Heart Diseases & Conditions-Heart Attack

Heart Attack

A heart attack occurs when the flow of blood to the heart is blocked, most often by a build-up of fat, cholesterol and other substances, which form a plaque in the arteries that feed the heart (coronary arteries). The interrupted blood flow can damage or destroy part of the heart muscle.

A heart attack, also called a myocardial infarction, can be fatal, but treatment has improved dramatically over the years. It's crucial to call emergency medical help if you think you might be having a heart attack.

Symptoms of Heart Attack

Common heart attack signs and symptoms include:

• Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back
• Nausea, indigestion, heartburn or abdominal pain
• Shortness of breath
• Cold sweat
• Fatigue
• Light headedness or sudden dizziness

Heart attack symptoms may vary 

Not all people who have heart attacks have the same symptoms or have the same severity of symptoms. Some people have mild pain; others have more severe pain. Some people have no symptoms, while for others, the first sign may be sudden cardiac arrest. However, the more signs and symptoms you have, the greater the likelihood you're having a heart attack.

Some heart attacks strike suddenly, but many people have warning signs and symptoms hours, days or weeks in advance. The earliest warning may be recurrent chest pain (angina) that's triggered by exertion and relieved by rest. Angina is caused by a temporary decrease in blood flow to the heart.

A heart attack differs from a condition in which your heart suddenly stops (sudden cardiac arrest, which occurs when an electrical disturbance disrupts your heart's pumping action and causes blood to stop flowing to the rest of your body). A heart attack can cause cardiac arrest, but it's not the only cause.

What to do if you see someone having a heart attack

If you encounter someone who is unconscious, first call for emergency medical help. Then begin CPR to keep blood flowing. Push hard and fast on the person's chest — about 100 compressions a minute. It's not necessary to check the person's airway or deliver rescue breaths unless you've been trained in CPR.

Causes of Heart Attack

A heart attack occurs when one or more of your coronary arteries become blocked. Over time, a coronary artery can narrow from the buildup of various substances, including cholesterol (atherosclerosis). This condition, known as coronary artery disease, causes most heart attacks.

During a heart attack, one of these plaques can rupture and spill cholesterol and other substances into the bloodstream. A blood clot forms at the site of the rupture. If large enough, the clot can completely block the flow of blood through the coronary artery.

Another cause of a heart attack is a spasm of a coronary artery that shuts down blood flow to part of the heart muscle. Use of tobacco and of illicit drugs, such as cocaine, can cause a life-threatening spasm. A heart attack can also occur due to a tear in the heart artery (spontaneous coronary artery dissection).

Medications for Heart Attack

Medications given to treat a heart attack include:

• Aspirin. The Emergency operator may instruct you to take aspirin, or emergency medical personnel may give you aspirin immediately. Aspirin reduces blood clotting, thus helping maintain blood flow through a narrowed artery.
• Thrombolytics. These drugs, also called clotbusters, help dissolve a blood clot that's blocking blood flow to your heart. The earlier you receive a thrombolytic drug after a heart attack, the greater the chance you'll survive and with less heart damage.
• Antiplatelet agents. Emergency room doctors may give you other drugs to help prevent new clots and keep existing clots from getting larger. These include medications, such as clopidogrel (Plavix) and others, called platelet aggregation inhibitors.
• Other blood-thinning medications. You'll likely be given other medications, such as heparin, to make your blood less "sticky" and less likely to form clots. Heparin is given intravenously or by an injection under your skin.
• Pain relievers. You may receive a pain reliever, such as morphine, to ease your discomfort.
• Nitroglycerin. This medication, used to treat chest pain (angina), can help improve blood flow to the heart by widening (dilating) the blood vessels.
• Beta blockers. These medications help relax your heart muscle, slow your heartbeat and decrease blood pressure, making your heart's job easier. Beta blockers 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.

Surgical and other procedures

In addition to medications, you may undergo one of the following procedures to treat your heart attack:

• Coronary angioplasty and stenting. Doctors insert a long, thin tube (catheter) that's passed through an artery, usually in your leg or groin, to a blocked artery in your heart. If you've had a heart attack, this procedure is often done immediately after a cardiac catheterization, a procedure used to locate blockages.
  This catheter is equipped with a special balloon that, once in position, is briefly inflated to open a blocked coronary artery. A metal mesh stent may be inserted into the artery to keep it open long term, restoring blood flow to the heart. Depending on your condition, your doctor may opt 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. If possible, your doctor may suggest that you have bypass surgery after your heart has had time — about three to seven days — to recover from your heart attack.
  Bypass surgery involves sewing veins or arteries in place beyond a blocked or narrowed coronary artery, allowing blood flow to the heart to bypass the narrowed section.

Once blood flow to your heart is restored and your condition is stable, you're likely to remain in the hospital for several days.

Lifestyle and home remedies for Heart Attack

 Following steps can help you not only prevent but also recover from a heart attack:

• Avoid smoking. The most important thing you can do to improve your heart's health is to not smoke. Also, avoid being around secondhand smoke. If you need to quit, ask your doctor for help.
• Control your blood pressure and cholesterol levels. If one or both of these is high, your doctor can prescribe changes to your diet and medications. Ask your doctor how often you need to have your blood pressure and cholesterol levels monitored.
• Get regular medical checkups. Some of the major risk factors for heart attack — high blood cholesterol, high blood pressure and diabetes — cause no symptoms early on. Your doctor can perform tests to check for these conditions and help you manage them, if necessary.
• Exercise regularly. Regular exercise helps improve heart muscle function after a heart attack and helps prevent a heart attack by helping you to control your weight, diabetes, cholesterol and blood pressure. Exercise needn't be vigorous. Walking 30 minutes a day, five days a week can improve your health.
• Maintain a healthy weight. Excess weight strains your heart and can contribute to high cholesterol, high blood pressure and diabetes.
• Eat a heart-healthy diet. Saturated fat, trans fats and cholesterol in your diet can narrow arteries to your heart, and too much salt can raise blood pressure. Eat a heart-healthy diet that includes lean proteins, such as fish and beans, plenty of fruits and vegetables and whole grains.
• Manage diabetes. High blood sugar is damaging to your heart. Regular exercise, eating well and losing weight all help to keep blood sugar levels at more-desirable levels. Many people also need medication to manage their diabetes.
• Control stress. Reduce stress in your day-to-day activities. Rethink workaholic habits and find healthy ways to minimize or deal with stressful events in your life.
• If you drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and men older than age 65, and up to two drinks a day for men age 65 and younger.