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What is Heart Attack? - Symptoms, Diagnosis, Treatment & More

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What is Heart Attack? - Symptoms, Diagnosis, Treatment & More

Cardiac emergencies are often life threatening. While they may occur due to various causes, the result can be permanently harmful.

 

What is a Heart Attack?

A heart attack, or a Myocardial Infarction, occurs when a blood vessel which supplies blood to the heart is blocked. This can occur because of a build-up of cholesterol, blood cells, fibrin and calcium. A heart attack can follow a severe chest pain which then radiates to the left hand, to the jaw, or to the back. It is usually accompanied by heavy sweating. Its suddenness can cause the patient to collapse without warning, and become unresponsive.

Any patient exhibiting these symptoms should be immediately sent to the nearest hospital with ECF facilities and a physician/cardiologist on call. Emergency procedures include supplying oxygen via a face mask, relieving pain with strong analgesics, and a dosage of aspirin and statins (drugs that lower lipid levels).

If a diagnosis of a heart attack is made, treatment is swiftly administered. The main aim is to prevent the heart muscles from being permanently damaged by the lack of blood supply. This can be avoided by using blood thinning medications, drugs that improve demand-supply imbalance (beta blockers), drugs that reduce blood cholesterol (statins) and drugs that improve the re-modelling of the heart after the attack (ACE inhibitors).

The main treatment is Conventional Thrombolytic Therapy, which utilizes Streptokinase, Urokinase or Recombinant TPA to improve blood flow.

Alternatively, Primary Percutaneous Coronary Intervention or Primary Angioplasty (PCI) can be performed. This involves an emergency coronary angiogram (to visualize the blockade), followed by balloon angioplasty with stenting to improve blood flow. While Primary PCI is more effective in reducing the probability of future heart attacks, it incurs higher costs. Furthermore, cathlabs and trained professionals who can perform PCI are relatively scarce.

 

 

 

 

 

 

 

 

Complications of heart attack:

Cardiogenic shock

A patient is said to be in ‘cardiogenic shock’ if he continues to have chest pains and develops low blood pressure after a thrombolysis. A ‘Rescue PCI’ is performed to restore blood supply to the heart, and to widen the occluded blood vessel. Patients in cardiogenic shock typically benefit from mechanical support (an intra-aortic balloon pump, or IABP) which augments blood pressure and restores sufficient blood flow to the heart and brain.

 

Rhythm Disturbances

A heart attack can be caused by disturbances in the heart rhythm. A slow heart rate can be temporarily elevated by the implantation of a temporary pacemaker in the heart. A fast heart rate can be remedied by medications or DC electric shock, which is administered externally over the chest.

 

Heart Failure

The heart’s failure to pump efficiently can cause low oxygen levels in the blood and fluid accumulation in the lungs, which can necessitate ventilatory assistance.

 

Septal Rupture

A ventricular septal rupture occurs when the heart muscle gives way at the partition between two ventricles (septum) that facilitates communication between the left and right ventricles. The left valve may leak, thus further affecting the heart’s ability to pump. This necessitates an early intervention and an emergency surgical correction.

 

How is a heart attack treated?

A heart attack case without any complications typically involves 5-7 days of hospitalization, with the first 2-3 days spent in CCU care for the patient to stabilize. After a coronary angiogram, the mode of treatment is decided on. This can be medical, PTCA (Angioplasty) or CABG surgery (Bypass surgery).

Patients are counselled before being discharged, and should engage in a regular follow up (6 months to one year), keep taking medications, engage in regular exercise, quit smoking, and maintain a strict diet.

Timely intervention is a critical factor in ensuring that patients successfully recover from heart attack. This involves a competent cardiologist, intensivist, and excellent nursing care. With our world-class cardiologists and cardiothoracic surgeons, technologically advanced Cath Labs and Operating Rooms, and efficient Critical Care Unit, we consistently maintain high success rates in dealing with heart attack patients.

 

 

Why do some people get Heart Attacks? Can one prevent it?

The major contributing risk factors that increase the risk of cardiovascular diseases include the following:

 

Non-modifiable Risk Factors:

  • Old age: Most of the patients (over 85%) who die of coronary heart disease are 65 or older.
  • Gender: Men are at a greater risk of heart attacks, and suffer from them earlier in life.
  • Heredity (including race): Individuals with a family history of heart attacks are more like to develop it.

 

Modifiable Risk Factors:

  • Smoking: Smoker are 24 times more likely to develop coronary heart disease than non-smokers. Smoking also negates the actions of Aspirin (cardiovascular protecting drug) and 75% of Statins activity.

 

  • High blood cholesterol: rising blood cholesterol correlates with a higher risk of coronary heart disease.

 

  • High blood pressure: this increases the burden of the heart, causing it to thicken and stiffen. It also elevates the risk of developing strokes, heart attacks, kidney failures and congestive heart failure. When high blood pressure co-exists with obesity, smoking, high blood cholesterol levels or diabetes, the risk of heart attack or stroke increases several times.

 

  • Physical inactivity: vigorous exercise and regular moderately intense activities help protect against heart disease by reducing blood cholesterol, lowering blood pressure and preventing diabetes and obesity.

Obesity: the accumulation of excessive body fat (especially at the waist) increases one’s chances of developing heart disease and stroke regardless of other risk factors. Excessive weight increases the heart’s burden, raises blood pressure, blood cholesterol and triglyceride levels, and lowers HDL (‘good’) cholesterol levels. It also increases the likelihood of diabetes.

  • Diabetes mellitus: Diabetes increases the risk of heart disease and stroke even when blood sugar levels are normal, and the risks escalate when blood sugar levels are high.

 

  • Stress: an individual’s response to stress can contribute to heart disease. Scientists have observed that high stress levels correlate with risk factors such as overeating, smoking, alcohol consumption and mental illness.

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