Heart
Attack (Myocardial Infarction)
A heart
attack, or myocardial infarction, occurs when
one of more regions of the heart muscle experience
a severe or prolonged lack of oxygen caused by
blocked blood flow to the heart muscle.
The
blockage is often a result of atherosclerosis
- a buildup of plaque, known as cholesterol, other
fatty substances, and a blood clot. Plaque inhibits
and obstructs the flow of blood and oxygen to
the heart, thus reducing the flow to the rest
of the body. The cause of a heart attack is a
blood clot that forms within the plaque-obstructed
area.
If the
blood and oxygen supply is cut off severely or
for a long
period of time, muscle cells of the heart suffer
damage and die. The result is dysfunction of the
muscle of the heart in the area affected by the
lack of oxygen.
There
are two types of risk factors for heart attack,
including:
|
Inherited (or genetic):
|
Acquired: |
| Inherited
or genetic risk factors are risk factors
you are born with that cannot be changed,
but can be improved with medical management
and lifestyle changes. |
Acquired
risk factors are caused by activities that
we choose to include in our lives that can
be managed through lifestyle changes and
clinical care. |
- persons with inherited
hypertension (high blood pressure)
- persons with inherited
low levels of HDL (high-density lipoproteins),
triglycerides, or high levels of LDL (low-density
lipoprotein) blood cholesterol
- persons with a family
history of heart disease (especially with onset
before age 55)
- aging men and women
- persons with type 1
diabetes
- women, after the onset
of menopause (generally, men are at risk at
an earlier age than women, but after the onset
of menopause, women are equally at risk)
- persons with acquired
hypertension (high blood pressure)
- persons with acquired
low levels of HDL (high-density lipoproteins),
triglycerides or high levels of LDL (low-density
lipoprotein) blood cholesterol
- cigarette smokers
- people who are under
a lot of stress
- individuals who lead
a sedentary lifestyle
- persons overweight
by 30 percent or more
- persons who eat a diet
high in saturated fat
- persons with Type II
diabetes
A heart
attack can happen to anyone - it is only when
we take the time to learn which of the risk factors
apply to us, specifically, can we then take steps
to eliminate or reduce them.
Managing
your risks for a heart attack begins with:
- examining which of
the risk factors apply to you, and then taking
steps to eliminate or reduce them.
- becoming aware of conditions
like hypertension or abnormal cholesterol levels,
which may be "silent killers."
- modifying risk factors
that are acquired, not inherited, through lifestyle
changes. See your physician as the first step
in starting right away to make these changes.
- consulting your physician
soon to determine if you have risk factors that
are genetic or inherited and cannot be changed,
but can be managed medically and through lifestyle
changes.
The
following are the most common symptoms of a heart
attack. However, each individual may experience
symptoms differently. Symptoms may include:
Indigestion
Indigestion,
also known as upset stomach or dyspepsia, is
a painful or burning feeling in the upper abdomen
that may include nausea; abdominal bloating;
belching; vomiting; severe pain in the upper
right abdomen; discomfort unrelated to eating;
and indigestion accompanied by shortness of
breath, sweating, or pain radiating to the jaw,
neck, or arm
The
symptoms of indigestion may resemble other medical
conditions, such as chest pain. Always consult
your physician for diagnosis.
- severe pressure, fullness,
squeezing, pain and/or discomfort in the center
of the chest that lasts for more than a few
minutes
- pain or discomfort
that spreads to the shoulders, neck, arms, or
jaw
- chest pain that increases
in intensity
- chest pain that is
not relieved by rest or by taking cardiac prescription
medication
- chest pain that occurs
with any/all of the following (additional) symptoms:
- sweating, cool,
clammy skin, and/or paleness
- shortness of breath
- nausea or vomiting
- dizziness or fainting
- unexplained weakness
or fatigue
- rapid or irregular
pulse
Although
chest pain is the key warning sign of a heart
attack, it may be confused with indigestion, pleurisy,
pneumonia, or other disorders.
If you,
or someone you know exhibits any of the above
warning signs, act immediately. Call 911, or your
local emergency number.
The
goal of treatment for a heart attack is to relieve
pain, preserve the heart muscle function, and
prevent death.
Treatment
in the emergency department may include:
- intravenous therapy
- nitroglycerin, morphine
- continuous monitoring
of the heart and vital signs
- oxygen therapy - to
improve oxygenation to the damaged heart muscle
- pain medication - by
decreasing pain, the workload of the heart decreases,
thus, the oxygen demand of the heart decreases
- cardiac medication
- such as beta-blockers or calcium channel blockers
to promote blood flow to the heart, prevent
blood clotting, improve the blood supply, prevent
arrhythmias, and decrease heart rate and blood
pressure
- fibrinolytic therapy
- intravenous infusion of a medication which
dissolves the blockage, thus, restoring blood
flow
- antithrombin/antiplatelet
therapy - used to prevent further blood clotting
Once
the condition has been diagnosed and the patient
stabilized, additional procedures to restore coronary
blood flow may be utilized. Those procedures include:
- coronary angioplasty
- with this procedure, a catheter is used to
create a bigger opening in the vessel to increase
blood flow. Although angioplasty is performed
in other blood vessels, Percutaneous Transluminal
Coronary Angioplasty (PTCA) refers to angioplasty
in the coronary arteries to permit more blood
flow into the heart. There are several types
of PTCA procedures, including:
- balloon angioplasty
- a small balloon is inflated inside the
blocked artery to open the blocked area.
- atherectomy -
the blocked area inside the artery is cut
away by a tiny device on the end of a catheter.
- laser angioplasty
- a laser used to "vaporize" the
blockage in the artery.
- coronary artery
stent - a tiny coil is expanded inside the
blocked artery to open the blocked area
and is left in place to keep the artery
open.
- coronary artery bypass
- Most commonly referred to as simply "bypass
surgery," this surgery is often performed
in people who have angina (chest pain) and coronary
artery disease (where plaque has built up in
the arteries). During the surgery, a bypass
is created by grafting a piece of a vein above
and below the blocked area of a coronary artery,
enabling blood to flow around the obstruction.
Veins are usually taken from the leg, but arteries
from the chest may also be used to create a
bypass graft.
Click
here to view the Online
Resources of Cardiovascular Disease
|
