WHEN the supply of blood to the heart is sharply reduced or cut off, the heart is deprived of needed oxygen. If blood flow is not restored within minutes, portions of the heart muscle begin to die, permanently damaging the heart muscle. This process is referred to as a myocardial infarction, more commonly known as heart attack.
The most common type of heart attack is caused by a thrombosis, or blockage, of one of the coronary arteries by a thrombus, or blood clot. This cuts off the blood supply to the region of the heart muscle served by the artery, damaging or killing the deprived tissue. Heart attack generally occurs only if your coronary arteries are already narrowed by coronary artery disease. If the infarct, or damaged area of the heart, is small, it does not impair the electrical conducting system that regulates heartbeat. Therefore, the attack should not be fatal and you will have a good chance of recovery.
What are the symptoms?
The main symptom of a heart attack is usually a crushing pain in the center of your chest. The pain may also appear in the neck, jaw, arms, and upper abdomen. A heart attack can come on gradually, preceded by a few weeks of angina (chest pain), but it can also happen without any warning. The pain varies in degree from a feeling of discomfort to antagonizing tightness in the chest. The pain may be continuous, or it may last for only a few minutes, then fades away, and then return. It may come on during exercise or emotional stress or even at rest. Unlike the pain of angina pectoris, the pain of a heart attack does not go away after the exercise or stress ceases.
Other possible symptoms of heart attack are dizziness, shortness of breath, sweating, chills, nausea, and fainting. In a few instances, mainly in older people, there are few if any symptoms. The condition, known as a silent infarct, can be confirmed only by electrocardiography (ECG) and blood enzyme tests.
What are the risks?
Two out of three people who have a heart attack recover, but the attack may be fatal if it interferes with the electrical impulses that regulate your heartbeat or if it severely damages your heart muscle. Most deaths from heart attack occur within 2 hours of the onset of symptoms. About 10 percent of patients admitted to hospitals with heart attacks go into shock, which can also be fatal. Heart failure may also develop.
After a heart attack, a thrombus, or a clot, may form inside one of the four chambers of the heart. If the thrombus becomes detached (it is called an emboli) and is swept into the circulation, it can travel and cause damage elsewhere in the body. Fortunately, this occurs in only about 5 percent of cases.
Damage caused by heart attack may weaken and stretch one of the walls of the heart chambers. The resultant aneurysm, or ballooning, can lead to complications such as heart failure. There is the added risk that bed rest may cause thrombosis (blood clots) in the veins especially in the legs.
What should be done?
A heart attack is a medical emergency. Half of the deaths from heart attacks occur in the first 3 or 4 hours after symptoms begin. The sooner the treatment begins the better the chances of survival. Anyone having a symptom that might indicate a heart attack should get prompt medical attention.
What is the treatment?
Self-help: None is possible.
1. The most effective treatment for a heart attack is to dissolve the blood clot that caused it, but this is possible only within a few hours of the start of a heart attack, which is why it is vital to treat any possible heart attack as an emergency.
2. Once a diagnosis is arrived at, a clot-dissolving (thrombolytic) drug is given, usually by injection into a vein.
3. Further special tests will be performed, including coronary angiography, to assess whether thrombolytic drug treatment has been successful.
4. If the coronary artery is still blocked, an attempt may be made to reopen the artery by transluminal (balloon) angioplasty.
5. Coronary artery bypass graft operations are performed in cases of coronary artery disease in which the narrowing or blockages are multiple or involve the left main coronary artery.
Prognosis and prevention:
Most people who survive for a few days after a heart attack can expect a full recovery, but about 10 percent die within a year. Most death occur in first 3 or 4 months, typically in people who continue to have angina, irregular heart beat, and heart failure.
The old saying “prevention is better than cure” is very true in the case of heart ailments. In fact in the cases of disorders of the circulatory system and the heart it is only prevention that offers the real chance of your staying alive.
* Make sure your diet is high in fiber.
* Do not eat red meat, highly spiced foods, salt, sugars, or white flour. Refined sugars produce adverse reactions in all cells by causing wide variations in blood sugar.
* Eliminate fried foods, coffee, black tea, colas, and other stimulants from the diet.
* Do not smoke. Avoid secondhand smoke.
* Refrain from alcohol use, as it has a direct toxic effect on the heart.
* Drink plenty of water.
* Do physical exercises regularly.
* Learn to meet stress efficiently.
Dr. Gary S. Sy, M.D. is the Medical Director of Life Extension Medical Center located at The Garden Plaza Hotel (formerly Swiss Inn Hotel) 1370 Gen. Luna St., Paco, Manila. He is Diplomate in Gerontology and Geriatrics, Advocate Diet-Nutritional Therapy, and conducts free seminar every Friday about Age-Related Health Problems.
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Author: Dr. Gary S. Sy