Our heart is a hollow muscle organ which primary role is to pump blood through our body. It beats approximately once a second. During a day, it pumps about 2,000 gallons of blood through our circulatory system. Your heart beats approximately once a second. During a day, your heart pumps about 2,000 gallons of blood through your circulatory system. Because, heart is working all the time, it needs adequate blood supply all the time. A heart attack is an injury to the heart muscle caused by a loss of blood supply. The underlying mechanism of a heart attack is the destruction of heart muscle cells due to a lack of oxygen. It usually occurs when a blood clot blocks the flow of blood through a coronary artery — a blood vessel that feeds blood to a part of the heart muscle. Good think about all this is that, although some years ago- it was mostly a fatal condition, while now- the vast majority of people who have a heart attack survive. This is all because, before the development of the electrocardiogram, it was impossible to objectively diagnose myocardial infarction. Healthy lifestyle can help you prevent a first or subsequent heart attack by controlling risk factors.
Incidence
Each year, more than a million persons in the U.S. have a heart attack and about half (515,000) of them die. About one-half of those who die do so within 1 hour of the start of symptoms and before reaching the hospital.
Signs and symptoms
Although, heart attack have many possible symptoms, problem is that not all the people experience the same symptoms and some even don’t experience nether one. Approximately one third of all myocardial infarctions are silent, without chest pain or other symptoms. This happens more often in elderly patients and patients with diabetes mellitus. According to some researches done in the past- the symptoms in women may be a bit different from those felt by men. Angina (chest pain) is not a heart attack, but may be a warning of an impending heart attack.
The most common symptoms and signs of a heart attack include:
- Pressure, fullness or a squeezing sensations and pain in the center of chest that lasts for more than a few minutes
- Pain extending beyond chest to shoulder, arm, back, or even to your teeth and jaw
- Increasing episodes of chest pain
- Prolonged pain in the upper abdomen
- Shortness of breath
- Sweating
- Impending sense of doom
- Lightheadedness
- Fainting
- Nausea and vomiting
Problem with heart attack is that it happen anytime and anywhere! Some heart attacks strike suddenly, but many people who experience a heart attack have warning signs and symptoms hours, days or weeks in advance.
These symptoms are called prodromal symptoms!
Prodromal symptoms - Fatigue, sleep disturbances, and dyspnea have been reported as frequently occurring prodromal symptoms which may manifest as long as one month before the actual clinically manifested ischemic event.
Possible causes of heart attack
The mechanism of hart attack is well studied and it is discovered that a heart attack occurs when one or more of the tiny arteries supplying your heart with oxygen-rich blood become blocked.
These arteries are called coronary arteries because they are covering the whole surface of the heart like some crown. The main mechanism of narrowing of these small arteries is one process called atherosclerosis. It refers to the buildup of cholesterol and other substances in arteries throughout the body. When the coronary arteries narrow due to atherosclerosis, the condition is known as coronary artery disease. Coronary artery disease is the major underlying cause of heart attacks.
There are also some rare causes of heart attacks and one of them is when a blood clot from inside a diseased heart breaks loose and lodges in a healthy or narrowed coronary artery.
Drugs, such as cocaine, can cause such a life-threatening spasm of a coronary artery that shuts down blood flow to part of the heart muscle.
Complications of heart attack
ACUTE
- Heart failure -fatal-
- Recurrent infarction
- Mitral regurgitation
- Pericarditis
- Papillary muscle rupture -fatal-
- Arrhythmias (ventricular tachycardia, ventricular fibrillation, complete heart block)
- Cardiac tamponade
- Cardiogenic shock
- Thrombosis
CHRONIC
- Dressler's syndrome
- Arrhythmias
- Infarction
- Thrombosis
- Ventricular aneurysm –fatal-
Risk factors for developing heart attack
There are many possible risk factors for developing a coronary heart disease and eventually- a heart attack! Most of them contribute to the atherosclerosis process in arteries all throughout the body, including arteries to heart.
Some of the most common risk factors are:
- Smoking
It is proven that long term-smoking as well as the exposure to second-hand smoke damage the interior walls of arteries making small micro-lesions.
- High blood pressure
Although, it can rarely damage arteries suddenly- over time, high blood pressure can damage arteries that feed your heart by accelerating atherosclerosis. It is also well known that this could be an inherited problem. The risk of high blood pressure increases with age!
- High blood cholesterol or triglyceride levels
Cholesterol is a major part of the deposits that can narrow arteries throughout your body, including those that supply your heart. There are several types of cholesterol and some of them are considered bad and some-to be beneficial for heart! Low-density lipoprotein (LDL) cholesterol is most likely to narrow arteries and it is considered to be bad! A high LDL level is often a byproduct of a diet high in saturated fats and cholesterol.
- Lack of physical activity
An inactive lifestyle contributes to high blood cholesterol levels and obesity. Conversely, people who get regular aerobic exercise have better cardiovascular fitness, which decreases their overall risk of heart attack. Exercise is also beneficial in lowering high blood pressure.
- Obesity
Obesity is directly connected with the previous risk fact or because it involves having a high proportion of body fat and it's associated with high blood cholesterol levels, high blood pressure and diabetes.
- Diabetes
It is proven that diabetes- serious hormonal disorder can significantly increase the risk of a heart attack by speeding up atherosclerosis.
- Stress
It is proven that stress is raising blood pressure and- indirectly, makes a person more prone to some other risk factors such as smoking and alcohol!
- Alcohol
Excessive drinking can raise blood pressure and triglyceride levels, increasing risk of heart attack.
- Family history of heart attack
It is proven that the big part of this problem is inherited.
- Homocysteine, C-reactive protein and fibrinogen
People who have higher blood levels of homocysteine, C-reactive protein and fibrinogen appear to have an elevated risk of heart disease.
Prevention of heart attack
It is proven that a person can make several changes to prevent heart attack very successfully. These changes include lifestyle modifications and use of some medications.
Most common lifestyle modifications which could be done in order to prevent heart attack are:
- Don't smoke
Quitting with smoking is one of the best and effective ways to significantly reduce the risk of heart attack!
- Check your cholesterol regularly
It is also a very good method for controlling the level of “vessels health state”. If someone finds out that the level of bad cholesterol is way to high- doctor could prescribe him some dietary changes medications to help lower the cholesterol.
- Control your blood pressure
Several medications and dietary changes could be done in order to control blood pressure!
- Exercise regularly
Regular exercise helps improve heart muscle function before and following a heart attack.
- Loose weight if you are overweight!
Excess weight have many negative effects on heart because it
- strains heart
- can contribute to high cholesterol,
- high blood pressure and
- Diabetes
- Healthy diet
Eat a low fat diet rich in fruits and vegetables and low in animal fat. Fish is also considered to be a part of a heart-healthy diet. It contains omega-3 fatty acids, which help improve blood cholesterol levels and prevent blood clots.
- Reduce stress
Reduce stress in your day-to-day activities because it is very effective type of prevention. Try to find some healthy ways to minimize or deal with stressful events in life.
Medications which are given to prevent a heart attack are:
- Blood-thinning medications
Aspirin is one of the best blood-thinning medications! It makes your blood less "sticky" and likely to clot. Doctors recommend a daily aspirin for most people who've had a heart attack. It is very important to know that painkiller ibuprofen (Advil, Motrin, others) at the same time may increase the risk of gastrointestinal problems and may interfere with the heart benefits of aspirin.
- Beta blockers
This is one group of medications which primary role is to lower your heart rate and blood pressure, reducing demand on your heart.
- Angiotensin-converting enzyme (ACE) inhibitors
These drugs allow blood to flow from your heart more easily.
- Cholesterol-lowering medications
A variety of medications, including statins, niacin, fibrates and bile acid sequestrants, can help lower levels of unwanted LDL blood cholesterol and reduce the chance of heart attack!
- Aldosterone antagonist
The aldosterone antagonist agent eplerenone has been shown to further reduce risk of cardiovascular death post-MI in patients with heart failure and left ventricular dysfunction.
