Heart Attack – What it is, Symptoms, Causes and Treatments

Heart attacks are leaders in death in the world, being responsible for almost 30% of deaths in Brazil. In addition, Acute Myocardial Infarction ( AMI ) is the main cause. According to Datasus, the government’s data control agency, 2028 deaths from cardiovascular diseases were recorded in the state of São Paulo in August 2016 alone.

Hospital mortality from acute infarction at admission is high , and higher the longer the time between the onset of symptoms and final care. Risk factors for a heart attack are obesity, hypertension, high cholesterol, stress, diabetes or previous heart attacks. Middle-aged men and post-menopausal women are the most affected by the problem.

A heart attack happens when part of the heart muscle has died from lack of oxygen . Muscle nutrition is provided by the coronary arteries, which carry blood and nutrients to the heart. If such an artery “clogs” – which occurs when a fatty plaque near the inner wall of the vessel ruptures – the blood flow is interrupted and that area suffers (causing pain) and if this flow is not reestablished in time, the tissue dies. So, check out now  Heart Attack: Symptoms, Causes and Treatments:

Identifying the Infarction:  AMI pain is an ill-defined, dull sensation that can lodge in any location between the lower lip and the umbilicus. Although most people experience tightness in the middle of the chest, spreading to the right arm, we very often see less characteristic presentations.

I’ve seen people with chin pain, back pain. The features of a heart attack in women are much less typical, with complaints of burning or pins and needles in the chest or painless shortness of breath. Any pain in these regions that lasts longer than 20 minutes should be investigated and considered a serious illness, especially if associated with the following symptoms:

  • vomiting .
  • Cold sweat.
  • Intense Weakness.
  • Palpitations.
  • Nausea.
  • indigestion.
  • heartburn.
  • abdominal pain.
  • Shortness of breathe.
  • Cold sweat.
  • fatigue _
  • Sudden dizziness or lightheadedness.

In the presence of these sensations, it is extremely important to seek help in the nearest emergency room within one hour. As time passes, the pain diminishes, but the damage becomes more extensive and irreversible. After 12 hours of pain, the suffering muscle has almost completely died.

Heart Attack Symptoms Vary:  Not all people who have a heart attack have the same symptoms or have the same severity of symptoms. Some people have mild pain; Others have more severe pain. Some people have no symptoms, while for others, the first sign may be sudden cardiac arrest. However, the more signs and symptoms you have, the more likely you are to have a heart attack .

Some heart attacks strike suddenly, but many people have warning signs and symptoms hours, days, or weeks in advance. The first warning may be recurrent chest pain (angina) that is triggered by exertion and relieved by rest. Angina is caused by a temporary decrease in blood flow to the heart.

heart attack differs from a condition where your heart suddenly stops (sudden cardiac arrest, which occurs when an electrical disturbance stops the heart’s pumping action and causes blood to stop flowing to the rest of your body). A heart attack can cause cardiac arrest, but it’s not the only cause.

When to See a Doctor:  Act immediately. Some people wait too long because they don’t recognize the important signs and symptoms. Follow these steps:

  • Emergency medical help call . If you suspect you are having a heart attack , don’t hesitate. Immediately call 911 or your local emergency number. If you don’t have access to emergency medical services, have someone take you to the nearest hospital.

Go only if there are no other options. Because your condition can get worse, driving yourself puts you and others at risk.

  • Take nitroglycerin if prescribed by a doctor. Take it as instructed while waiting for emergency help.
  • Take aspirin if recommended. Taking aspirin during a heart attack can reduce heart damage by helping to keep your blood from clotting.

Aspirin can interact with other medications, however, so don’t take aspirin unless your doctor or emergency medical personnel recommend it. Don’t delay calling 911 for an aspirin. Call for emergency help first.

What to Do if You See Someone with a Heart Attack:  If you find someone who is unconscious, first call for emergency medical help. Then start CPR to keep the blood flowing. Push hard and fast into the person’s chest – about 100 compressions per minute. It is not necessary to check the person’s airway or deliver rescue breaths unless you have been trained in CPR.

Causes:  A heart attack occurs when one or more of your coronary arteries become blocked. Over time, a coronary artery can narrow from the buildup of various substances, including cholesterol (atherosclerosis). This condition, known as coronary artery disease, causes most heart attacks .

During a heart attack , one of these plaques can rupture and spill cholesterol and other substances into the bloodstream. A blood clot forms at the rupture site. If large enough, the clot can completely block blood flow through the coronary artery.

Another cause of a heart attack is a spasm of a coronary artery that shuts off blood flow to part of the heart muscle. Use of tobacco and illicit drugs such as cocaine can cause a potentially fatal spasm. A heart attack can also occur due to a tear in the heart artery (spontaneous coronary artery dissection).

Risk Factors:  Certain factors contribute to the unwanted buildup of fatty deposits (atherosclerosis) that narrows arteries throughout the body. You can improve or eliminate many of these risk factors to reduce your chances of having a first or subsequent heart attack . Heart attack risk factorsinclude :

  • Age: Men age 45 and older and women age 55 and older are more likely to have a heart attack than younger men and women.
  • Tobacco: Smoking and long-term exposure to secondhand smoke increase the risk of a heart attack .
  • High blood pressure: Over time, high blood pressure can damage the arteries that feed your heart, speeding up atherosclerosis. High blood pressure that occurs with obesity, smoking, high cholesterol or diabetes increases the risk even more.
  • High levels of blood cholesterol or triglycerides: A high level of low-density lipoprotein (LDL) cholesterol (the “bad” cholesterol) is more likely to narrow your arteries. A high level of triglycerides, a type of blood fat related to your diet, also increases your risk of heart attack . However, a high level of high-density lipoprotein (HDL) cholesterol (the “good” cholesterol) lowers the risk of heart attack.
  • Diabetes: Insulin, a hormone secreted by the pancreas, allows your body to use glucose, a form of sugar. Having diabetes – not producing enough insulin or not responding properly to insulin – causes your body’s blood sugar levels to rise. Diabetes, especially uncontrolled diabetes, increases the risk of a heart attack .
  • Family history of heart attack: If your siblings, parents, or grandparents had early heart attacks (by age 55 for male relatives and by age 65 for female relatives), you may be at increased risk.
  • Lack of physical activity: An inactive lifestyle contributes to high blood cholesterol levels and obesity. People who get regular aerobic exercise have better cardiovascular fitness, which lowers their overall risk of heart attack . Exercise is also beneficial in lowering high blood pressure.
  • Obesity: Obesity is associated with high blood cholesterol levels, high triglyceride levels, high blood pressure and diabetes. Losing just 10 percent of your body weight can lower that risk, however.
  • Stress: You can respond to stress in ways that can increase your risk of a heart attack .
  • Illegal drug use: Using stimulant drugs such as cocaine or amphetamines can trigger a spasm of your coronary arteries that can cause a heart attack .
  • A history of preeclampsia: This condition causes high blood pressure during pregnancy and increases the lifetime risk of heart disease.
  • A history of an autoimmune condition such as rheumatoid arthritis or lupus: Conditions such as rheumatoid arthritis, lupus and other autoimmune conditions can increase your risk of having a heart attack .

Complications:  Complications are often related to the damage done to your heart during an attack . Damage can lead to:

  • Abnormal heart rhythms (arrhythmias): Electrical “short circuits” can develop, resulting in abnormal heart rhythms, some of which can be serious, even fatal.
  • Heart Failure: An attack  can damage so much heart tissue that the remaining heart muscle cannot properly pump blood out of your heart. Heart failure can be temporary, or it can be a chronic condition resulting from extensive and permanent damage to your heart.
  • Heart rupture:  Areas of heart muscle weakened by a heart attack can rupture, leaving a hole in part of the heart. This rupture is often fatal.
  • Valve Problems: Heart valves damaged during a heart attack can develop serious leakage problems.

Preparing for Your Appointment:  A heart attack is usually diagnosed in an emergency setting. However, if you are concerned about your heart attack risk , see your doctor to check your risk factors and talk about prevention. If your risk is high, you may be referred to a cardiology specialist (cardiologist). Here is some information to help you prepare for your appointment. What can you do :

  • Be aware of pre-appointment restrictions: When you make the appointment, ask if there is anything you need to do in advance, such as restricting your diet. For a cholesterol test, for example, you may need to fast beforehand.
  • Write down your symptoms: Write down your symptoms, including any that seem unrelated to coronary artery disease.
  • Write down key information: Write down key personal information, including a family history of heart disease, stroke, high blood pressure or diabetes, and recent major stresses or recent life changes.
  • Make a medication list: Make a list of medications, vitamins and supplements you are taking.
  • Take someone , if possible . Someone accompanying you may remember something you miss or forget.
  • Be prepared to discuss your diet and exercise habits. If you don’t follow a diet or exercise routine, be prepared to talk to your doctor about the challenges you may face getting started.

Write down Questions to Ask Your Doctor:  Preparing a list of questions can help you make the most of your time with your doctor. Some basic questions to ask your doctor about heart attack prevention include:

  • What tests do I need to determine my current heart health?
  • What foods should I eat or avoid?
  • What is the appropriate level of physical activity?
  • How often should I be screened for heart disease?
  • I have other health conditions. How can I better manage these conditions together?
  • Are there brochures or other printed materials I may have?
  • What sites do you recommend?
  • Don’t hesitate to ask any other questions, too.

What to Expect from Your Doctor: Your doctor is likely to ask you a number of questions, including:

  • Have you ever had symptoms of heart disease, such as chest pain or shortness of breath? If so, when did they start?
  • Do these symptoms persist or do they come and go?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms? If you have chest pain, does it get better with rest?
  • What, if anything, makes your symptoms worse? If you have chest pain, does stinging activity make it worse?
  • Do you have a family history of heart disease or heart attacks ?
  • Have you been diagnosed with high blood pressure, diabetes or high cholesterol?

What You Can Do In the meantime: It’s never too early to make healthy lifestyle changes like quitting smoking, eating healthy foods, and becoming more physically active. These are primary lines of defense against having a heart attack .

Treatments: Heart, attack , treatment, hospital: With every minute that passes after a heart attack , more heart tissue loses oxygen and deteriorates or dies. The main way to prevent heart damage is to restore blood flow quickly.

Medications: Medications given to treat a heart attack include:

  • Aspirin : The 911 operator can instruct you to take aspirin, or emergency medical personnel can give you aspirin right away. Aspirin reduces blood clotting, thus helping to maintain blood flow through a narrowed artery.
  • Thrombolytics : These medications, also called clotbusters, help dissolve a blood clot that is blocking blood flow to your heart. The sooner you are given a thrombolytic drug after a heart attack , the better chance you have of surviving and with less heart damage.
  • Antiplatelet Agents: Emergency physicians may give you other drugs to help prevent new clots and keep existing clots from getting bigger. These include medicines such as clopidogrel (Plavix) and others called platelet aggregation inhibitors.
  • Other Blood-Thinning Medications:   You will likely be given other medications, such as heparin, to make your blood less “sticky” and less likely to form clots. Heparin is given intravenously or by injection under the skin.
  • Pain relievers: You may be given a pain reliever, such as morphine, to relieve your discomfort.
  • Nitroglycerin: This medicine, used to treat chest pain (angina), can help improve blood flow to the heart by widening (dilation) of blood vessels.
  • Beta-Blockers: These medications help relax the heart muscle, slow the heart rate, and lower blood pressure, making the heart’s job easier. Beta blockers can limit the amount of heart muscle damage and prevent future heart attacks .
  • ACE inhibitors:  These drugs lower blood pressure and reduce stress on the heart.

Surgical and Other Procedures : In addition to medications, you may have one of the following procedures to treat your heart attack :

Coronary Angioplasty and Stenting:  Doctors insert a long, thin tube (catheter) that is passed through an artery, usually in your leg or groin, to a blocked artery in your heart. If you’ve had a heart attack , this procedure is usually done immediately after a heart catheterization, a procedure used to locate blockages.

This catheter is equipped with a special balloon that, once in position, is briefly inflated to open a blocked coronary artery. A wire mesh stent can be inserted into the artery to keep it open for the long term, restoring blood flow to the heart. Depending on your condition, your doctor may choose to place a stent coated with a slow-release drug to help keep your artery open.

Coronary Artery Bypass Surgery: In some cases, doctors may perform emergency bypass surgery at the time of a heart attack . If possible, your doctor may suggest that you have bypass surgery after your heart has had time — about three to seven days — to recover from your heart attack .

Bypass surgery involves sewing veins or arteries in place beyond a blocked or narrowed coronary artery, allowing blood flow to the heart to bypass the narrowed section. Once blood flow to your heart is restored and your condition is stable, you are likely to stay in the hospital for several days.

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