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We all probably know that 90% of the times, a heart attack presents with an excruciating chest pain. However, sometimes the pain is not as severe, and many people tend to delay treatment as result.

The tightening in the chest, the sensation that a weight is suddenly placed on one’s heart, the unbearable pain, the indescribable pressure, all added to a feeling of impending doom; you would surely be familiar with all these symptoms if you have ever experienced a heart attack. And the more intense the pain is, the more severe the condition.

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The pain of a heart attack tends to develop progressively; and just like physicians believe that the slower the pain progresses, the more delayed the treatment is; patients in turn tend to delay seeking treatment until the pain becomes excruciating and absolutely unbearable. But is this really the best way to go? And could early intervention give patients a better chance of survival?

Understanding the Functioning of the Heart

A heart attack (medically known as myocardial infarction) is a medical condition in which the heart muscle is temporarily deprived of oxygen, causing it to stop pumping blood efficiently to the other organs.

Each and every organ of the body requires a certain “fuel” to function, including the heart. For all organs, that fuel is oxygen, distributed to via blood. However, due to the fact that the heart is the organ responsible for dispatching liters of blood to all the other organs, people tend to believe that the heart itself does not need blood to function, because it supposedly “have enough” (for instance, people might say that a beer factory that distributes beer to all retailers, stores and supermarkets does not need to purchase beer itself, as they are the main producers of their product). But it doesn’t work that way. As a matter of fact, that analogy is not possible when it comes to the functioning of the heart.

Blood is supplied to the heart via the coronary vessels which provide oxygen to the anterior, posterior, superior and inferior parts of the heart; including the four chambers (atria and ventricles). Collateral blood vessels also exist to reinforce the blood supply to this important organ, in order to ensure that enough blood is offered and to maintain the blood circulation in the event that one main artery gets blocked.  

The Importance Of Collateral Circulation

Now, suppose that one of the coronary arteries supplying blood to the heart get blocked. Should such an event occur, the part of the heart that is normally taken care of by the blocked artery would be in danger, as no more blood would be able to flow to that part. However, if there is collateral circulation (which means that other minor arteries also provide blood to the affected heart muscle), then there will be a continuous supply of oxygen. In people with coronary artery disease (occlusion of one of the coronary arteries with a cholesterol plaque or a thrombus), depending on how severe the obstruction is, collateral circulation could take time to develop and the heart would adjust to this new physiological state. This is why generally, in the early stages of myocardial infarction, there are no symptoms and the patient seems normal. However, as the obstruction continues to worsen, the collateral circulation is unable to compensate for the deficient blood supply, and this is when the patient starts experiencing the pain. 

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