Heart Attack: Causes, Symptoms and Treatment

Your heart is a muscular pump that needs a continuous supply of oxygen. It gets oxygen from your blood, which flows to the heart muscle through arteries on its surface. These arteries are called coronary arteries. A heart attack happens when the supply of oxygen-rich blood is cut off from part of the heart muscle.

They are usually caused by blockages in the arteries that provide the heart with blood. As a result of the blockage, some of the heart muscles begin to die. Without early medical treatment, this damage can be permanent.

A heart attack is also called Myocardial infarction. ‘Myo’ means muscle, ‘cardial’ refers to the heart and ‘infarction’ means the death of tissue because of a lack of blood supply.

Causes

A heart attack occurs when one or more of your coronary arteries become blocked. Over time, a buildup of fatty deposits, including cholesterol, forms substances called plaques, which can narrow the arteries (atherosclerosis). This condition, called coronary artery disease, causes most heart attacks.

During a heart attack, plaque can rupture and spill cholesterol and other substances into the bloodstream. A blood clot forms at the site of the rupture. If the clot is large, it can block blood flow through the coronary artery, starving the heart of oxygen and nutrients (ischemia).

There are two types of a heart attacks.

  1. ST-Elevation Myocardial Infarction (STEMI): If the coronary artery in question gets completely blocked, blood flow stops entirely and the full thickness of heart muscle fed by that artery is damaged. This causes a characteristic change on the electrocardiogram (ECG) readout called an ST-segment elevation.
  2. Non_STEMI (NSTEMI): If the coronary artery is only partially blocked by clots, blood flow decreases but does not stop. Only part of the heart muscle is damaged and ST-segment elevation is not seen on the ECG. This is called a non-ST-elevation myocardial infarction or non-STEMI heart attack. In general, STEMIs are larger heart attacks than non-STEMIs, and the larger the size of the heart attack, the greater the chance of complications down the road such as heart failure.

Diagnosis and treatment might be different depending on which type you’ve had.

  • Infection with COVID-19: This also may damage your heart in ways that result in a heart attack.
  • Spasm of the artery: Your blood vessels have a muscle lining that allows them to become wider or narrower as needed. Those muscles can sometimes twitch or spasm, cutting off blood flow to heart muscle.
  • Rare medical conditions: An example of this would be any disease that causes unusual narrowing of blood vessels.
  • Trauma: This includes tears or ruptures in the coronary arteries.
  • Obstruction that came from elsewhere in the body: A blood clot or air bubble (embolism) that gets trapped in a coronary artery.
  • Electrolyte imbalances: Having too much or too little of key minerals like potassium in your blood can cause a heart attack.
  • Eating disorders: Over time, an eating disorder can cause damage to your heart and ultimately result in a heart attack.

Symptoms

Heart attack warning signs vary. Know the warning signs of a heart attack and what to do if you or someone around you experience the warning signs.

With a heart attack, every minute counts.

Warning signs include:

  • Discomfort or pain in the centre of your chest
  • discomfort in your arms, shoulders, neck or jaw
  • shortness of breath
  • nausea (feeling sick)
  • a cold sweat
  • feeling dizzy or light-headed.
  • unusual fatigue
  • pressure, squeezing sensation or tightness in the chest
  • discomfort in the gut
  • severe weakness
  • sweating, upset stomach, vomiting or dizziness.

Risk factors

Heart attack risk factors include

  • Male gender: Men have a greater risk of heart attack than women do, and men have attacks earlier in life. Even after women reach the age of menopause, when women’s death rate from heart disease increases, women’s risk for heart attack is less than that for men.
  • Heredity (including race): Children of parents with heart disease are more likely to develop heart disease themselves. African-Americans have more severe high blood pressure than Caucasians, and a higher risk of heart disease. Heart disease risk is also higher among Mexican-Americans, American Indians, native Hawaiians and some Asian-Americans. This is partly due to higher rates of obesity and diabetes. Most people with a significant family history of heart disease have one or more other risk factors. Just as you can’t control your age, sex and race, you can’t control your family history. So, it’s even more important to treat and control any other modifiable risk factors you have.

Diagnosis

Ideally, your doctor should screen you during regular physical exams for risk factors that can lead to a heart attack.

If you’re in an emergency setting for symptoms of a heart attack, you’ll be asked about your symptoms and have your blood pressure, pulse and temperature checked. You’ll be connected to a heart monitor and have tests to see if you’re having a heart attack.

Tests to diagnose a heart attack include:

  • Electrocardiogram (ECG): This first test done to diagnose a heart attack records electrical signals as they travel through your heart. Sticky patches (electrodes) are attached to your chest and limbs. Signals are recorded as waves displayed on a monitor or printed on paper. Because injured heart muscle doesn’t conduct electrical impulses normally, the ECG may show that a heart attack has occurred or is in progress.
  • Blood tests: Certain heart proteins slowly leak into your blood after heart damage from a heart attack. Emergency room doctors will take samples of your blood to check for these proteins, or enzymes.

Additional tests

If you’ve had or you are having a heart attack, doctors will take immediate steps to treat your condition. You might also need to do these additional tests

  • Chest X-ray: An X-ray image of your chest allows your doctor to check the size of your heart and its blood vessels and to look for fluid in your lungs.
  • Echocardiogram: Sound waves (ultrasound) create images of the moving heart. Your doctor can use this test to see how your heart’s chambers and valves are pumping blood through your heart. An echocardiogram can help identify whether an area of your heart has been damaged.
  • Coronary catheterization (angiogram): A liquid dye is injected into the arteries of your heart through a long, thin tube (catheter) that’s fed through an artery, usually in your leg or groin, to the arteries in your heart. The dye makes the arteries visible on X-ray, revealing areas of blockage.
  • Cardiac CT or MRI: These tests create images of your heart and chest. Cardiac CT scans use X-rays. Cardiac MRI uses a magnetic field and radio waves to create images of your heart. For both tests, you lie on a table that slides inside a long tubelike machine. Each can be used to diagnose heart problems, including the extent of damage from heart attacks.

Treatment

Your treatment will depend on what is causing your symptoms. If you have an acute case of angina (chest pain), your doctor will probably give you nitroglycerin and aspirin. Nitroglycerin improves blood flow to your heart. It can temporarily relieve your symptoms by widening the arteries that carry blood to the heart.

If you are having a heart attack, your doctor can:

  • Give you medicine: The medicine is called a thrombolytic. It can help dissolve the blood clot that is blocking the coronary artery. Other medications like antiplatelet drugs, ACE Inhibitor, Beta Blockers, pain relievers and other blood thinners can work well.
  • Do a coronary angiography(X-ray of the blood vessels): Do an angioplasty or stent

Angioplasty involves inserting a tiny balloon into an artery in your arm or leg. The balloon is threaded up the artery to the heart. The balloon pushes open blocked coronary arteries. A small metal rod called a stent might be put into the artery where the blockage was to hold the artery open.

  • Do coronary artery bypass surgery: If an angioplasty and/or stenting is not appropriate, you may need this major surgery. Your doctor removes a healthy vein from your leg or an artery from your upper body. He or she makes a bypass around the blockage in your coronary artery. This allows blood to flow around the blockage.

Lifestyle Changes to Prevent a Heart Attack

How to Prevent a Heart Attack

The goal after your heart attack is to keep your heart healthy and lower your risk of having another heart attack. Take your medications as directed, make healthy lifestyle changes, see your doctor for regular heart checkups, and consider a cardiac rehabilitation program. Here are some lifestyle changes that can help to prevent a heart attack.

  • Stop smoking
  • Choose good nutrition
  • Manage high blood pressure
  • Be physically active every day
  • Aim for and maintain a healthy weight
  • Reduce your stress
  • Limit alcohol intake
  • Choose anti-inflammatory foods
  • Address and manage stress
  • Embrace moments of positivity
  • Evaluate and stop unhealthy habits
  • Prioritize restorative sleep
  • Manage high cholesterol
  • Add plenty of fruits, vegetables, grains and foods that are high in omega-3 fatty acids to your diet
  • Avoid tobacco
  • Eat grains and legumes that are rich in fiber
  • Choose lean meats and fatty fish
  • Get healthy fat from nuts,seeds and oils
  • Limit salt and sodium
  • Limit added sugars
  • Cut unhealthy fat away from your diet
  • Watch your calorie intake
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