What is a Heart Attack?

Heart attack, also known as myocardial infarction, occurs when a portion of the heart muscle does not receive enough blood.
The longer the heart muscle continues without treatment to restore blood flow, the more damage it sustains.
Coronary artery disease (CAD) is the common cause of heart attack. A strong spasm or sudden constriction of a coronary artery, which can cut off blood supply to the heart muscle, is also a reason for heart attack, however, it is less common


Symptoms

The symptoms of a heart attack differ from person to person. Some people have minor symptoms; others suffer from severe symptoms, and some experience no symptoms.

Symptoms of Heart Attack
Heart Attack Warning Sign

Common heart attack symptoms include

  • Chest pain that may feel like tightness, pressure, pain, aching or squeezing.
  • Pain or discomfort that spreads to the arm, shoulder, neck, back jaw, and teeth
  • Shortness of breath
  • Heartburn or indigestion
  • Lightheadedness
  • Sudden dizziness
  • Nausea
  • Fatigue
  • Cold sweat

Women may experience unusual symptoms such as brief or intense neck, back or arm discomfort.

Some heart attacks occur unexpectedly. Many people show warning signs and symptoms that appear hours, days, or weeks before an event. Angina (chest pain or pressure) that persists and does not go away with rest may be an early warning.


When to See a Doctor?

If a person has chest pain, shortness of breath or other symptoms such as nausea or cold sweats, he or she should visit an emergency department immediately. If the symptoms are severe, the doctor may refer the patient to a specialist, such as a heart specialist or cardiologist.
Our cardiologist at Medicover Hospitals will provide you with the finest heart care and treatment possible


Causes of Heart Attack

Most of the heart attacks are caused by coronary artery disease. One or more of the heart's (coronary) arteries are blocked in coronary artery disease, and this is typically caused by cholesterol-containing deposits known as plaques.
Plaques can cause artery narrowing, limiting blood flow to the heart.
When a plaque breaks down, it might create a blood clot in the heart.
However, a heart attack can be caused by a total or partial blockage of a coronary artery in the heart. One way to identify heart attacks is when an electrocardiogram (ECG or EKG) reveals certain changes (ST elevation) that necessitate immediate invasive treatment. Your doctor may use ECG data to describe various sorts of heart attacks.

  • Acute total blockage of a medium or large heart artery usually indicates an ST-elevation myocardial infarction (STEMI).
  • A partial blockage frequently indicates a non-ST elevation myocardial infarction (NSTEMI). Some persons with NSTEMI, however, have a complete blockage.

Not all heart attacks are caused by blocked arteries. Here are the other causes:

Coronary artery spasm

The artery typically exhibits cholesterol plaques or early stiffening owing to smoking or other risk factors. Coronary artery spasms are sometimes known as Prinzmetal's angina, vasospastic angina, or variant angina.

Certain infections

COVID-19 and other viral infections can harm the cardiac muscle.

Spontaneous coronary artery dissection (SCAD)

A tear within a cardiac artery causes this possibly life-threatening condition


Risk factors

Age

Men over 45 and women over 55 of age are more likely than younger men and women to have a heart attack.

Tobacco use

This includes smoking and long-term secondhand smoke exposure.

High blood pressure

This can damage the arteries that lead to the heart over time. High blood pressure and other illnesses, such as obesity, high cholesterol, or diabetes, raise the risk even further.

High cholesterol or triglycerides

This can increase the likelihood of artery narrowing. A high level of triglycerides, or blood fats, increases the chance of a heart attack.

Obesity

Obesity is associated with high blood pressure, diabetes, high triglyceride and bad cholesterol levels, and low good cholesterol levels

Diabetes

Blood sugar levels rise when the body does not produce or uses the hormone insulin properly. High blood sugar levels raise the chance of having a heart attack.

Unhealthy diet

A diet heavy in sugar, animal fats, processed foods, trans fats, and salt raises the risk of heart disease.

Stress

Extreme emotional stress, such as anger, may raise the chance of a heart attack.

Illegal drug use

Stimulants like amphetamines and cocaine can produce coronary artery spasms, leading to a heart attack.

A history of preeclampsia

During pregnancy, this syndrome produces elevated blood pressure. It raises the risk of heart disease with time.

Risk Factors for Heart Attack
Heart Attack Risk Factors

Diagnosis of Heart Attack

Usually, a health care provider should screen patients for risk factors that can contribute to a heart attack during routine examinations.
A heart attack is frequently diagnosed in an emergency room. Medical personnel will act quickly to address the situation if you've had or are experiencing a heart attack. Individuals may be questioned about their symptoms and medical history.
A heart attack is diagnosed by monitoring blood pressure, pulse, and temperature. Tests are performed to determine how the heart is beating and to assess overall heart health.

Test

Tests to diagnose a heart attack include

Electrocardiogram (ECG or EKG)

This is a test to diagnose a heart attack monitors electrical impulses as they flow through the heart. Sticky patches (electrodes) are placed to the chest and, in certain cases, the arms and legs. Signals are recorded as waves that can be viewed on a monitor or printed on paper. An ECG can detect if you are experiencing or have had a heart attack.

Blood tests

After a cardiac attack, certain heart proteins progressively leak into the bloodstream. These proteins can be detected using blood testing (cardiac markers).

Chest X-ray

A chest X-ray displays the condition and size of the heart and lungs.

Echocardiogram

Ultrasound waves provide images of the beating heart. This test can reveal how blood flows through the heart and its valves. Echocardiography can assist in determining whether your heart has been damaged.

Coronary catheterization (angiogram)

A long, thin tube (catheter) is guided to the heart after being inserted into an artery, generally in the leg.

Cardiac CT or MRI

These examinations create images of the heart and chest. X-rays are used. Cardiac MRI uses a magnetic field and radio waves to create images of your heart. Patients normally lie on a table that glides into a long tubelike machine for both examinations. Each test has the potential to diagnose heart issues. They can help to determine the extent of heart damage.


Treatment

More heart tissue is injured or dies every minute after a heart attack. Urgent treatment is required to restore blood flow and oxygen levels. The type of heart attack treatment depends on whether blood flow is partially or completely blocked.

Treatment for Heart Attack

Medications

Following are the list of medications to treat a heart attack:

Aspirin

Aspirin decreases blood clotting. It helps in the movement of blood through a clogged artery. Aspirin may be given quickly by emergency medical personnel.

Clot busters (thrombolytics or fibrinolytics)

Every minute after a heart attack, more cardiac tissue is harmed or dies. To restore blood flow and oxygen levels, oxygen is quickly provided. Whether blood flow is partially or fully restricted determines the type of heart attack treatment.

Other blood-thinning medications

These medications are administered through IV or injection which makes the blood less sticky and less prone to clotting.

Nitroglycerin

This drug dilates the blood vessels. It helps in the improvement of blood flow to the heart. Nitroglycerin is a medication used to alleviate severe chest pain (angina). It is administered as a tablet beneath the tongue, a pill to swallow, or an injection.

Morphine

This medication treats chest pain that does not respond to nitroglycerin.

Beta-blockers

These medicines reduce blood pressure and slow the heartbeat. Beta-blockers can reduce heart muscle damage and help avoid future heart attacks.

ACE inhibitors

These drugs lower blood pressure and reduce stress on the heart.

Statins

These medications help in the reduction of harmful cholesterol levels. Too much bad (LDL, or low-density lipoprotein) cholesterol can clog arteries.


Surgical and other procedures for heart attack

Surgery or a technique to unblock a blocked artery may be required if someone has had a heart attack. The following surgeries and procedures are used to treat a heart attack:

Coronary angioplasty and stenting

This procedure clears blocked cardiac arteries. Percutaneous coronary intervention is another name for it (PCI). If you've had a heart attack, this treatment is generally performed as part of a procedure to detect blockages (cardiac catheterization).
Angioplasty is performed by an expert cardiologist who directs a thin, flexible tube (catheter) to the constricted section of the heart artery. To help expand the blocked artery and enhance blood flow.
During angioplasty, a tiny wire mesh tube (stent) may be put in the artery. The stent helps in keeping the artery open, and it reduces the likelihood of the artery narrowing again. Some stents contain medicine that keeps the arteries open.

Coronary artery bypass graft (CABG)

This is open-heart surgery. A surgeon uses a healthy blood artery from another part of the body to create a new path for blood in the heart. The blood then circulates the restricted or obstructed coronary artery. CABG can be performed as an emergency procedure in the event of a heart attack. It is sometimes done a few days later after the heart has recovered.


Lifestyle and self-care

To improve heart health, take the following steps:

Exercise

Regular exercise can help improve heart health. If you've had a heart attack or had heart surgery, you may be limited in your daily activities. Consult your doctor about what is best.

Eat a heart-healthy diet

Avoid or reduce foods high in saturated fat, trans fats, salt, and sugar. Have fruits, whole grains, vegetables, and lean proteins like fish and beans.

Maintaining a healthy weight

Excess weight causes pressure on the heart. Obesity raises the risk of high cholesterol, high blood pressure, and diabetes

Don't smoke

Quit smoking and also stay away from secondhand smoke.

Limit alcohol

It's better to avoid or limit the intake of alcohol or alcoholic products.

Get regular health checkups

Some major risk factors for a heart attack are high blood cholesterol, high blood pressure, and diabetes. Consult the doctor for regular checkups.

Control stress

Stress can be reduced by increasing physical activity, practising mindfulness, and connecting with others through support groups.


Dos and Don’ts

If you think someone is having a heart attack, here’s a list of dos and don’ts that need to be followed during a heart attack (myocardial infarction)

Do’sDon’ts
The patient should sit down, rest, and try to keep calm. Leave the patient alone
Loosen any tight clothing.Wait to see if the symptoms go away
Chest compressions that keep patient's blood circulatingDrive or take public transport to the hospital
Call an emergency, if the person is unconscious and unresponsive. Panic and become restless
Rescue breathing that provides oxygen to patient's lungsApply undue pressure on the chest

If you have survived a heart attack and suffer from diabetes, high cholesterol, or high blood pressure, the doctor may prescribe medications and recommend lifestyle modifications. Take the meds exactly as prescribed by the doctor and maintain a healthy lifestyle.


Heart Attack Care at Medicover Hospitals

At Medicover, we have the best team of cardiologists and cardiothoracic surgeons who work together to provide the best diagnosis and treatment for heart issues with the utmost precision. Our highly skilled team utilizes the latest medical equipment, diagnostic procedures, and technologies to treat various types of heart diseases and ailments. Our excellent cardiac specialists handle the most sensitive cardiac situations among all age groups. Their expertise spans the entire spectrum of cardiac problems, including coronary artery disease, congenital heart disease, coronary artery disease, heart rhythm disorders, valvular disease, and heart failure disorders. Our emergency department is ready 24x7 to attend to any critical conditions like heart attack and provide the best care in the least possible time.

Citations

https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.79.12.1608
https://www.sciencedirect.com/science/article/abs/pii/0277953694002782
https://academic.oup.com/aje/article-abstract/108/3/161/138306

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