Heart attack is a very common disease worldwide, not just in India. One person dies of a heart attack every 33 seconds in India. It is a major health problem that needs immediate attention. People need to be aware of it and on ways how to prevent it. We all know through movies and other sources of entertainment that when a person has a heart attack, the first thing he does is to clutch his chest.
So what is heart attack?
The medical term for a heart attack is myocardial infarction. It is also known as acute myocardial infarction, AMI. The heart is made up of muscles and its primary function is to keep the blood circulating in the body through blood vessels, which are basically like pipes. A heart attack occurs when these blood vessels are blocked, hence obstructing the blood flow to the heart. The obstruction causes damage to the heart muscle. Discomfort in the chest or acute pain in the chest is the most common sign of a heart attack. This pain or discomfort can also be felt in the shoulder, arm or neck, usually on the left side. Difficulty in breathing, nausea, dizziness, or fatigue are some of the more common symptoms. A myocardial infarction or heart attack can cause the heart to fail, make it beat out of rhythm, cardiac arrest or cardiac shock.
The deposition of fat deposits on the walls of the blood vessels is a condition known as coronary artery disease or in short, CAD. This disease is the main cause of a myocardial infarction. CAD occurs due to high blood pressure, smoking, diabetes, physical inactivity, high cholesterol, fatty diet and alcohol abuse. Myocardial infarctions occurs when a coronary artery is completely blocked.
Diagnosis of Heart Attack
This condition can be diagnosed by number of methods like electrocardiograms (ECG), blood tests and angiography. If one or more symptoms of a heart attack are felt, an immediate treatment is aspirin. Pain killers of different intensity can be administered or prescribed for the pain. As the oxygen levels are lowered due to inadequate supply of blood, additional oxygen is supplied in order to raise oxygen levels. Surgical treatments include angioplasty, in which the blood vessels are pushed open. In thrombolysis, the blockage in the blood vessels is reduced through medications. Apart from these, blood thinners like heparin along with angioplasty is used for patients who are at a higher risk. Bypass surgery is done when multiple arteries are blocked and the patient is diabetic.
Symptoms Indicating Heart Attack
The symptoms of a heart attack are not sudden. They appear gradually over a period of minutes. A sudden heart attack without any symptoms or signs are very rare.
Angina pectoris is a condition where chest pain occurs due to shirtless of blood and oxygen supply in the heart, hence causing damage to heart muscle. The pain usually starts in the left arm. It may also radiate to the right arm, jaw, back, upper abdomen and the neck. When the pain is radiating in the upper abdomen, people confuse it with heartburn.
Levine’s sign – In this, a person clenches his fist over his breastbone because of the pain in chest. This was thought to be a classic sign of a heart attack but according to recent studies, this method proved to yield poor predictions.
Difficulty breathing – When the heart muscles are damaged, they restrict the blood output of the left ventricle. This leads to left ventricular failure and ultimately pulmonary edema.
Diaphoresis – Excessive sweating just before a heart attack.
Weakness, light headedness, nausea, vomiting and palpitations are some more symptoms which are brought on by huge rush of catechol amines. Catechol amines are adrenaline and dopamine. These hormones are stimulated by the pain and irregularities in the blood flow patterns which happen due to the problems in the heart muscle. Myocardial infarction can cause fainting or loss of consciousness due to insufficient blood flow to the brain and even instantaneous death if ventricular fibrillation is developed. Ventricular fibrillation is a very serious cardiac rhythm disturbance in which the heart cannot pump any blood due to the shivering of the heart muscles.
Apart from these defining symptoms, there are also some atypical symptoms of a heart attack which normally develop in women, the older people and people who also have diabetes. These kind of symptoms do not appear in younger males. The number of symptoms shown by women for heart attacks are more than men. It is 2.6 on average in women as compared to 1.6 in men. The most common symptom in women is dyspnea which means difficulty in breathing or labored breathing. This is accompanied by fatigue and weakness. These symptoms can appear as early as a month before the actual heart attack. Pain in the sternum or breastbone is less likely to appear in women than men. During the heart attack, women are more likely to experience jaw and neck pain.
One fourth of all the heart attacks happen without the presence of chest pain or displaying any other symptoms. Such cases are identified after the said event has occurred with the help of electrocardiograms, blood enzyme tests or if death has occurred, autopsy. Such a heart attack is known as a Silent myocardial infarction. A silent myocardial infarction is more common in the elder people and those who are struggling with diabetes mellitus. In diabetics, it occurs due to their lower pain threshold and autonomic neuropathy which means management of a group of nerve related symptoms which need to be managed on a daily basis through medication. People who have had heart transplant surgery are also more likely to suffer a silent heart attack most probably because the donor heart is poorly accepted by the nervous system of the recipient. Acute coronary syndrome is caused when any symptom which is caused by the obstruction of blood flow to heart like STEMI or unstable angina. Unstable angina is when the blockage is caused by a blood clot blocking the flow the blood. STEMI is the blockage of blood in a major artery that takes blood to the heart.