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When the flow of blood to the heart is obstructed, a heart attack ensues. The most common cause of a blockage is a buildup of fat, cholesterol, and other substances that create a plaque in the arteries that supply the heart (coronary arteries).
A plaque can break and generate a clot, obstructing blood flow. Interrupted blood flow has the potential to harm or kill a portion of the heart muscle.
A heart attack, also known as a myocardial infarction, can be fatal, although therapy has greatly improved over the years. If you believe you are experiencing a heart attack, call 911 or an emergency medical service immediately.
WHAT ARE THE SYMPTOMS OF A HEART ATTACK?
The following are common indications and symptoms of a heart attack:
- Pressure, tightness, pain, squeezing, or hurting sensations in your chest or arms, which may spread to your neck, jaw, or back
- Nausea, indigestion, heartburn, or stomach pain
- Breathing difficulty
- Sweating coldly
- Fatigue
- Lightheadedness or dizziness that occurs suddenly
Symptoms of a heart attack vary.
Not everyone who has a heart attack experiences the same symptoms or the same level of symptoms. Some people experience modest pain, while others experience severe pain. Some persons show no signs of illness. For others, the initial symptom could be a cardiac arrest. The more indications and symptoms you have, however, the more likely you are suffering a heart attack.
Although some heart attacks occur unexpectedly, many patients have warning signs and symptoms hours, days, or weeks in advance. The first sign could be recurring chest pain or pressure (angina), which is caused by exercise and eased by rest. Angina is produced by a brief reduction in blood flow to the heart.
WHAT ARE THE CAUSES OF A HEART ATTACK?
When one or more of your coronary arteries get clogged, you have a heart attack. A buildup of fatty deposits, including cholesterol, forms plaques over time, which can restrict the arteries (atherosclerosis). The majority of heart attacks are caused by this ailment, known as coronary artery disease.
A plaque can break during a heart attack, releasing cholesterol and other chemicals into the bloodstream. At the site of the breach, a blood clot forms. If the clot is large enough, it can prevent blood flow via the coronary artery, depriving the heart of oxygen and nutrition (ischemia).
The coronary artery may be completely or partially blocked.
- A total blockage indicates that you have suffered a ST elevation myocardial infarction (STEMI).
- A partial blockage indicates that you experienced a non-ST elevation myocardial infarction (NSTEMI).
Depending on the type, your diagnosis and treatment may differ.
A spasm of a coronary artery, which cuts off blood flow to a portion of the heart muscle, is another cause of a heart attack. Tobacco and illegal narcotics, such as cocaine, can produce a potentially fatal spasm.
Infection with COVID-19 may also cause heart damage, leading to a heart attack.
WHAT ARE THE RISK FACTORS FOR A HEART ATTACK?
Certain factors contribute to the undesirable accumulation of fatty deposits (atherosclerosis), which narrows arteries throughout your body. Many of these risk factors can be improved or eliminated to lessen your chances of having a first or subsequent heart attack.
The following are risk factors for a heart attack:
- Age: Men over the age of 45 and women over the age of 55 are more likely to have a heart attack than younger men and women.
- Tobacco: This includes smoking and long-term secondhand smoke exposure.
- Hypertension (high blood pressure): High blood pressure can damage the arteries that lead to your heart over time. High blood pressure combined with other illnesses, such as obesity, high cholesterol, or diabetes, raises your risk even further.
- Stress: You may react to stress in ways that increase your chance of having a heart attack.
- Use of illicit drugs: Using stimulants like cocaine or amphetamines can produce a spasm in your coronary arteries, which can lead to a heart attack.
- Preeclampsia in the past: This condition causes high blood pressure during pregnancy and increases the risk of heart disease later in life.
- An autoimmune disease: A illness like rheumatoid arthritis or lupus can raise your risk of having a heart attack.
- Obesity: Obesity has been associated to high blood cholesterol, triglyceride levels, high blood pressure, and diabetes. This risk can be reduced by losing merely 10% of your body weight.
- Diabetes: Inadequate production of a hormone generated by your pancreas (insulin) or improper insulin response causes your blood sugar levels to rise, increasing your risk of a heart attack.
- Metabolic syndrome (MS): Obesity, high blood pressure, and excessive blood sugar all contribute to this syndrome. If you have metabolic syndrome, you are twice as likely to get heart disease as if you don't.
- A family history of heart attacks: If any of your siblings, parents, or grandparents had a heart attack while they were young (by the age of 55 for men and 65 for women), you may be at a higher risk.
- Insufficient physical activity: Inactivity relates to elevated blood cholesterol and obesity. Regular exercisers had improved heart health, as well as reduced blood pressure.
WHAT ARE THE COMPLICATIONS OF A HEART ATTACK?
Complications are frequently associated with the damage done to your heart following a heart attack, which can result in:
- Arrhythmias (abnormal heart rhythms): Electrical "short circuits" can form, resulting in aberrant heart rhythms, some of which are fatal.
- Heart failure: A heart attack may cause so much damage to your heart tissue that the remaining heart muscle is unable to pump enough blood out of your heart. Heart failure can be either transient or chronic, resulting from substantial and irreversible damage to your heart.
- Sudden cardiac arrest: Your heart pauses without warning due to an electrical disruption that generates an irregular heart rhythm (arrhythmia). Heart attacks raise the risk of abrupt cardiac arrest, which can result in death if not treated immediately.
HOW IS A HEART ATTACK DIAGNOSED?
Ideally, your doctor should check you for risk factors that can contribute to a heart attack during routine physical exams.
If you're in an emergency room with symptoms of a heart attack, you'll be asked about them and your blood pressure, pulse, and temperature will be taken. You will be hooked up to a heart monitor and tested to see if you are experiencing a heart attack.
The following tests are used to diagnose a heart attack:
- Electrocardiogram (ECG): This initial test for detecting a heart attack detects electrical signals as they flow through your heart. Electrodes (sticky patches) are placed to your chest and limbs. Signals are captured as waves that can be viewed on a monitor or printed on paper. Because wounded heart muscle does not ordinarily conduct electrical impulses, the ECG may indicate that a heart attack has occurred or is currently occurring.
- Blood tests: Following cardiac damage following a heart attack, certain heart proteins slowly leak into your bloodstream. Doctors in the emergency room will obtain blood samples to look for these proteins, or enzymes.
Additional tests
If you've had or are suffering a heart attack, doctors will treat your condition as soon as possible. You may also be subjected to these extra tests.
- Chest X-ray: An X-ray scan of your chest allows your doctor to examine the size of your heart and blood arteries, as well as the presence of fluid in your lungs.
- Echocardiogram: Images of the moving heart are created by sound waves (ultrasound). This test can be used by your doctor to determine how well your heart's chambers and valves are flowing blood through your heart. An echocardiography can assist determine whether your heart has been damaged in any way.
- Coronary catheterization (angiogram): A liquid dye is injected into your heart's arteries via a long, thin tube (catheter) that is fed through an artery, generally in your leg or groin, to the arteries in your heart. On an X-ray, the dye makes the arteries visible, indicating areas of obstruction.
- Cardiac CT or MRI: These examinations produce images of your heart and chest. X-rays are used in cardiac CT scans. Cardiac MRI creates images of your heart using a magnetic field and radio waves. You lie on a table that glides within a long tubelike machine for both exams. Each of these tests can be used to diagnose heart abnormalities, including the level of damage caused by heart attacks.
WHAT ARE THE TREATMENTS FOR A HEART ATTACK?
More heart tissue deteriorates or dies every minute after a heart attack. Quickly restoring blood flow aids in the prevention of cardiac injury.
Medications
The following medications may be used to treat a heart attack:
- Aspirin: The 911 operator may advise you to take aspirin, or emergency medical staff may administer aspirin to you right away. Aspirin lowers blood clotting, which aids in the maintenance of blood flow through a restricted artery.
- Thrombolytics: These medications, also known as clotbusters, aid in the dissolution of a blood clot that is impeding blood flow to your heart. The sooner you receive a thrombolytic medicine after a heart attack, the more likely you will survive with less cardiac damage.
- Nitroglycerin: This medicine, which is used to treat chest pain (angina), can enhance blood flow to the heart by widening (dilating) the blood arteries.
- Beta blockers: These medications aid in the relaxation of your heart muscle, the slowing of your heartbeat, and the reduction of blood pressure, making your heart's job simpler. Beta blockers can reduce heart muscle damage and help avoid future heart attacks.
- ACE inhibitors: These medications lower blood pressure and put less strain on the heart.
- Statins: These medications aid in the regulation of your blood cholesterol levels.
- Antiplatelet agents: Other medications known as platelet aggregation inhibitors may be prescribed by emergency room doctors to help prevent new clots and keep existing clots from growing larger.
- Other blood-thinning medications: Other medications, such as heparin, will most likely be administered to make your blood less "sticky" and less likely to clot. Heparin is administered intravenously or through an injection under the skin.
- Pain relievers: A pain reliever, such as morphine, may be administered to you.
Surgical and non-surgical procedures
In addition to drugs, you may be subjected to one of the following procedures to treat your heart attack:
- Coronary angioplasty and stenting: Doctors pass a long, thin tube (catheter) through an artery in your groin or wrist to a blocked artery in your heart during this operation, also known as percutaneous coronary intervention (PCI). If you've had a heart attack, this surgery is usually performed right after a cardiac catheterization, which is used to detect blockages.
The catheter has a unique balloon that is temporarily inflated once in place to unblock a blocked coronary artery. Almost always, a metal mesh stent is put into the artery to keep it open indefinitely, restoring blood flow to the heart. Typically, a stent is covered with a slow-releasing medicine to assist in keeping your artery open.
- Coronary artery bypass surgery: Doctors may do emergency bypass surgery during a heart attack in some situations. However, if possible, you could have bypass surgery after your heart has had time to recuperate from your heart attack (approximately three to seven days).
Sewing veins or arteries in place beyond a blocked or narrowed coronary artery allows blood flow to the heart to bypass the narrowed segment.
After blood supply to your heart is restored and your condition stabilizes, you will most likely be hospitalized for many days.
Cardiac rehabilitation
Most hospitals provide programs that begin while you are in the hospital and last for many weeks to several months after you leave. Cardiac rehabilitation programs often concentrate on four primary areas: medications, lifestyle changes, mental concerns, and a gradual return to normal activity.
It is critical that you enroll in this program. People who participate in cardiac rehabilitation after a heart attack live longer and are less likely to have another heart attack or complications from the heart attack. Inquire with your doctor if cardiac rehab is not indicated during your hospitalization.
HEART ATTACK HOME REMEDIES
Take the following steps to improve your heart health:
- Smoking should be avoided: The most important thing you can do to promote the health of your heart is to quit smoking. Also, stay away from secondhand smoke. If you need to quit smoking, seek advice from your doctor.
- Maintain a healthy blood pressure and cholesterol level: If either or both of these are elevated, your doctor may recommend dietary and pharmaceutical modifications. Inquire with your doctor about how frequently you should have your blood pressure and cholesterol levels checked.
- Diabetes management: Regular exercise, a healthy diet, and decreasing weight all contribute to blood sugar levels that are more desired. Many people require medicine to control their diabetes.
- Stress management: Reduce the amount of tension in your daily tasks. Rethink your workaholic tendencies and look for healthier ways to reduce or deal with stressful occurrences in your life.
- Avoid or limit alcohol consumption: If you must consume alcohol, do it in moderation. That equates to up to one drink per day for women and up to two drinks per day for males in healthy people.
- Maintain frequent medical checkups: Some of the key risk factors for a heart attack, such as high blood cholesterol, high blood pressure, and diabetes, have no early signs. Your doctor can screen for these diseases and, if required, help you manage them.
- Exercise: Regular exercise both improves and prevents cardiac muscle function after a heart attack. Get at least 150 minutes of moderate aerobic activity per week or 75 minutes of vigorous aerobic activity per week, or a combination of the two.
- Keep a healthy weight: Excess weight puts stress on your heart and can lead to high cholesterol, high blood pressure, and diabetes.
- Consume a heart-healthy diet: Dietary saturated fat, trans fats, and cholesterol can restrict arteries leading to the heart, and too much salt can elevate blood pressure. Consume a heart-healthy diet rich in lean proteins such as fish and legumes, as well as fruits, vegetables, and whole grains.
WHAT SHOULD YOU DO IF YOU NOTICE SOMEONE WHO APPEARS TO BE HAVING A HEART ATTACK?
If you encounter someone who is unconscious and suspects they are suffering a heart attack, call 911 immediately. Check to see if the individual is breathing and has a pulse. Only start CPR if the victim isn't breathing or if you can't identify a pulse.
Push firmly and fast on the person's chest in a very quick cadence — 100 to 120 compressions per minute.
Doctors recommend merely chest compressions if you haven't been trained in CPR. If you have had CPR training, you can progress to opening the airway and rescue breathing.