Each year more than one million Americans have a heart attack. Of those, the ones who do not seek medical help usually die.
Thanks to medical technology, most heart attacks can be successfully treated if immediate medical help is provided.
This reference summary will help you understand the signs and causes of heart attacks, in case you or your loved one is at risk. It will also help you prepare for such an emergency. Tips for preventing heart attacks will also be presented. Symptoms
Most patients feel severe chest pain or pressure during a heart attack. This pain can spread to the arms, neck, back, and jaw area. The pain is prolonged, lasting anywhere from 30 minutes to several hours.
Resting does not stop the pain or provide very much relief. Changing the position of the body does not relieve or change the pain either.
Some people feel indigestion and nausea during a heart attack. This may be coupled with sweating, dizziness, or shortness of breath.
Some people do not feel any chest pain during a heart attack. This is especially true of diabetic people and people over the age of 75.
Heart Anatomy
The heart is responsible for pumping blood to all the organs in the body. It is a highly specialized muscle that is expected to work continuously, without rest, for a lifetime!
The heart has a right and a left side. Each side has 2 chambers: the atrium and the ventricle. Special valves divide the chambers and prevent blood from flowing backward. Blood loaded with oxygen comes from the lung and enters the left atrium. It stays there until the mitral valve opens up and the atrium contracts. This forces the blood into the left ventricle. The blood is then pumped to the rest of the body through the aortic valve into the biggest blood vessel of the body, the aorta.
After the blood comes back from circulating through the body, it goes into the right atrium. From there, it is pumped into the right ventricle through the tricuspid valve and then to the lung through the pulmonic valve.
In the lung, the blood picks up oxygen and returns to the left atrium, where the whole cycle starts again.
The heart needs a continuous supply of oxygen and sugar to be able to function. Oxygen-rich blood is delivered to the heart through the coronary arteries. These arteries branch off from the aorta.
The heart contracts automatically in a very coordinated manner. Special cells in the atrium set off the electric current needed to cause the atrium to contract.
The electric current spreads to the ventricles through specialized cells. This causes the ventricles to contract after the atrium does.
Causes
Fatty material, called plaque, can narrow the blood vessels of the heart. This is called atherosclerosis. Coronary artery disease develops if the blood vessels that carry oxygen to the heart become clogged.
Atherosclerosis can cause decreased blood flow and oxygen to the heart muscle; this is called ischemia. The first sign of coronary artery disease may be a chest pain called angina.
Unlike a heart attack, angina disappears after about 10 minutes of rest or after taking special medications.
A coronary artery can become completely blocked by plaque or by a thrombus. A thrombus, or thrombosis, is when blood clots in an artery and totally blocks it; this usually happens in arteries that are already damaged and narrowed by plaque. When thrombosis occurs, blood flow to that part of the heart stops. Without blood, the cells of the affected heart muscle will become permanently damaged; this is what happens during a heart attack.
Angina vs. Heart Attack
The signs of a heart attack are similar to those of angina, with 3 main differences:
1. The pain is more severe.
2. The pain usually lasts longer than 5 minutes.
3. Nitroglycerin or rest does not relieve the pain.
As the coronary arteries get blocked, angina develops. If coronary artery disease is not controlled by changing to a healthier lifestyle, the blockage will get worse. Eventually, some of the coronary arteries will become completely blocked and cause a heart attack.
If you feel chest pain during a physical activity and the pain stops when you rest, you probably have angina. You should check with your doctor about the pain as soon as possible.
If you have medication for angina, and neither resting nor taking the medicine relieve the pain, you could be having a heart attack and you should call for help immediately.
Treatment
During angina, the heart does not receive enough oxygen. During a heart attack, the oxygen supply to part of the heart is completely blocked. The heart muscle starts to die by the minute. Within 6 hours, damage to the heart is extensive.
If medical treatment is received within the first hour after a heart attack, the chances of survival and limiting damage to the heart are the best.
At the hospital or doctor’s office, your doctor will do an electrocardiogram, or EKG, to help confirm whether you are having a heart attack. Blood tests are also done to check for heart muscle damage.
Treatment is usually initiated before the results of the blood tests are back from the lab. If a heart attack is confirmed, your doctor can:
• Give you medications to dissolve blood clots and open the arteries. These are known as thrombolytic drugs or "clot-busters". Most of these medications are effective within ONE hour of the start of the heart attack. This is why it is EXTREMELY important to get to the hospital within an hour of the start of chest pain or other symptoms.
• Give you medication to relieve your pain.
• Stabilize your heart rhythm.
• Help you breathe better.
Cardiac catheterization may be done to look at the blood vessels of the heart.
Depending on what that shows during this procedure, the cardiologist may be able to open the clogged or narrowed arteries with balloons and metallic meshes known as ‘stents’ during cardiac catheterization.
If the cardiac angiogram is not successful, or if the cardiologist decides that he or she cannot open the clogged artery with balloons or stents, open heart surgery may be recommended. During open heart surgery the clogged arteries are bypassed with leg veins or chest arteries.
If treated early, the heart will heal itself of any minor damage caused by a heart attack. If an effort is made to live a healthier lifestyle, future heart attacks can be prevented.
A happy ending to the experience of a heart attack depends on getting medical attention as quickly as possible! If or when you have a heart attack, it will be more difficult for you to plan what to do while it is happening. It is best to have a plan ready in case it happens. Your Emergency Plan
In case you feel signs of a heart attack, you need to know:
1. WHO you are going to tell.
2. WHEN you will go to receive medical care.
3. WHICH medical facility you will go to and HOW you will get there.
4. WHAT information you will need to provide your doctor with.
#1 is to tell someone how you are feeling and that you think you may be having a heart attack. In case you are alone when the signs of a heart attack start, decide now whom you will call and have his or her phone number on hand. This might be a friend or your doctor. It is a good idea to share your health condition with a friend, spouse, roommate, or doctor; this could help to ensure that you get help when needed.
#2 is to decide when you should seek medical help. If you have already seen a doctor for angina, your doctor will tell you when to call for help. You should not wait more than 5 minutes before calling for help. This is especially true if the symptoms are severe and different from any milder angina pain you may have had in the past.
As you rest, untie any tight clothing and sit or lie in a comfortable position. Open a window if the room you are in is unventilated.
#3 is to decide how you are going to seek medical help:
• Which hospital emergency room are you going to go to?
Most hospitals nowadays are able to stabilize a patient with a heart attack. Because time is of the essence, the closest hospital is usually the best choice. If you have already been prescribed medication, follow your doctor’s instructions.
In case you are taking nitroglycerin, this usually means calling for help if the pain lasts longer than five minutes and one dose of nitroglycerin does not relieve it.
This is unless it is obvious that the pain is of a different type and intensity as your usual angina.
#4 is to know what information you should provide at the hospital. Be prepared to tell the emergency room doctor:
1. What type of pain you are feeling
2. When it started
3. If the pain changed since it started
4. What medications you have taken for the pain
You should also tell your emergency healthcare team
1. If you have had a heart attack before
2. If you have had angina before and
3. What medications you take on a regular basis.
When you arrive at the emergency room, make sure you say, “I think I’m having a heart attack.” If you don’t and they have other emergencies, you may not get immediate attention.
Some people are afraid of being embarrassed if they say they are having a heart attack and it turns out that they are not. Others tend to deny having a heart attack by convincing themselves it is indigestion or a sore muscle. Nearly 1/3 of the people who do not seek treatment on time die.