Heart attack is the death of a segment of heart muscle caused by the loss of blood supply.
The blood supply is usually lost because a coronary artery, one that supplies blood to the heart muscle, is blocked by a blood clot (coronary thrombosis).
If some of the heart muscle dies, the patient experiences chest pain and electrical instability of the heart muscle tissue.
This article will cover information about how and why heart attacks occur, how they are treated, and how to prevent them.
Contents of this article:
What is a heart attack?
Myocardial infarction is another name for a heart attack.
Other terms used for a heart attack include myocardial infarction, cardiac infarction, and coronary thrombosis (Infarction refers to the process whereby an area of dead tissue is caused by a loss of blood supply).
According to the American Heart Association:
- During a heart attack, the heart muscle that loses its blood supply starts to suffer injury.
- How much damage occurs depends on the size of the area that is supplied by the blocked artery, as well as the length of time between injury and treatment.
- The damaged heart muscle heals by forming scar tissue. The healing process may take several weeks.
- Despite severe injury to a part of the heart, the rest of the organ carries on working.
- However, as part of the heart has been damaged, it will probably be weaker and will not pump as much blood as it used to.
- With the right treatment and lifestyle changes, further damage can be prevented or limited.
Symptoms of a heart attack
The following are signs and symptoms for diagnosing a heart attack:
- Chest discomfort, mild pain
- Crushing chest pain
- Pressure tightness, pain, squeezing or aching in the chest or arms that spreads to the neck, jaw, or back
- Dyspnea (shortness of breath)
- Face seems gray
- A feeling of terror that your life is coming to its end
- Feeling really awful (general feeling)
- Feeling clammy and sweaty
- Shortness of breath
The emergency services should be called immediately.
The pain of a heart attack is not alleviated by changing position; the pain is normally constant, but it may sometimes come and go. Patients describe the pain as one of pressure, like a clamp squeezing inside your chest. The pain can last from a few minutes to many hours.
Causes of a heart attack
The following are possible factors associated with increased risk of heart attack.
- Age: Risk increases when a man is over 45, and a woman is over 55.
- Angina: An illness where not enough oxygen reaches the heart, causing chest pain resembling a heart attack, but it resolves after taking medication. Angina raises the risk of a heart attack.
- High blood cholesterol levels: Increases the risk of developing blood clots in the arteries.
- Diabetes: People with diabetes have a higher risk of developing several diseases and conditions, many of them contribute to a higher risk of heart attack.
- Diet: Someone who consumes large quantities of, for example, saturated fats, will eventually have a higher risk of having a heart attack.
- Genes: You can inherit a higher risk of heart attack.
- Heart surgery: Patients who have had heart surgery have a higher risk.
- Hypertension (high blood pressure).
- Obesity, overweight.
- Physical inactivity: More active people have a lower risk.
- Previous heart attack: Anybody who has already had a heart attack is more likely to have another one, compared with people who have not.
- HIV: People who are HIV positive have a 50 percent higher risk of heart attack.
- Work stress: Individuals with stressful jobs, or shift workers have an increased risk of heart attack.
Diagnosis of heart attacks
Any doctor, nurse, or health care professional, will send a patient straight to hospital if they suspect they may have a heart attack. In hospital, several tests might be done:
- ECG (Electrocardiograph): Monitors the electrical activity of the heart muscles
- Cardiac enzyme tests: Blood tests detect enzymes produced during a heart attack
- Chest X-ray: To look for swelling of the heart
Treatments for a heart attack
The faster the heart attack patient can be treated, the more successful his/her treatment will be. These days, the majority of heart attacks can be treated effectively. It is crucial to remember that the patient's survival depends largely on how quickly they can be taken to hospital.
Treatments during a heart attack
CPR (cardio-pulmonary resuscitation)
Some heart attack patients stop breathing; they do not move or respond when spoken to or touched, they may also be coughing. If this is the case, CPR should be started straight away. This involves:
- Manual chest compressions - continuous chest compressions to the heart at about 100 beats per minute.
- Defibrillator - the defibrillator sends electric shocks across the patient's chest - the aim is to use electricity to shock the heart back into proper activity.
- Aspirin - often given to patients during a heart attack. Aspirin will help stop the clot in the artery from growing.
- Thrombolytics - these dissolve blood clots.
- Painkillers - morphine is sometimes injected into the patient to control the pain and reduce anxiety.
Treatments following a heart attack
Most patients will need several different medications after their heart attack. The aim being to prevent future heart attacks from occurring.
- Aspirin and other antiplatelets: Antiplatelets lower the chances of blood clotting
- Beta-blockers: Make the heart beat slower and with less force
- ACE (Angiotensin-converting enzyme) inhibitors: Ease the workload on the heart by opening up blood vessels and lowering blood pressure
- Statins: Lower blood cholesterol levels
- Procedures after a heart attack: If the patient's heart has been severely damaged they may need a procedure. The most common two are:
- Angioplasty: This procedure opens up the coronary artery. A small wire enters the artery and is pushed until it reaches the clot in the coronary artery. A small balloon at the end of the wire is placed at the narrowest part of the artery and inflated, squashing the clot. A flexible metal mesh, called a stent, is then placed there to keep the artery open.
- CABG (Coronary artery bypass graft): The damaged blood vessel is bypassed with grafts taken from blood vessels elsewhere in the body. The bypass effectively goes around the blocked area of the artery, allowing blood to pass through into the heart muscle.
Recovery after a heart attack
Resting after a heart attack is essential.
Recovering from a heart attack can be a slow and gradual process.
It may involve liaising with various types of health care professionals, including doctors, dietitians, nurses, physiotherapists, pharmacists, and personal trainers.
- Physical activity: It is vital that a recovering heart attack patient tries to stay active. However, it is important that any exercise program is devised by a specialist.
- Going back to work: When a heart attack patient can go back to work depends on various factors including the severity of the heart attack and the type of job. It is vital that people do not rush back to work.
- Depression: About 20 percent of heart attack patients go on to have a major episode of depression not long afterward. Heart attack patients who feel depressed or anxious should tell their doctors immediately.
- Driving: Experts advise that a person refrains from driving for at least 4 weeks after a heart attack.
- Erectile dysfunction: Approximately one third of all men who have a heart attack have problems getting, or sustaining, an erection. Experts say that sexual activity does not raise a person's risk of having another heart attack. It is important that men with erectile dysfunction talk to their doctors - in the majority of cases, medications are effective at restoring function.
Complications after a heart attack
There are two types of complications, those that occur pretty much straight away, and those that happen later.
- Arrhythmias - the heart beats irregularly, either too fast or too slowly. Most patients, with time, will return to regular rhythms.
- Cardiogenic shock - the patient's blood pressure suddenly drops dangerously. The heart cannot supply enough blood for the body to work adequately.
- Hypoxemia - levels of blood oxygen become too low.
- Pulmonary edema - fluid accumulation in and around the lungs.
- DVT (deep vein thrombosis) - the deep veins of the legs and pelvis develop blood clots which either block or interrupt the flow of blood in the vein.
- Myocardial rupture - the heart attack damages the wall of the heart. This increases the risk of a heart wall rupture.
- Ventricular aneurysm - one of the chambers (ventricles) of the heart forms a bulge.
Complications that can occur later
- Aneurysm - scar tissue builds up on the damaged heart wall. This leads to blood clots, low blood pressure, and abnormal heart rhythms.
- Angina - Not enough oxygen is reaching the heart. Symptoms may be similar to those of a heart attack.
- Congestive heart failure - the heart can only beat very weakly. The patient feels exhausted and breathless.
- Edema - fluid accumulates in the ankles and legs (they 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 - this is especially the case with men.
- Pericarditis - the lining of the heart becomes inflamed, causing serious chest pain.
Patients who comply with their doctor's instructions have a much better chance of recovery than those who don't. It is important that the doctor monitors a heart attack patient for several months afterwards.
Minimizing your chances of having a heart attack
- Don't smoke
- Eat a balanced, healthy diet
- Get plenty of exercise
- Get plenty of good quality sleep
- Keep diabetes under control
- Keep alcohol intake down
- Keep blood cholesterol at optimum levels
- Keep blood pressure at safe levels
- Maintain a healthy body weight
- Avoid stress where possible
- Learn how to manage stress