Heart Attack - Symptoms, Causes and risk factors, Diagnosis and Treatment
What is a Heart Attack?
Heart attack, also known as Myocardial Infarction occurs when the flow of the blood to the heart is blocked. The main function of the heart is to pump oxygenated blood to all parts of the body so that it can function properly. The heart, itself functions properly, when it receives oxygen-rich blood, via blood vessels, called coronary arteries.
Signs & Symptoms:
Common heart attack symptoms include chest pain which is described as a heavy or crushing sensation. This chest pain may spread to the arms, neck, jaw, or back. Some other symptoms are heartburn, nausea, indigestion or abdominal pain, breathlessness, sweating, fatigue, light-headedness, or sudden dizziness. These symptoms may vary from person to person. Some people experience mild chest pain, while others have heavy pain. Some people do not experience chest pain at all. Some heart attacks strike suddenly, but many people have warning signs and symptoms, hours, days, or weeks in advance.
A build-up of cholesterol plaque or fatty deposits in the walls of arteries obstructs blood flow leading to a heart attack. Plaque rupture spills cholesterol and other substances into the bloodstream, forming clots at the site of rupture & causing complete blockage to the artery. Blockage of the coronary artery damages part of the heart muscle permanently.
Heart attack risk factors include:
- 1. Smoking - Almost 40% of patients younger than 65 years who die of heart disease are smokers. When a person smokes, nicotine in the smoke speeds up the heart rate raises the blood pressure, and disturbs the flow of the blood and air in the lungs. The Carbon monoxide present in the smoke lowers the amount of oxygen carried in the blood to the rest of the body, including the heart and brain. Tar and cancer-causing substances are deposited in the lungs and the airways.
- 2. High blood pressure - Hypertension usually occurs without any symptoms. Over some time, it can damage the heart and blood vessels, leading to stroke or heart attack. Some other medical conditions, such as co-existing obesity, high cholesterol, or diabetes can increase the risk even more. Marginally elevated blood pressure may normalize when you lose weight, exercise more, and reduce salt intake. If these measures are not successful, then drug treatment may be needed. However, once the medicine has started, it is essential to continue with the treatment, complemented by a healthy lifestyle. Treatment of hypertension is life-long.
- 3. High Cholesterol- Any excess cholesterol in the blood may be deposited in the arteries. This build-up causes hardening of the arteries, such that they become narrow & blood flow to the heart is reduced or blocked.
- 4. Diabetes- Diabetes mellitus is a chronic illness. People with diabetes are 2 to 4 times more likely to develop coronary artery disease and stroke. It is often associated with other cardiovascular risk factors, such as high blood pressure, increased total cholesterol and triglyceride levels, decreased HDL - cholesterol levels, and obesity.
The basic treatment strategy is to maintain good control over the amount of glucose in your blood. While maintaining a healthy weight, a balanced diet and a regular exercise routine can prevent the onset of diabetes mellitus.
- 5. Obesity- Obese people are more prone to develop heart disease and stroke, even if they have no other risk factors because excess weight increases the strain on the heart. It raises blood pressure, blood cholesterol, and triglyceride levels, and lowers the good cholesterol in the body(HDL).
Regular physical activity, healthy food intake, and lifestyle can help in reducing weight.
- 6. Lack of Physical Activity-An inactive lifestyle contributes to high blood cholesterol and obesity. Regular exercise helps prevent heart and blood vessels disease. Regular exercise also leads to improvement in other cardiovascular risk factors, such as weight loss, lower blood pressure, decreased stress, and improved cholesterol levels.
- 7. Stress - Your blood pressure goes up when you get angry, excited, or when you are stressed. Your stressful life over a prolonged period can contribute to a higher risk of developing high blood pressure.
- 8. Illicit Drug use- Using stimulant drugs, such as cocaine or amphetamines, can trigger a spasm of your coronary arteries that can cause a heart attack.
- 9. Age- Age increases a person’s susceptibility to heart disease. For women, the effects of menopause, including the loss of hormone oestrogen, appear to increase their risks of coronary heart disease and stroke.
- 9. Gender- Men have a 3 to 5 times higher risk of heart attack than women. However, the risk for women increases after menopause.
- 10. Ethnicity- The risk of heart disease varies with different ethnic groups. A study suggests that South Asians are more likely to have coronary heart disease.
- 11. Hereditary- You can be at higher risk if your siblings, parents, or grandparents have a history of a premature heart attack.
- 12. Menopause- Many women before the age of menopause seem to be partly protected from coronary heart disease, heart attack, and stroke. A woman’s oestrogen level is highest during her childbearing years and declines during menopause. However, women’s loss of natural oestrogen as they age may contribute to a higher risk of heart disease and stroke after menopause.
The diagnosis of heart attack is based on three findings: characteristics of chest pain, ECG , and blood test. If two of the three findings are present, it will confirm the diagnosis of a heart attack.ECG is the most useful test as it usually shows characteristic changes within minutes of a heart attack.
The eventual confirmation of heart attack is the blood tests, which detect proteins released into the bloodstream when part of the heart muscle dies. However, these proteins (cardiac enzymes) can only be detected four to six hours after a heart attack, which may be too late to implement treatment if treatment of heart attack is based on this alone.
The goal of treatment of heart attack is early diagnosis and to open up the blocked artery quickly and effectively to minimize the extent of damage to the heart muscle. Currently, there are two treatment options to unblock the artery. The fastest way to treat a heart attack is to give a powerful blood-thinning medication (thrombolytic agents) to dissolve the clot and therefore unblock the artery. Any qualified physician can give this immediately upon diagnosis of a heart attack. However, it is only effective in slightly more than 50% in opening the blocked artery and may cause serious bleeding complications from other areas, including the brain.
A more effective way to unblock the artery is by inserting a balloon or stent through a small puncture in the groin or wrist to open up the artery, known as coronary angioplasty . It is successful in more than 90% of the cases. The disadvantage of this treatment is that the procedure needs to be performed in the procedure suite and requires experienced operators.
Aakash Healthcare Super Speciality Hospital offers comprehensive solutions for the management of heart diseases, which include prevention, diagnosis, treatment, and rehabilitation. Our Cardiology doctors have extensive experience and expertise in diagnosing and treating the most complex heart conditions like heart valve surgery. Our hospital provides immaculate, value for money and evidence-based patient care. The Cardiology and Cardiac Surgery department is equipped with cutting-edge technology and state-of-the-art infrastructure in the field of Interventional Cardiology, Cardiac Surgeries both adult and paediatric. Our Cardiologists and Cardiac surgeons are experienced in minimally invasive valve replacement, key-hole surgeries, beating heart coronary artery bypass grafting, and awake Cardiac Surgery. For any type of cardiac malfunction and surgery like heart valve treatment or heart valve surgery in Delhi, Aakash Healthcare Dwarka is the best facility available.
Dr Ashish Agarwal,
Senior Consultant & HOD