A heart attack is the death of a part of the cardiac muscle, caused by interruption of the blood supply. Due to narrowing of the coronary arteries, a portion of the cardiac muscle has a lack of oxygen, doesn’t contract anymore and gradually dies. It is one of the leading causes of death in the Western world. Heart attack, as well as angina pectoris, falls under the heading of ‘coronary artery disease’.
Cause
A heart attack occurs when one or more coronary arteries are completely closed. The coronary arteries are the arteries that supply the heart with oxygen and nutrients. Narrowings may arise in the coronary arteries, because in the long run platelets and fat-like substances are deposited against the wall of the vessels. This process is called atherosclerosis. Due to such a narrowing of the coronary arteries, a person can have angina pectoris. If a blood clot gets stuck in such a narrowing, the coronary artery is completely closed. As a result, the rear portion of the heart muscle gets no oxygen and nutrients anymore and dies.
There are several factors that increase the risk of a heart attack:
- Smoking.
- High blood pressure.
- High cholesterol.
- Diabetes.
- Gender. Men have a higher risk of having a heart attack than women.
- Age.
- Heredity. The risk of a heart attack is higher when cardiovascular diseases occur in the family.
Symptoms
A heart attack may show the following symptoms:
- Pain or a crushing, pinching sensation in or on the chest, sometimes in the upper abdomen. The pain doesn’t go away when sitting or lying.
- The pain may radiate to one or both arms, shoulders, neck, jaw and/or back.
- Sweaty, clammy skin.
- Nausea and/or vomiting.
- A pale or gray appearance.
- Anxiety.
Sometimes, there is no pain in or on the chest but, for example, only pain in the arms, neck, jaw or back.
Diagnosis
The diagnosis of heart attack can usually easily be made with the aid of electrocardiography (ECG). The electrical activity of the heart is registered and reveals changes that indicate a heart attack. Usually, it can be seen which part and how much of the cardiac muscle is damaged and whether the heart rhythm is still normal or irregular. With the aid of blood tests for specific substances that are released from the damaged cardiac muscle into the bloodstream, the diagnosis can be confirmed.
Treatment
Very important are the reduction of pain and the restoration of blood supply to the cardiac muscle. The damage should be limited and the risk of complications must be reduced. At the emergency cardiac care department, heart rhythm, blood pressure and respiration are constantly monitored. During the first six hours after the heart attack, the patient possibly receives thrombolytics to dissolve the blood clot that closes off the coronary artery. It may also be decided to perform angioplasty immediately.
When the patient is restored of a heart attack, the coronary arteries and cardiac muscle will be examined. With the aid of an ECG and echocardiography can be decided upon the best follow-up. If the heart is not pumping well enough, medication may be given. If one of the coronary arteries is narrowed, there can be chosen for a bypass operation. In the case of a too slow heart rate, it can be decided to implant a pacemaker. A range of medicines, which reduce the risk of a new heart attack, are prescribed to the patient. A diet can also be prescribed, as well as cholesterol-lowering drugs.
Prognosis
When a person has had a heart attack for the first time, has been treated quickly and no complications have occurred, then the prospects are good. Two weeks after a heart attack, the risk of a new heart attack is considerably diminished. It looks even better if the patient adopts a healthy lifestyle. When a person has had a heart attack before, the prospects depend on the extent to which the cardiac muscle is damaged and of any complications that may have occurred.
Considerations
- By means of a healthy lifestyle, a person can reduce the risk of symptoms or a new heart attack. Moreover, one is likely to feel more comfortable.
- Quit smoking. Smoking is the major cause of cardiovascular diseases. The sooner one stops, the better.
- Get sufficient exercise, without forcing. Build activities gradually and take physical capabilities into account.
- Try to lose weight. Overweight is an extra burden on the heart.
- Eat healthy. Use a lot of herbal foods, fresh vegetables and fruits. Use little fat and preferably select foods containing polyunsaturated fats, such as vegetable oil, fish or nuts.
- Limit the consumption of alcohol to one or two glasses a day.
- Try to address causes of stress. There are several ways to deal with stress.
