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A heart is a hollow muscle organ whose primary role is to pump blood through the body. It beats approximately once every second. During one day, it pumps about 2,000 gallons of blood through the circulatory system.
Since the heart is working all the time, it needs an adequate blood supply. A heart attack is an injury to the heart muscle caused by a loss of blood supply. The underlying mechanism of the heart attack is the destruction of the heart muscle cells due to a lack of oxygen. It usually occurs when a blood clot blocks the flow of blood through the coronary artery - the blood vessel that feeds blood to a part of the heart muscle. Although only a few years ago this was a fatal condition, nowadays a vast majority of people who suffered a heart attack survive. This is mostly due to the development of the electrocardiogram because before it’s development, it was impossible to objectively diagnose the myocardial infarction. Healthy lifestyle can help you prevent either first or any subsequent heart attacks by controlling the risk factors.

Incidence

Each year, more than a million people in the U.S. experience a heart attack and about a half (515,000) of them die. About one half of those who die do so within 1 hour of the start of the symptoms and before reaching the hospital.

Signs and symptoms

Although heart attack has many possible symptoms, not all the people experience the same symptoms and some even don’t experience any. Approximately one third of all myocardial infarctions are silent, without chest pain or any 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 the chest that last for more than a few minutes
  • Pain extending beyond the 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

The problem with the heart attack is that it can happen at anytime and anywhere. Some heart attacks strike suddenly, but many people who experience a heart attack have warning signs and symptoms hours, even days or weeks in advance.
These symptoms are called the prodromal symptoms.

Fatigue, sleep disturbances and dyspnea have been reported as frequently occurring prodromal symptoms which may manifest even for a month before the actual clinically manifested ischemic event.

Possible causes of a heart attack

The mechanism of the hart attack is well studied and it is discovered that the 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 a crown. The main mechanism behind the narrowing of these small arteries is a process called atherosclerosis. It refers to the buildup of cholesterol and other substances in arteries throughout the body. When the coronary arteries get 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 a blood clot from the inside of the diseased heart that broke loose and lodged in a healthy or narrowed coronary artery.

Drugs, such as cocaine, can cause such life-threatening spasm of the coronary artery that it shuts down blood flow to the 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 a heart attack

There are many possible risk factors for developing a coronary heart disease and eventually a heart attack. Most of them are contributed to the atherosclerosis process in the arteries throughout the body, including arteries in the 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 do a sudden damage directly causeing a heart attack over time, high blood pressure can damage the arteries that feed your heart by accelerating atherosclerosis. It is also well known that this can 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 even beneficial for the heart. Low-density lipoprotein (LDL) cholesterol is most likely to narrow arteries and 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 a heart attack. Exercise is also beneficial for lowering high blood pressure.

Obesity
Obesity is directly connected with the previous risk factor 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 as a serious hormonal disorder can significantly increase the risk of a heart attack by speeding up atherosclerosis.

Stress
It is proven that stress is raising the 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 the risk of a heart attack.

Family history of heart attacks
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 a heart attack

It is proven that a person can make several changes in their lifestyle to prevent heart attack very successfully.
Most common lifestyle modifications which can be done in order to prevent a heart attack are:

Stop smoking
Quitting the smoking is one of the best and the most effective ways to significantly reduce the risk of a heart attack!

Check your cholesterol regularly
This 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 too high, a doctor could prescribe him some dietary changes and medications to help lower the cholesterol.

Control your blood pressure
Several medications and dietary changes can be done in order to control the 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 has many negative effects on the heart because it

  • strains the heart
  • can contribute to high cholesterol, high blood pressure and diabetes

Healthy diet
Eat a 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 the blood cholesterol levels and prevent blood clots.

Reduce stress

Reduce stress in your day-to-day activities because it is a very effective type of prevention. Try to find healthy ways to minimize or deal with stressful events in life.

Reduce the alcohol intake

Medications which are given to prevent a heart attack

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 one aspirin a day 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 a group of medications whose primary role is to lower your heart rate and blood pressure, reducing the 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 the levels of unwanted LDL blood cholesterol and reduce the chance of a heart attack.

Aldosterone antagonist
The aldosterone antagonist agent eplerenone has been shown to further reduce the risk of cardiovascular death post-MI in patients with heart failure and left ventricular dysfunction.