Heart
attack
Overview
Illustration showing blocked
artery and injured tissue in a heart attack:
A heart attack occurs when
the flow of blood to the heart is blocked. The blockage is most often a buildup
of fat, cholesterol, and other substances, which form a plaque in the arteries
that feed the heart (coronary arteries).
Sometimes, a plaque can rupture
and form a clot that blocks blood flow. 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 is crucial to call 911 or emergency medical help if you
think you might be having a heart attack.
Symptoms
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
Lightheadedness or sudden
dizziness
Heart attack symptoms
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. For others, the first sign may be sudden cardiac arrest. However, the
more signs and symptoms you have, the greater the chance you are 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 might be recurrent chest pain or pressure
(angina) that is triggered by activity and relieved by rest. Angina is caused
by a temporary decrease in blood flow to the heart.
When to see a doctor
Act immediately. Some people
wait too long because they do not recognize the important signs and symptoms.
Take these steps:
Call for emergency
medical help. If you suspect you are having a heart
attack, do not hesitate. Immediately call 911 or your local emergency number.
If you do not have access to emergency medical services, have someone drive you
to the nearest hospital.
Drive yourself only if there
are no other options. Because your condition can worsen, driving yourself puts
you and others at risk.
Take nitroglycerin,
if prescribed to you by a doctor. Take it as instructed while
awaiting emergency help.
Take aspirin, if
recommended. Taking aspirin during a heart attack could
reduce heart damage by helping to keep your blood from clotting.
Aspirin can interact with
other medications, however, so do not take an aspirin unless your doctor or
emergency medical personnel recommend it. Do not delay calling 911 to take an
aspirin. Call for emergency help first.
What to do if you see
someone who might be having a heart attack
If you see someone who is
unconscious and you believe is having a heart attack, first call for emergency
medical help. Then check if the person is breathing and has a pulse. If the
person is not breathing or you do not find a pulse, only then should you begin
CPR.
Push hard and fast on the
person's chest in a fairly rapid rhythm — about 100 to 120 compressions a
minute.
If you have not been trained
in CPR, doctors recommend performing only chest compressions. If you have been
trained in CPR, you can go on to opening the airway and rescue breathing.
Causes
A heart attack occurs when
one or more of your coronary arteries becomes blocked. Over time, a buildup of
fatty deposits, including cholesterol, form substances called plaques, which
can narrow the arteries (atherosclerosis). This condition, called coronary
artery disease, causes most heart attacks.
During a heart attack, a
plaque can rupture and spill cholesterol and other substances into the
bloodstream. A blood clot forms at the site of the rupture. If the clot is
large, it can block blood flow through the coronary artery, starving the heart
of oxygen and nutrients (ischemia).
You might have a complete or
partial blockage of the coronary artery.
A complete blockage means you
have had an ST elevation myocardial infarction (STEMI).
The ST segment is an
interval between ventricular depolarization and ventricular repolarization. It
is identified as the end of the QRS complex to the beginning of the T wave. The
end of the T wave to the beginning of the P wave is described as the TP
segment, which is the zero potential or isoelectric point.
A partial blockage means you
have had a non-ST elevation myocardial infarction (NSTEMI).
Diagnosis and treatment
might be different depending on which type you have had.
Another cause of a heart
attack is a spasm of a coronary artery that shuts down blood flow to part of
the heart muscle. Using tobacco and illicit drugs, such as cocaine, can cause a
life-threatening spasm.
Infection with COVID-19 also
may damage your heart in ways that result in a heart attack.
Risk factors
Certain factors contribute
to the unwanted buildup of fatty deposits (atherosclerosis) that narrows
arteries throughout your body. You can improve or eliminate many of these risk
factors to reduce your chances of having a first or another heart attack.
Heart attack risk factors
include:
Age.
Men aged forty-five or older and women aged fifty-five or older are more likely
to have a heart attack than are younger men and women.
Tobacco.
This includes smoking and long-term exposure to secondhand smoke.
High blood pressure.
Over time, high blood pressure can damage arteries that lead to your heart.
High blood pressure that occurs with other conditions, such as obesity, high cholesterol,
or diabetes, increases your risk even more.
High blood
cholesterol or triglyceride levels. An elevated level of
low-density lipoprotein (LDL) cholesterol ("bad" cholesterol) is most
likely to narrow arteries. An elevated level of triglycerides, a type of blood
fat related to your diet, also increases your risk of a heart attack. However, an
elevated level of high-density lipoprotein (HDL) cholesterol ("good"
cholesterol) may lower your risk.
Obesity.
Obesity is linked with high blood cholesterol levels, high triglyceride levels,
high blood pressure and diabetes. Losing just 10% of your body weight can lower
this risk.
Diabetes.
Not producing enough of a hormone secreted by your pancreas (insulin) or not
responding to insulin properly causes your body's blood sugar levels to rise,
increasing your risk of a heart attack.
Metabolic syndrome.
This syndrome occurs when you have obesity, high blood pressure and high blood
sugar. Having metabolic syndrome makes you twice as likely to develop heart
disease than if you do not have it.
Family history of
heart attacks. If your siblings, parents, or grandparents
have had early heart attacks (by age 55 for males and by age 65 for females),
you might be at increased risk.
Lack of physical
activity. Being inactive contributes to high blood
cholesterol levels and obesity. People who exercise regularly have better heart
health, including lower blood pressure.
Stress. You might respond to
stress in ways that can increase your risk of a heart attack.
Illicit drug use.
Using stimulant drugs, such as cocaine or amphetamines, can trigger a spasm of
your coronary arteries that can cause a heart attack.
A history of
preeclampsia. This condition causes high blood pressure
during pregnancy and increases the lifetime risk of heart disease.
An autoimmune condition.
Having a condition such as rheumatoid arthritis or lupus can increase your risk
of a heart attack.
Complications
Complications are often
related to the damage done to your heart during a heart attack, which can lead
to:
Abnormal heart
rhythms (arrhythmias). Electrical "short
circuits" can develop, resulting in abnormal heart rhythms, some of which
can be serious, and may lead to death.
Heart failure. A
heart attack might damage so much heart tissue that the remaining heart muscle cannot
pump enough blood out of your heart. Heart failure can be temporary, or it can
be a chronic condition resulting from extensive and permanent damage to your
heart.
Sudden cardiac
arrest. Without warning, your heart stops due to an
electrical disturbance that causes an abnormal heart rhythm (arrhythmia). Heart
attacks increase the risk of sudden cardiac arrest, which can cause death
without immediate treatment.
Prevention
It is never too late to take
steps to prevent a heart attack — even if you have already had one. Here are
ways to prevent a heart attack.
Medications.
Taking medications can reduce your risk of a subsequent heart attack and help
your damaged heart function better. Continue to take what your doctor prescribes
and ask your doctor how often you need to be monitored.
Lifestyle factors.
You know the drill: Maintain a healthy weight with a heart-healthy diet, do not
smoke, exercise regularly, manage stress and control conditions that can lead
to a heart attack, such as high blood pressure, high cholesterol, and diabetes.
Jan Ricks Jennings, MHA,
LFACHE
Senior Consultant
Senior Management
Resources, LLC
412.913.0636 Office
724.733.0509 Cell
January 23, 2022
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