Death of part of the heart muscle, following a blockage in its blood supply is commonly called a heart attack but is also known as myocardial infarction.
A heart attack is the end result of atherosclerosis in the coronary arteries that supply heart muscle and it may have been presaged by angina (chest pain). Heart attack is one of the major causes of death in developed countries.
What are the Causes of Heart Attack?
A heart attack is usually a result of coronary artery disease, which stems from atherosclerosis.
What are the Symptoms of Heart Attack?
The symptoms of a heart attack usually develop suddenly and include:
- Severe, heavy, crushing pain just like angina but worse in the centre of the chest spreading up to the neck and teeth and into the arms, especially in the left arm, sometimes centring
on the elbow
- Pale clammy skin
- Shortness of breath
- Nausea and, sometimes, vomiting
- Anxiety, sometimes accompanied by a fear of dying
Measures You Can Take
Making changes in your lifestyle after a heart attack can help speed your recovery and
reduce the risk of another attack occurring.
- Stop smoking. This is the single most important factor in preventing a further
- Eat a healthy diet and try to keep your weight within the ideal range for your height
- If you drink alcohol, take only moderate amounts. You should have not more than 1 -2 small glasses of wine or beer a day.
- Together with your doctor, agree on a programme of increasing exercise until you are able to engage in moderate exercise, such as swimming regularly, for 30 minutes or more at a time.
- Take the trouble to learn how to relax with relaxation exercises. After a period of recovery, you can make a gradual return to your normal daily routine.
- You will probably be able to return to work within six weeks, or sooner if you have a desk
job. You might consider working part-time at first.
- Try to avoid stressful situations.
- You should be able to drive a car within four weeks.
- You can resume having sexual intercourse about four weeks after a heart attack.
Are There Ant Complications?
■ In the first few minutes the main danger is acute heart failure and cardiac arrest.
■ In the first few hours and days after a heart attack, the main risks are the development of
an irregular heartbeat (arrythmia).
■ In the weeks or months after the attack, the pumping action of the heart muscle may be
too weak, leading to a condition called chronic heart failure. Its symptoms include fatigue,
shortness of breath and swollen ankles. Less common complications include damage to one
of the heart valves or inflammation of the membrane covering the heart’s surface, the pericardium, leading to pericarditis, both of which may also lead to heart failure.
How Is Heart Attack Diagnosed?
An electrocardiogram (ECG) will show evidence of a heart attack. To confirm the diagnosis, blood samples may be taken to measure the levels of particular enzymes that leak into the blood from damaged heart muscle.
What is the Treatment of Heart Attack?
- The immediate aims of treatment are to relieve pain and restore the blood supply to the
heart muscle in order to minimize the amount of damage and prevent further complications.
These aims are best achieved by immediate admission to an intensive care unit (ICU). You will be given an injection of a powerful painkiller, such as morphine, to relieve pain.
- To help minimize damage to your heart within the first six hours of the attack, you may
also be given a drug to dissolve the blood clot that is blocking the coronary artery.
- Alternatively, you may have immediate coronary angioplasty to open the artery. If the
blood flow to the damaged heart muscle can be restored within six hours, there is a greater
likelihood of full recovery.
- Once you have recovered from the attack, the condition of your coronary arteries and
heart muscle is assessed. Tests such as exercise ECG and echocardiography are used to help
decide on further treatment.
- If the pumping action of the heart is impaired, you may be prescribed an ACE inhibitor and/or a diuretic drug.
- If tests reveal that you have a persistent irregular heartbeat, you may need to have
a pacemaker implanted in your chest.
- Certain drugs taken long term can reduce the risk of another heart attack, and you mav be prescribed a beta-blocker drug and/or aspirin for this reason.
- You may also be advised to eat a low-fat diet and to take lipid-lowering drugs to lower your blood cholesterol level. These drugs are beneficial after a heart attack even if your cholesterol level is not elevated.
- If a coronary artery is blocked, you may need bypass surgery.
An episode of Angina that does not respond to your usual treatment or thatlasts longer than 15 minutes may be a heart attack and requires immediate emergency hospital treatment.
About 1 in 5 people experiences no chest pain in a heart attack. However, there may be other symptoms, such as breathlessness, faintness, sweating and
pale skin. This pattern of symptoms is known as a “silent heart attack” or “silent infarction”.
It is important to avoid becoming disabled by the fear of having another heart attack. Many hospitals offer ongoing cardiac rehabilitation programmes after discharge from the hospital.
If you have not had a previous heart attack, if you are treated quickly and if there are no complications, your outlook is good. After two weeks the risk of another heart attack is considerably reduced. The prognosis is better if you stop smoking, reduce alcohol intake, exercise regularly and follow a healthy diet.