Heart Attack

Heart attack is a layman’s term for myocardial infarction, a condition caused by an interruption of blood supply to the heart resulting in a shortage of oxygen or ischemia.

The longer a heart attack lasts, the more damage is caused to the tissue of the heart due to oxygen deprivation, and after a period of time the damage may become irreversible.

A heart attack is an extremely serious medial emergency, and one of the leading causes of death worldwide. You may be at greater risk of a heart attack if you have a history of vascular diseases, such as angina or coronary heart disease, or any previous heart problems including but not limited to abnormal heart rhythm and high blood pressure.

Smokers and heavy alcohol users are at increased risk of suffering a heart attack, as are some other recreational drug users and anybody over the age of 40. Diabetes, obesity and stress are also conditions conducive to myocardial infarction.

Myocardial refers to the heart muscle, and infarction means tissue death caused by oxygen starvation. A sudden heart failure is often referred to as a heart attack, but may technically not be if it is not caused by acute myocardial infarction.

Typical symptoms to watch out for in the event of a heart attack are chest pain, sometimes radiating to the neck and along the left arm, shortness of breath, palpitations and sweating, nausea, vomiting and anxiety. Many sufferers have reported feeling an overwhelming self-awareness that they were about to die. These feelings will usually come on quite suddenly, though around a third of heart attacks occur without any symptoms at all.

The first course of action in the event of a suspected heart attack is to seek emergency medical help immediately. A physician may give the patient oxygen to make them more comfortable and aspirin to thin the blood, as well as a pain reliever such as morphine.

Diagnosing a heart attack involves such tests as an electrocardiogram or ECG, chest x-rays and blood tests to look for the telltale traces of tissue damage (elevated troponin and creatine kinase levels). Treatment may then progress to the source of the blockage, which may mean medication being given to break down a blood clot, or emergency bypass surgery to circumnavigate the problem.

Dilation of the coronary artery may also be possible. Most coronary care units will be well-equipped to deal with complications, so you should ensure that you reach one as soon as possible.

A lot of the risk factors for heart attack are self-controlled and can therefore be modified. You can reduce your risk of having a heart attack by eating healthily and maintaining a healthy wait, as well as taking moderate regular exercise, not smoking or drinking, or taking other dangerous drugs.

Some risk factors however are unmodifiable, and include age, gender (men are more likely to suffer a heart attack, and at an earlier age), and family medical history, as it is believed that one can be genetically predisposed to be at risk of myocardial infarction.

People in lower socio-economic groups are generally at greater risk of suffering a heart attack, partly because maintaining a healthy lifestyle and diet, and getting regular medical checkups, can be an expensive business.

Taking oral contraceptive pills may increase a woman’s likelihood of suffering a heart attack, especially when combined with other risk factors such as smoking, drinking, or genetic predisposition.

Symptoms of a heart attack will typically become apparent over the course of a few minutes, and most begin with chest pains and shortness of breath, due ischemia, which is the shortage of oxygen due to interrupted blood supply. Many sufferers describe it as a feeling of tightness or crushing, squeezing sensation.

This pain can often extend the length of the patient’s left arm, and sometimes also to the neck, lower jaw, right arm and back. The victim may also experience heartburn-like feelings of discomfort. Any symptom or combination of symptoms potentially caused by the sudden interruption of blood flow to the heart are termed ‘acute coronary syndrome’.

Dyspnea is the medical term for shortness of breath, and is another key feature of a heart attack. Sufferers experience shortness of breath due to the reduced output of the damaged heart, sometimes caused by pulmonary edema. They may also start to sweat profusely, a condition known as diaphoresis, feel weak and light headed, sick and shaky. Loss of consciousness is a very real risk during a heart attack, and cases of sudden death are not uncommon.

Around half of all heart attack sufferers experience symptoms such as shortness of breath or chest pain prior to an attack.

Women may present with markedly different symptoms than men in the event of a heart attack, with fewer experiencing the same crushing chest pains. Shortness of breath, weakness and sleep disturbance are the primary indicators of myocardial infarction in women, and any experiencing these symptoms should seek medical help immediately.

Around one quarter of all heart attacks are ‘silent’, presenting without chest pain or any other symptoms. In these cases, the infarction may be detected by an ECG or in unfortunate cases, at an autopsy. The elderly are more likely to experience sudden, silent heart attacks, but diabetics are also at increased risk due to their elevated pain threshold and autonomic neuropathy.

Following a heart attack, patients will likely be put on medication in order to reduce the risk of further damage and complications arising. Such medication may include antiplatelet drug therapy (aspirin/clopidogrel) to reduce the chance of plaque rupture and other cardiovascular events, beta blockers such as metoprolol and carvedilol, ACE inhibitors, and omega-3 fatty acids, which have been demonstrated to lower the mortality rate following a heart attack.