Heart Attack
What is Heart Attack?
A heart attack or myocardial infarction refers to a sudden and permanent damage of the heart muscle. Usually this happens when blood supply through the arteries to a part of the heart is stopped. The coronary artery which carries the blood to the heart is clogged and interruption to the supply of blood to the heart takes place. This leads to destruction of a part of the heart muscle.
A heart attack is the last step of a process that requires several hours to take place. A quick reaction to restore the blood supply to the heart is necessary to treat heart attacks. Although the dead or damaged cells cannot be recovered, a quick action may limit the destruction and stop further damaging.
Symptoms of Heart Attack
There are various symptoms of a heart attack. The most prominent are the following;
• The heart may become upset and discomfort, pressure, heaviness may be felt. A pain in the chest, arm or below the breastbone may also occur.
• There may be feelings of uneasiness or discomfort that spreads to the back, jaw, throat or arm
• Sensations of fullness, indigestion, or choking feeling may occur. It may also feel like heartburn.
• Profuse sweating, vomiting, nausea or dizziness may also be present.
• The individual may suffer from anxiety, extreme weakness and shortness of breath
• Rapid or irregular heartbeats may also be symptoms of heart attack.
The heart attack symptoms may last for 30 minutes and taking rest or oral medications can’t stop these signs and symptoms. Sometimes, people may also suffer from silent myocardial infarction, which has no symptom.
Diagnosis of Heart Attack
Diagnosis of heart attack starts with a close inspection of the health conditions and the medical history of the patient. The doctor may check the temperature, heartbeats and pulse to determine whether there is a malfunction. The doctor will also listen to the sounds made by your heart and lungs with a stethoscope. The doctor might also want to know the health history to determine whether the symptoms are due to a heart disease or there are some other reasons for it.
The tests that are usually done to detect heart attacks include Electrocardiogram and blood tests.
Electrocardiogram (ECG): ECG is a very common test to detect heart 
attacks. It uses electrodes placed on the skin to detect the electrical activity of the heart. The impulses are recorded as waves on a monitor. If heart muscles have died they won’t conduct electricity and this can be detected with the help of ECG. It may show past attacks or an attack in progress.
Blood tests: Damage of the heart muscles usually leads to leakage of certain enzymes to the blood. The doctor may test sample of blood for the presence of these enzymes to detect whether there is any abnormality in heart conditions.
The doctor may also advise for some additional tests for determining the exact condition of the heart. The following tests may be performed.
Chest X ray: A chest X ray may reveal critical conditions about the heart and the adjoining blood vessels.
Nuclear Scan: In this process a radioactive element, such as thallium, is injected into the bloodstream and the special cameras track the flow of blood to detect any abnormalities. The portions of heart that has been damaged are represented by dark spots in the results. From the position and occurrence of these spots, the doctors may determine the malfunctioning portion of the heart.
Echocardiogram: Echocardiogram uses sound waves that are projected and reflected back from the walls of the heart. The results are obtained as images and if any portion of the heart is not functioning properly, the images may reveal the condition.
Coronary catheterization (angiogram): This process uses a dye that is injected into the arteries and this can be tracked through X rays. As the dye fills up the arteries, the images of blockage may be obtained through X rays. After detection, the doctor may perform an angioplasty to treat the blockage to avoid heart attacks.
Causes of Heart Attack
The heart needs a constant supply of oxygen rich blood to survive. The blood supply is maintained by the coronary arteries. But due to disease or some other reason the pathway may get narrowed. This may happen due to plaques formed by fatty deposits and calcium, protein and inflammatory cells inside the arteries. The plaques are harder outside but soft and inside. When the harder cell breaks up due to ruptures, platelets come to the area. As platelets are the cells that help blood to clot, the arteries may get clotted due to these platelets. When the artery gets clotted the heart doesn’t get the required oxygen to live and the blood cells start dying within a short span of time. This results in a heart attack.
Another cause of heart attack is coronary spasm that blocks the flow of blood to the heart. This may be caused by drugs, such as cocaine and is a life threatening condition.
Types of Heart Attack
Doctors usually classify the heart attacks depending upon the following three categories
I. The part of the heart that was damaged.
II. The changes seen on an electrocardiogram.
III. The anatomic (or morphologic) extent of necrosis.
Each of these criterions is divided into two parts.
According to the first criterion heart attacks are divided into
1. anterior (frontal portion of heart) and
2. posterior (the rear portion of heart) infarcts.
According to the second criterion, the attacks may be divided into the following two segments
1. ST segment elevation myocardial infarction (STEMI).- this is characterized by longer periods of blockage of blood supply and usually affects the larger portion of myocardium.
2. Non-ST segment elevation myocardial infarction (NSTEMI): This results from a temporary blockage and the area affected is minimal.
The third criterion also divides the heart attacks into two types.
1. Transmural myocardial infarction: It is characterized by death of three layers of tissue.
2. Nontransmural myocardial infarction: This type of attack results in limited area of myocardial wall.
Treatment of Heart Attack
Treatment of heart attack may include medications and surgical procedures.
Medications: There are various medications that may be prescribed for heart attacks. Aspirin may be advised for stopping blood clotting immediately as soon as the emergency medical personnel arrive. Thrombolytics helps dissolve the blood clots that block the arteries. Doctors may also offer superaspirins to prevent forming new blood clots. Some other medications such as heparin may also be given to make the blood less sticky and to prevent forming dangerous clots. To provide relief from pain, pain relievers, such as morphine may be offered. Nitroglycerins are also common medication that is offered to improve the blood circulation to and from the heart. Beta blockers may also be prescribed to slow the heartbeat, decrease blood pressure and to prevent future heart attacks. Cholesterol lowering medications, such as statins, niacin, fibrates and bile acid sequestrants are also prescribed to lower the levels of cholesterol which may contribute to blocking of the arteries.
Surgical procedures: A coronary angioplasty may be performed to perforate the blocked arteries. In this process, as catheter with a balloon on the tip is inserted into the coronary arteries and once in position the balloon is gently blown up to open the clogged artery. A metal mesh may also be inserted through the catheter to keep the artery open for a long time.
Byepass surgery: A coronary artery byepass surgery may be performed for restoring blood flow to theg heart. It includes sewing arteries or veins at a position beyond the blocked or clogged coronary artery. This may be performed after stabilization of the heart from an attack.
Living with Heart Attack
Heart attacks usually last for half an hour and it is important to understand and act on the condition quickly. If you have an attack, do try to call the emergency healthcare personnel immediately. If you have some other person who can drive, reach for immediate help from a health center. It is also important to follow the doctor’s advises and keep on checking the condition frequently.
Prevention of Heart Attack
Simple lifestyle tricks may go a long run in preventing heart attacks. Quitting smoking is probably the most important step. Checking the cholesterol levels is also important. Checking and keeping blood pressure within normal levels is also needed for a healthy heart. Other important steps for secure a healthy heart include, keeping weight under control, managing stress, eating a healthy diet, exercising regularly and consume alcohol moderately etc.
