A heart attack, or myocardial infarction (MI), is permanent damage to the heart
muscle. "Myo" means muscle, "cardial" refers to the heart,
and "infarction" means death of tissue due to lack of blood supply.
What Happens During a
Heart Attack?
The heart muscle requires a constant supply of oxygen-rich
blood to nourish it. The coronary arteries provide the heart with this critical
blood supply. If you have coronary artery disease, those arteries become narrow
and blood cannot flow as well as they should. Fatty matter, calcium, proteins,
and inflammatory cells build up within the arteries to form plaques of
different sizes. The plaque deposits are hard on the outside and soft and mushy
on the inside.
When the plaque is hard, the outer shell cracks (plaque
rupture), platelets (disc-shaped particles in the blood that aid clotting) come
to the area, and blood clots form around the plaque. If a blood clot totally
blocks the artery, the heart muscle becomes "starved" for oxygen.
Within a short time, death of heart muscle cells occurs, causing permanent
damage. This is a heart attack.
Heart Attack Symptoms
Symptoms of a heart attack include:
- Discomfort, pressure, heaviness, or pain in the chest, arm, or below the breastbone
- Discomfort radiating to the back, jaw, throat, or arm
- Fullness, indigestion, or choking feeling (may feel like heartburn)
- Sweating, nausea, vomiting, or dizziness
- Extreme weakness, anxiety, or shortness of breath
- Rapid or irregular heartbeats
- During a heart attack, symptoms last 30 minutes or longer and are not relieved by rest or nitroglycerin under the tongue.
Some people have a heart attack without having any symptoms
(a "silent" myocardial infarction). A silent MI can occur in anyone,
but it is more common among people with diabetes.
What Do I Do if I
Have a Heart Attack?
After a heart attack, quick treatment to open the blocked
artery is essential to lessen the amount of damage. At the first signs of a
heart attack, call for emergency treatment. The best time to treat a heart
attack is within one to two hours of the first onset of symptoms. Waiting
longer increases the damage to your heart and reduces your chance of survival.
Keep in mind that chest discomfort can be described in many
ways. It can occur in the chest or in the arms, back, or jaw. If you have
symptoms, take notice. These are your heart disease warning signs. Seek medical
care immediately.
How Is a Heart Attack
Diagnosed?
To diagnose a heart attack, an emergency care team will ask
you about your symptoms and begin to evaluate you. The diagnosis of the heart
attack is based on your symptoms and test results. The goal of treatment is to
treat you quickly and limit heart muscle damage.
Tests to Diagnose a
Heart Attack
ECG . The ECG
(also known as EKG or electrocardiogram) can tell how much damage has occurred
to your heart muscle and where it has occurred. In addition, your heart rate
and rhythm can be monitored.
Blood tests.
Blood may be drawn to measure levels of cardiac enzymes that indicate heart
muscle damage. These enzymes are normally found inside the cells of your heart
and are needed for their function. When your heart muscle cells are injured,
their contents -- including the enzymes -- are released into your bloodstream.
By measuring the levels of these enzymes, the doctor can determine the size of
the heart attack and approximately when the heart attack started. Troponin
levels will also be measured. Troponins are proteins found inside of heart
cells that are released when they are damaged by the lack of blood supply to
the heart. Detecting troponin in the blood may indicate a heart attack.
Echocardiography.
Echocardiography is an imaging test that can be used during and after a heart
attack to learn how the heart is pumping and what areas are not pumping
normally. The "echo" can also tell if any structures of the heart
(valves, septum, etc.) have been injured during the heart attack.
Cardiac catheterization, also called cardiac cath, may be
used during the first hours of a heart attack if medications are not relieving
the ischemia or symptoms. The cardiac cath can be used to directly visualize
the blocked artery and help your doctor determine which procedure is needed to
treat the blockage.
What Is the Treatment
for a Heart Attack?
Once heart attack is diagnosed, treatment begins immediately
-- possibly in the ambulance or emergency room. Drugs and surgical procedures
are used to treat a heart attack.
What Drugs Are Used
to Treat a Heart Attack?
The goals of drug therapy are to break up or prevent blood
clots, prevent platelets from gathering and sticking to the plaque, stabilize
the plaque, and prevent further ischemia.
These medications must be given as soon as possible (within
one to two hours from the start of your heart attack) to decrease the amount of
heart damage. The longer the delay in starting these drugs, the more damage can
occur and the less benefit they can provide.
Drugs used during a heart attack may include:
- Aspirin to prevent blood clotting that may worsen the heart attack
- Other antiplatelets, such as Brilinta, Effient, or Plavix, to prevent blood clotting
- Thrombolytic therapy ("clot busters") to dissolve any blood clots in the heart's arteries
- Any combination of the above
- Other drugs, given during or after a heart attack, lessen your heart's work, improve the functioning of the heart, widen or dilate your blood vessels, decrease your pain, and guard against any life-threatening heart rhythms.
Are There Other
Treatment Options for a Heart Attack?
During or shortly after a heart attack, you may go to the
cardiac cath lab for direct evaluation of the status of your heart, arteries,
and the amount of heart damage. In some cases, procedures (such as angioplasty
or stents) are used to open up your narrowed or blocked arteries.
If necessary, bypass surgery may be performed in the days
following the heart attack to restore the heart muscle's supply of blood.
Treatments (medications, open heart surgery, and
interventional procedures, like angioplasty) do not cure coronary artery
disease. Having had a heart attack or treatment does not mean you will never
have another heart attack; it can happen again. But, there are several steps
you can take to prevent further attacks.
How Are Future Heart
Attacks Prevented?
The goal after your heart attack is to keep your heart
healthy and reduce your risks of having another heart attack. Your best bet to
ward off future attacks are to take your medications, change your lifestyle,
and see you doctor for regular heart checkups.
Why Do I Need to Take
Drugs After a Heart Attack?
Drugs are prescribed after a heart attack to:
- Prevent future blood clots
- Lessen the work of your heart and improve your heart's performance and recovery
- Prevent plaques by lowering cholesterol
- Other drugs may be prescribed if needed. These include medications to treat irregular heartbeats, lower blood pressure, control angina, and treat heart failure.
It is important to know the names of your medications, what
they are used for, and how often and at what times you need to take them. Your
doctor or nurse should review your medications with you. Keep a list of your
medications and bring them to each of your doctor visits. If you have questions
about them, ask your doctor or pharmacist.
What Lifestyle
Changes Are Needed After a Heart Attack?
There is no cure for coronary artery disease. In order to
prevent the progression of heart disease and another heart attack, you must
follow your doctor's advice and make necessary lifestyle changes -- quitting
smoking, lowering your blood cholesterol, controlling your diabetes and high
blood pressure, following an exercise plan, maintaining an ideal body weight,
and controlling stress.
When Will I See My
Doctor Again After I Leave the Hospital?
Make a doctor's appointment for four to six weeks after you
leave the hospital following a heart attack. Your doctor will want to check the
progress of your recovery. Your doctor may ask you to undergo diagnostic tests
such as an exercise stress test at regular intervals. These tests can help your
doctor diagnose the presence or progression of blockages in your coronary
arteries and plan treatment.
Call your doctor sooner if you have symptoms such as chest
pain that becomes more frequent, increases in intensity, lasts longer, or
spreads to other areas; shortness of breath, especially at rest; dizziness, or
irregular heartbeats.
Source: WebMD
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