Heart Attack

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A heart attack occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely. It is important to seek treatment for a heart attack immediately, otherwise, further damage to the heart muscle can occur. If blood flow isn't restored quickly, the consequences could be fatal.

Heart attacks are a major killer in all parts of the world. But they can often be prevented. If you have ever had a heart attack or had to care for someone who has, you will know that it can seriously affect the life of both the individual and his or her family.

This section explains why heart attacks happen and how you can avoid them. It gives you tips to develop healthy habits, like eating a balanced diet and being physically active.

If you are at high risk, there is advice on the signs and symptoms to look out for. If you have already had a heart attack, this section provides information on how your condition can be treated and controlled, and how you can improve the quality of your life. 

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The symptoms of a heart attack can vary from person to person. Symptoms can be mild and barely detectable or more intense and sudden. They also may come and go over several hours. Symptoms can include any of the following:

  • Chest pain, which is often described as a tightness or heaviness
  • Pain in the upper abdomen
  • Pain in the back, neck, jaw, or arm
  • Shortness of breath, which can occur when resting or with light physical activity
  • Breaking out in a cold sweat
  • Feeling weak, lightheaded or faint
  • Nausea and vomiting
  • Heart palpitations
  • Loss of consciousness

Chest pain is the most common symptom of a heart attack in both men and women. However, women are somewhat more likely to report less common symptoms, such as shortness of breath, nausea and vomiting and pain in the back, shoulders, and jaw. Those with diabetes are also more likely to experience no symptoms or very mild ones.

If you think that you or someone you know may be having a heart attack, you should call for emergency medical help immediately.

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Your heart muscle needs oxygen to survive. A heart attack, also called a myocardial infarction, occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely. If blood flow isn't restored quickly, the section of heart muscle begins to die.

Coronary heart disease is when coronary arteries that supply the heart muscle with blood flow become narrow from a buildup of fat, cholesterol and other substances that together are called plaque. When a plaque in a heart artery breaks, a blood clot forms around the plaque. This blood clot can block the blood flow through the heart muscle and cause a heart attack. A less common cause is a severe spasm of a coronary artery, which also can prevent blood supply from reaching the heart.

A heart attack can be fatal. It is important to seek treatment for a heart attack immediately, otherwise, further damage to the heart muscle can occur.

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If you're having a heart attack or suspect you're having one, your diagnosis will likely happen in an emergency setting. You'll be asked to describe your symptoms and will have your pulse, blood pressure and temperature checked. Tests will begin almost immediately to determine whether you are indeed having a heart attack. These tests include:

  • Electrocardiogram (ECG): According to Mayo Clinic , this is the usually the first test done to diagnose a heart attack. An electrocardiogram  records the electrical activity of your heart via electrodes attached to your skin. The test shows how fast the heart is beating and whether its rhythm is steady or irregular. Because injured heart muscle doesn't conduct electrical impulses normally, the electrocardiogram may show that a heart attack has occurred or is in progress.
  • Blood tests: During a heart attack, heart muscle cells die and release proteins into the bloodstream. Doctors will take samples of your blood to measure the amount of these proteins in the bloodstream. If the levels are higher than normal, this indicates a heart attack. Commonly used blood tests include troponin tests, CK or CK–MB tests, and serum myoglobin tests.
  • Coronary angiography and cardiac catheterisation: A coronary angiography is often done during a heart attack to help find blockages in the coronary arteries. This test uses dye and special x-rays to view the insides of your coronary arteries and examine the blood flow through your heart. To inject the dye into your coronary arteries, your doctor will use a procedure called cardiac catheterisation. This involves threading a thin, flexible tube called a catheter through an artery, usually in the leg, to the arteries in the heart. The dye outlines narrow spots and blockages on the x-ray images.
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With each passing minute after a heart attack, more heart tissue loses oxygen and deteriorates or dies. The main way to prevent heart damage is early treatment to restore blood flow quickly. Calling for emergency help immediately, at the first symptoms of a heart attack, can save your life.

Once the diagnosis of a heart attack is confirmed or strongly suspected, doctors start treatments to try to promptly restore blood flow to the heart. Your treatment depends on the severity of your condition and the amount of damage to your heart. You may be treated with medications or undergo medical procedures. These include:

  • Medications: Medications given to treat a heart attack include:
    • Aspirin: You may be given aspirin by emergency medical personnel soon after they arrive. Aspirin reduces blood clotting, thus helping maintain blood flow through a narrowed artery.
    • Clot busters: Clot busters, also called thrombolytics, are used to dissolve blood clots that are blocking the coronary arteries. The earlier these medicines are given after a heart attack, the greater the chance you will survive and lessen the damage to your heart.
    • Other blood-thinning medications: You may also be given other medications, such as heparin, to make your blood less likely to form more dangerous clots. Heparin is given intravenously or by an injection under your skin after a heart attack.
    • Nitroglycerin: This medication temporarily opens arterial blood vessels, improving blood flow to and from your heart.
    • Beta blockers: Beta blockers slow down your heart rate and decrease your blood pressure, which consequently reduces the pressure on your heart for oxygen. These drugs can limit the amount of heart muscle damage and prevent future heart attacks.
    • ACE inhibitors: These drugs lower blood pressure and reduce stress on the heart.
    • Cholesterol-lowering medications: Drugs called statins help lower levels of unwanted blood cholesterol and may be helpful if given soon after a heart attack to improve survival.
  • Medical procedures: In addition to medications, you may undergo one of the following procedures to treat your heart attack:
    • Coronary angioplasty and stenting: Emergency angioplasty opens blocked coronary arteries, letting blood flow more freely to your heart. During this procedure, a thin, flexible tube with a balloon on the end is threaded through a blood vessel to the narrowed or blocked coronary artery. The balloon is then inflated to compress the plaque against your artery walls. This restores blood flow through the artery. During the procedure, the doctor may put a small mesh tube called a stent in the artery. The stent helps to keep the artery open long term, restoring blood flow to the heart. Depending on your specific condition, your doctor may also choose to place a stent coated with a slow-releasing medication to help keep your artery open.
    • Coronary artery bypass surgery: In some cases, doctors may perform emergency bypass surgery at the time of a heart attack. In coronary artery bypass surgery, arteries or veins from other areas in your body are used to bypass (that is, go around) your blocked or narrowed coronary arteries. This surgery can restore blood flow to the heart.
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Adopting a healthy lifestyle can prevent coronary heart disease, the leading cause of heart attacks. To improve your heart health:

  • Maintain a healthy weight: If you're overweight or obese, work with your doctor to create a reasonable weight-loss plan. Controlling your weight helps you control coronary heart disease risk factors.
  • Stop smoking: If you smoke, quit. Smoking can damage and tighten blood vessels and raise your risk for coronary heart disease and heart attack. Talk with your doctor about programs and products that can help you quit.
  • Control conditions such as high blood pressure, high cholesterol and diabetes: If you have high blood pressure, high cholesterol, or diabetes, make sure to take your prescription medicines to help you manage these conditions. Do not stop taking your medication without consulting your doctor first, as doing so is likely to make your symptoms worse and put your health at risk.
  • Stay physically active: Generally, 30 minutes or more of moderate activity, such as bicycle riding and brisk walking, per day is a good initial goal. Aerobic exercise, which uses large muscle groups in a rhythmic, repetitive fashion for prolonged periods of time, is the best type of exercise for the heart. However, flexibility exercises and resistance exercises are also beneficial.
  • Eat a healthy, well-balanced diet: A heart healthy diet includes a variety of vegetables and fruits. It also includes whole grains, fat-free or low-fat dairy products, and protein foods, such as lean meats, poultry without skin, seafood, processed soy products, nuts, seeds, and beans and peas. Avoid foods that are high in salt, added sugars, solid fats, and refined grains.
  • Get sufficient sleep: Both sleep deprivation and sleep apnea have been linked with an increased risk of heart disease. Aim for the recommended 7 to 9 hours of sleep per night.
  • Reduce and manage stress: According to Harvard Health , a growing body of evidence suggests that psychological factors can impact your heart health and can contribute to cardiac risk. Stress from all sorts of challenging situations and events plays a significant role in cardiovascular symptoms and outcome, particularly heart attack risk. So while it’s not always possible to eliminate all stressful events from your life, consider making some positive changes or employing relaxation techniques that can reduce stress levels, such as meditation.
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