Overview

A heart attack occurs when the blood flow to the heart is blocked, causing it to lose the oxygen that it needs.

Symptoms of Heart Attack

There are some symptoms associated with heart attack, and these are:

• Uneven or fast heartbeat
• Shortness of breath
• Severe weakness
• Fatigue
• Anxiety
• Pain, squeezing, pressure, heaviness or tightness in the chest, arm or below the breastbone
• The feeling of choking, indigestion or fullness
• Dizziness
• Vomiting
• Sweating
• Upset stomach
• The discomfort that is felt in the back, jaw, throat or arm

Signs of heart attack are different from one person to another, and no two heart attacks are the same as well. For women, the symptoms are usually shortness of breath, upset stomach, or pain in the back or jaw.  

There is a form of heart attack where the signs are not noticeable, and this commonly happens to people with diabetes. This situation is called “silent” heart attack.

Causes of Heart Attack

How does myocardial infarction happen? The heart muscle always needs a supply of oxygen-rich blood, and this supply comes from the coronary arteries. When a person’s coronary artery is not functioning properly, it becomes narrow, making the blood unable to flow, which then blocks the blood supply. The result of this is a heart attack.

As proteins, inflammatory cells, calcium, and fat accumulate in the arteries, they build plaques, and its deposits become hard on the outside, but on the inside, they are mushy and soft. The hard plaque causes the outer shell to crack, therefore leading to a rupture, which then results in the platelets coming to the area and blood clots forming around the plaque.

When the blood clot blocks the artery, the heart cannot get the oxygen that it needs, and the muscle cells die, causing permanent damage.

A spasm in the coronary artery does not often lead to a heart attack, but it cuts off the blood supply to the heart muscle when the arteries spasm on and off. This situation may occur even if you are at rest and may happen also if you do not have coronary artery disease.

The amount of damage to the muscle depends on two factors. One depends on the size that the blocked artery supplies, and the other one are the gaps between the heart attack and the treatment.

After a heart attack, the heart muscles eventually heal, but a scar develops in the area that is damaged, and this scar tissue does not function as it normally would, which is why the heart will not be able to pump as much as it used to.

What to do during a heart attack?

As soon as you get its first signs, call 911 so you can get treatment right away. The ideal time for treatment is around 1 to 2 hours after the signs begin to be experienced. The first procedure is to open the blocked artery to prevent further damage. The longer time that the attack is not treated, the further damage it causes to the heart muscles and, at the same time, also decreases the chance to survive.

Diagnosis and Treatment

There are different tests done to make a diagnosis of the heart attack, and aside from these tests, the doctor will also ask about the symptoms that you have.

Some of the tests to be expected are:

• ECG or electrocardiogram or also called EKG- this procedure will tell you about the location as well as the extent of damage the heart muscle has. ECG also monitors the heart rate.
• Blood tests- doing a blood test can show the levels of cardiac enzymes present in your blood. These enzymes reveal the damage in the heart muscle, and also, through this, the doctor will be able to evaluate when the heart attack happened. Cardiac enzymes are found inside the heart cells, but when the cells are damaged, these enzymes spill out into the bloodstream.
• Echocardiography- this procedure is used either during or after a heart attack. It is a type of imaging test that shows how the heart is pumping, and also reveals if there are areas that are not pumping normally. Echocardiography points out the areas of the heart that have been damaged during a myocardial infarction.
• Cardiac catheterization- this method is ideal to be performed in the 1st hours of a heart attack in case the medicines do not give signs of improvement in the symptoms. Because what it does is it provides an image of the artery that is blocked which then will help the doctor to know what kind of treatment he should give.

Treatments for Heart Attack

Treating the heart attack as soon as possible is always a priority to avoid further damage to the heart muscles, and it starts in the ambulance or the emergency room.  

Drugs are used to avoid further ischemia, keep the plaque stable, avoid blood clots, and prevent the platelets from collecting and sticking to the plaque. They are also used to widen the blood vessels, decrease the pain, and assist the heart to function correctly as well as to prevent having harmful heart rhythms.

It is recommended that medicines should be taken within 1 to 2 hours after the heart attack has started. Some of the drugs used are:

• Aspirin- it prevents the blood from clotting because blood clots make the heart attack worse.
• Antiplatelet drugs, such as Plavix, Efficient, and Brilinta. These drugs are used to stop the blood from clotting
• Thrombolytic therapy- it dissolves the blood clots in the arteries
• A combination of these 

Apart from drug therapy, other types of treatment options are:

• Cardiac catheterization- a procedure used to open blocked arteries
• Bypass surgery- this is performed to restore the blood supply to the heart, but this method can only be done days after the heart attack occurred

The treatments mentioned are not intended to cure diseases related to the coronary artery, but they are steps to at least help decrease the chances of having another heart attack.

Normal Conditions of a Heart Attack

Once a heart attack has happened, the aim is to make the heart healthy and to lessen the chance of getting another one. It is then appropriate to take your medications regularly and to follow your doctor’s instructions regarding their usage. Aside from the medications, it would be best to change your lifestyle into a healthy one and to keep regular check-ups with your doctor.

Why Should You Take Medications After a Heart Attack?

• To avoid blood clots
• To assist your heart in functioning better
• To lower cholesterol levels and prevent plaque build-up
• To treat an uneven heartbeat
• To lower the blood pressure
• To control the chest pain 
• To treat heart failure

Lifestyle Changes that Needs to be done after a Heart Attack

• If you are a smoker, stop smoking
• Control your cholesterol level
• Watch your blood pressure and diabetes
• Exercise regularly
• Maintain a healthy body weight
• Avoid or manage stress

The Next Trip to the Doctor after Leaving the Hospital

After surviving your heart attack, and after leaving the hospital, make sure to schedule an appointment with your doctor within 4 to 6 weeks. This is highly essential so that your doctor will be able to evaluate your recovery. It is also best if you regularly do an exercise stress test because this will help the doctor to see if there are blockages in your arteries, and if there are, he or she can provide a treatment plan.

Should you encounter any of these symptoms, call your doctor immediately: frequent chest pains that either gets stronger or lasts longer or if the pain is spreading to other areas of your body; uneven heartbeat, dizziness, shortness of breath even while resting.

Risks of Having Heart Attack

There are two sets of complications that may occur following a heart attack. One is immediate, and the second is experienced at a later time. 

Immediate complications:

• Irregular heartbeats called arrhythmias
• Sudden drop of the blood pressure known as cardiogenic shock
• Hypoxemia which is the slowing down of oxygen levels in the blood
• Pulmonary edema is when fluids build- up in and around the lung area
• Deep vein thrombosis, when blood clots develop in the deep veins of the legs and the pelvis which then blocks the flow of blood in the veins
• Myocardial rupture
• Ventricular aneurysm, when the ventricle bulges

Complications that May Occur at a Later Time

• When scar tissues accumulate on the injured heart wall resulting in blood clotting, low blood pressure, and irregular heart rhythms. This condition is called an aneurysm
• Angina happens when the oxygen in the heart is not enough and leads to chest pain
• Congestive heart failure results in the person being breathless and weak because the heartbeat is weak.
• Edema which is the build-up of fluids in the legs and the ankle making them swell
• Loss of erectile function
• Loss of sex drive
• Pericarditis which is the inflammation of the heart’s lining resulting in severe chest pain

Seeking Medical Help

You need to know the symptoms because they can be fatal, and some of these important signs are:

• Pressure or squeezing in the chest that is persistent
• Pain in the arms, back, jaw, neck, and stomach
• Sudden shortness of breath
• Others such as: feeling nauseous, lightheadedness, and cold sweat.

Table of Medications

• aspirin
• Plavix
• clopidogrel
• metoprolol
• lisinopril
• nitroglycerin
• Bayer Aspirin
• Activase
• Altace
• Coumadin