Heart attack – Getting to the ‘heart’ of the trouble
By Dr Pankaj Kshatriya, MD (Internal Medicine Specialist)
A heart attack may be defined as a sudden failure of the heart to function normally. If not treated in a timely manner it will result in permanent damage to the heart muscle. It is also known as Myocardial Infarction. The term ‘Myo’ refers to muscle and the term ‘cardium’ refers to the heart. Infarction refers to the death of tissue.
What happens during
a heart attack?
In a heart attack, the blood supply to the heart is impaired, due to a blockage in the arteries which supply blood and oxygen to the heart muscles, known as coronary arteries. The blockage or clot is formed by fatty material, thrombus or calcium.
Healing of the heart muscle begins soon after a heart attack. It takes about eight to twelve weeks. Just like a skin wound, the heart wound heals and a scar is formed in the damaged area. This new scar does not contract or pump as well as the healthy heart muscle tissue.
Symptoms of a heart attack
* Heaviness, pain or discomfort in chest, arm, jaw, below breast bone.
* Radiating pain or discomfort to the throat, back and jaw.
* Choking, feeling of indigestion.
* Hiccups and belching.
* Dizziness, sweating, nausea, vomiting.
* Rapid irregular heart beat.
* Shortness of breath.
* Some people may have a heart attack without symptoms. This is common in diabetics.
What do I do if I have
a heart attack?
At the first sign of a heart attack, consult your doctor immediately. The best time to treat a heart attack is within one to two hours of the onset of symptoms. Waiting longer will increase the damage to the heart muscles and reduce chances of survival.
How is a heart attack diagnosed?
The diagnosis of heart attack is based on symptoms, ECG and blood tests. Other specific tests are echocardiography, stress test and coronary angiography.
How is a heart attack treated?
Once an attack is diagnosed, treatment begins immediately. The goal of treatment is to treat you quickly and limit heart muscle damage. Medications and surgical procedures are used to treat a heart attack.
The goal of medication therapy is to break or prevent blood clots, stabilize the plaque and prevent further damage to the heart muscles.
These medications must be given as soon as possible, within one to two hours to decrease the amount of muscle damage.
Medications for this purpose are:
* Aspirin to prevent blood clotting.
* Antiplatelet drugs to prevent blood clotting.
* Clot busters to dissolve the blood clots, which are present in heart arteries.
* GTN tablets to improve blood supply to heart muscles and ease the chest (anginal) pain.
* Other drugs given during and after heart attack, reduce heart load, improve functioning of heart, decrease pain and guard against life-threatening complications.
What other treatment
options are there?
Cardiac catheterization may be required for an evaluation of the heart status, arteries and the amount of heart damage. Some special procedures such as angioplasty or stents are used to open up blocked arteries.
If necessary, bypass surgery may be performed to restore blood supply to the heart muscles.
How are subsequent heart
attacks prevented?
The main aim after a heart attack is to keep the heart healthy and reduce the risk of another attack. The best way to ward off future attacks is to take medications, make lifestyle changes and have regular heart check-ups.
Why do I need to take medicines after a heart attack?
Medicines given after a heart attack help to prevent further clots, reduce the work load of the heart, improve heart capacity and prevent fat deposition in the arteries by lowering cholesterol. Other medications may be needed to treat irregular heart beat, high blood pressure, and heart failure.
What lifestyle changes
will I need to make?
There is no cure for coronary artery disease. To prevent the progression of this disease, you must make the necessary lifestyle changes and follow the doctor’s advice.
Life style changes include: stopping smoking, lowering the amount of fat in food, controlling diabetes and high blood pressure, following an exercise plan, maintaining an ideal body weight and controlling stress.