Heart Attacks (Myocardial Infarctions)
By Brock Morris and Trevor Patton
What is a Heart Attack?
- A heart attack is when the heart muscle becomes "starved" for oxygen. Within a short time, death of heart muscle cells occurs, causing permanent damage
What Causes a Heart Attack?
-A heart attack occurs when one or more of your coronary arteries become blocked. Over time, a coronary artery can narrow from the buildup of various substances, including cholesterol (atherosclerosis). This condition, known as coronary artery disease, causes most heart attacks.
-Another cause of a heart attack is a spasm of a coronary artery that shuts down blood flow to part of the heart muscle. Use of tobacco and of illicit drugs, such as cocaine, can cause a life-threatening spasm. A heart attack can also occur due to a tear in the heart artery
Symptoms vary , but here are the most common ones :
- Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back
- Nausea, indigestion, heartburn or abdominal pain
- Shortness of breath
- Cold sweat
- Lightheadedness or sudden fizz I news
-Medication and lifestyle choices . ( Eat right and exercise ! Golden rule for everything .)
- Risk factors
Age. Men age 45 or older and women age 55 or older are more likely to have a heart attack than are younger men and women
Tobacco. Smoking and long-term exposure to secondhand smoke increase the risk of a heart attack.
High blood pressure. Over time, high blood pressure can damage arteries that feed your heart by accelerating atherosclerosis. High blood pressure that occurs with obesity, smoking, high cholesterol or diabetes increases your risk even more
High blood cholesterol or triglyceride levels. A high level of low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol) is most likely to narrow arteries. A high level of triglycerides, a type of blood fat related to your diet, also ups your risk of heart attack. However, a high level of high-density lipoprotein (HDL) cholesterol (the "good" cholesterol) lowers your risk of heart attack.
Diabetes. Insulin, a hormone secreted by your pancreas, allows your body to use glucose, a form of sugar. Having diabetes — not producing enough insulin or not responding to insulin properly — causes your body's blood sugar levels to rise. Diabetes, especially uncontrolled, increases your risk of a heart attack.
Family history of heart attack. If your siblings, parents or grandparents have had early heart attacks (by age 55 for male relatives and by age 65 for female relatives), you may be at increased risk.
Lack of physical activity. An inactive lifestyle contributes to high blood cholesterol levels and obesity. People who get regular aerobic exercise have better cardiovascular fitness, which decreases their overall risk of heart attack. Exercise is also beneficial in lowering high blood pressure
Obesity. Obesity is associated with high blood cholesterol levels, high triglyceride levels, high blood pressure and diabetes. Losing just 10 percent of your body weight can lower this risk, however
Stress. You may respond to stress in ways that can increase your risk of a heart attack.
Illegal drug use. Using stimulant drugs, such as cocaine or amphetamines, can trigger a spasm of your coronary arteries that can cause a heart attack.
A history of preeclampsia. This condition causes high blood pressure during pregnancy and increases the lifetime risk of heart disease.
A history of an autoimmune condition, such as rheumatoid arthritis or lupus. Conditions such as rheumatoid arthritis, lupus and other autoimmune conditions can increase your risk of having a heart attack.
- Aspirin. The 911 operator may instruct you to take aspirin, or emergency medical personnel may give you aspirin immediately. Aspirin reduces blood clotting, thus helping maintain blood flow through a narrowed artery.
- Thrombolytics. These drugs, also called clotbusters, help dissolve a blood clot that's blocking blood flow to your heart. The earlier you receive a thrombolytic drug after a heart attack, the greater the chance you'll survive and with less heart damage.
- Antiplatelet agents. Emergency room doctors may give you other drugs to help prevent new clots and keep existing clots from getting larger. These include medications, such as clopidogrel (Plavix) and others, called platelet aggregation inhibitors.
- Other blood-thinning medications. You'll likely be given other medications, such as heparin, to make your blood less "sticky" and less likely to form clots. Heparin is given intravenously or by an injection under your skin.
- Pain relievers. You may receive a pain reliever, such as morphine, to ease your discomfort.
- Nitroglycerin. This medication, used to treat chest pain (angina), can help improve blood flow to the heart by widening (dilating) the blood vessels.
- Beta blockers. These medications help relax your heart muscle, slow your heartbeat and decrease blood pressure, making your heart's job easier. Beta blockers can limit the amount of heart muscle damage and prevent future heart attacks.
- ACE inhibitors. These drugs lower blood pressure and reduce stress on the heart.
-Surgical procedures :
Coronary angioplasty and stenting. Doctors insert a long, thin tube (catheter) that's passed through an artery, usually in your leg or groin, to a blocked artery in your heart. If you've had a heart attack, this procedure is often done immediately after a cardiac catheterization, a procedure used to locate blockages.
This catheter is equipped with a special balloon that, once in position, is briefly inflated to open a blocked coronary artery. A metal mesh stent may be inserted into the artery to keep it open long term, restoring blood flow to the heart. Depending on your condition, your doctor may opt to place a stent coated with a slow-releasing medication to help keep your artery open.
Coronary artery bypass surgery. In some cases, doctors may perform emergency bypass surgery at the time of a heart attack. If possible, your doctor may suggest that you have bypass surgery after your heart has had time — about three to seven days — to recover from your heart attack.
Bypass surgery involves sewing veins or arteries in place beyond a blocked or narrowed coronary artery, allowing blood flow to the heart to bypass the narrowed section.
Once blood flow to your heart is restored and your condition is stable, you're likely to remain in the hospital for several days.