for people to learn more about the warning signs of a heart attack, as well.

Recovering from a heart attack can be a gradual process. It depends on the severity of the heart attack and other factors, such as a person’s age.

A person’s recovery may involve:

• Resuming physical activity: it is vital that a recovering heart attack patient stays active. However, a specialist should design any exercise program for them.
• Returning to work: the appropriate time for someone to go back to work depends on various factors, including the severity of the heart attack and the type of job they do. It is vital not to rush back to work.
• A period of depression: many people who have had a heart attack experience depression not long afterward. Those who feel depressed or anxious should tell their doctors.
• Driving again: experts advise that a person refrains from driving for at least 4 weeks after a heart attack.
• Erectile dysfunction: approximately one-third of men have problems getting or sustaining an erection after a heart attack.

It is important that men with erectile dysfunction talk to their doctors, as medication can restore function in most cases.

Experts say that sexual activity does not raise a person’s risk of having another heart attack.

written by: shahid Nazir university of narowal pakistan