A heart attack, medically known as a myocardial infarction, occurs when blood flow to a part of the heart muscle is severely reduced or completely blocked. This blockage usually happens due to a buildup of plaque (fatty deposits) in the coronary arteries, a process called atherosclerosis. If blood flow is not quickly restored, the affected heart muscle begins to die from lack of oxygen. This condition is a life-threatening medical emergency requiring immediate attention to limit damage to the heart muscle.
Recognizing Symptoms and Immediate Actions
Recognizing the signs of a heart attack is important. While many people associate heart attacks with sudden, crushing chest pain, this is not always the case. Some individuals, particularly those with diabetes, may experience no symptoms at all, or symptoms may begin slowly with mild discomfort.
Symptoms often include chest discomfort (pressure, squeezing, fullness, or pain) lasting more than a few minutes or recurring. This discomfort might spread to other areas of the upper body, such as one or both arms, the back, neck, jaw, or stomach. Shortness of breath, with or without chest discomfort, is another frequent symptom.
Other symptoms include cold sweats, nausea, vomiting, lightheadedness, dizziness, or unexplained fatigue. Women are somewhat more likely than men to experience these less typical symptoms, such as neck, shoulder, upper back, or abdominal pain, which can sometimes lead to delayed treatment. If any of these symptoms are present, calling emergency services (such as 911 in the US) immediately is crucial. Prompt action is important because the longer blood flow is restricted, the more damage occurs to the heart muscle.
While waiting for emergency medical personnel, if conscious and not allergic to aspirin, chewing a 300mg aspirin tablet may be beneficial, as it helps thin the blood and improve blood flow. Do not delay calling for emergency help to take aspirin. Emergency medical services can begin treatment en route to the hospital and are equipped to handle sudden cardiac arrest.
Hospital Care and Treatments
Upon arrival at the hospital, medical teams focus on restoring blood flow to the heart muscle quickly to minimize damage. The specific treatments depend on the type of heart attack and its severity. One common initial intervention for a complete blockage, known as a STEMI heart attack, is primary percutaneous coronary intervention (PCI), often called coronary angioplasty.
During angioplasty, a thin tube with a balloon at its tip, called a catheter, is inserted into a blood vessel and guided to the blocked coronary artery. Once positioned, the balloon is inflated to open the narrowed artery, pushing back any plaque or clot. A flexible metal mesh tube, called a stent, is inserted to help keep the artery open and reduce the chance of future blockages. This procedure aims to increase blood flow through the affected artery.
Another treatment option, if PCI is not available or suitable, involves clot-dissolving medications, also known as thrombolytics or fibrinolytics. These medications work by breaking down fibrin, a protein that forms blood clots, helping to restore blood flow. For more complex cases or multiple blocked arteries, coronary artery bypass graft (CABG) surgery may be recommended. In this open-heart procedure, a healthy blood vessel from another part of the body is used to create a new path around the blocked artery, bypassing the obstruction.
Factors Influencing Survival
Several factors influence a person’s chances of surviving a heart attack. The speed at which treatment is received is important; the sooner blood flow is restored to the heart muscle, the less damage occurs.
The type of heart attack also plays a role. A ST-elevation myocardial infarction (STEMI), which involves a complete blockage of a coronary artery, is more severe and requires immediate intervention to restore blood flow. In contrast, a non-ST-elevation myocardial infarction (NSTEMI) results from a partial blockage, leading to less immediate damage. The location of the blockage within the coronary arteries matters; a blockage near the origin of a major artery will affect a larger portion of the heart muscle, potentially leading to more extensive damage. For instance, a blockage in the left anterior descending (LAD) artery, often called the “widowmaker,” carries a higher risk of complications and death due to the large area of the heart it supplies.
An individual’s overall health status before the heart attack also impacts survival. Pre-existing conditions such as high blood pressure, high cholesterol, diabetes, and kidney disease can increase the risk of a severe heart attack and complicate recovery. Lifestyle factors like smoking, obesity, and a sedentary lifestyle also increase vulnerability. The quality of emergency medical care received contributes to better outcomes.
Life After a Heart Attack
Life after a heart attack involves recovery and preventing future cardiac events. Cardiac rehabilitation (CR) is a medically supervised program designed to improve heart health and is an important component of this recovery.
Participating in cardiac rehabilitation can reduce the risk of subsequent heart events and improve overall quality of life. Patients learn safe ways to increase physical activity and adopt dietary changes, such as focusing on whole foods, limiting saturated and trans fats, reducing sodium intake, and increasing fiber. These modifications help manage cholesterol levels and blood pressure.
Beyond rehabilitation, ongoing medical follow-up is necessary to monitor heart function and manage any prescribed medications. Medications like beta-blockers, aspirin, or statins are often continued to manage heart health and reduce the risk of another heart attack. Regular check-ups with healthcare providers ensure medications are effective and that risk factors like high blood pressure and cholesterol remain controlled. Adopting a heart-healthy lifestyle, including quitting smoking, maintaining a healthy weight, and engaging in regular physical activity, promotes long-term heart health and reduces the likelihood of future cardiac issues.