General Information About Heart Attacks

General Characteristics

More than a million Americans have a heart attack each year. Although heart disease remains the leading cause of death in the United States, significant progress has been made in the last decade in both treating heart attacks and assisting people who have had one to resume a full, active life.

A coronary thrombosis is the most common type of heart attack, which occurs when a clot (thrombus) blocks one or more of the blood vessels that supply the heart muscle. Part of the muscle may be damaged and its ability to contract may be lost as a result of the lack of blood. This is referred to as a myocardial infarction. The chances of recovery are excellent if the infarct is small and the electrical impulses that control the heart's contractions (beats) are not disrupted.

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Coronary Artery Disease

One of the symptoms of coronary artery disease is coronary thrombosis. Our blood vessels lose elasticity as we age, a condition known as arteriosclerosis. Atherosclerosis is a condition in which the arteries become narrowed or clogged with fatty material deposits called atheromas. Atherosclerosis is a progressive disease that typically does not cause symptoms until there is a significant blockage in blood flow. A heart attack is sometimes the first symptom of this heart disease.

Although the exact cause of atherosclerosis is unknown, certain risk factors have been discovered to aid in identifying population groups that are more likely to develop it. High levels of cholesterol and other blood fats, high blood pressure (hypertension), and cigarette smoking are three major risk factors. Diabetes, obesity, a sedentary lifestyle, aging, being male, and heredity are among the others.

Atherosclerosis begins as a fatty streak on the inner wall of an artery, usually at the point where it branches out, and disrupts the smooth flow of blood. As fatty tissue patches accumulate, the inner wall narrows, restricting blood flow more significantly. As the tissue buildup progresses, the artery narrows further, and the fatty deposit eventually hardens into a hard mass of fatty tissue with a tough outer lining of cells - a plaque. As plaques spread and thicken, they erode the artery wall, interfering with blood flow and making it more turbulent. This turbulence can cause blood to clot (thrombus), which can partially or completely block the artery. Furthermore, a clot fragment (embolus) may be carried by the bloodstream and block an artery at a later, narrower point.

Heart attacks can occur in people who have no or little coronary artery disease. Some experts believe that these heart attacks are caused by a spasm or sudden constriction of the coronary artery. It appears that a spasm can occur in a coronary artery that is completely free of atherosclerosis (as well as one that is heavily affected by the condition), explaining why many people suffer from angina and other cardiac problems with no evidence of underlying artery blockage.

Symptoms of a Heart Attack

A heart attack can occur gradually, with several attacks of angina preceding it over days, weeks, months, or even years. (Angina is the name given to chest pain caused by a temporary lack of oxygen to the muscular wall of the heart.) However, a heart attack can occur without warning and in people who have never previously experienced chest pain.

A heart attack typically causes a sensation of constriction in the central chest area; the intensity can range from tightness to agonizing crushing or bursting. The pain may be constant or intermittent, lasting a few minutes before dissipating and reappearing. It is common for it to spread to the back, jaw, and left arm. Although physical or emotional stress can trigger a heart attack, unlike angina, the pain does not go away when the stress is relieved.

Shortness of breath, sweating, nausea, dizziness, and pallor are all common symptoms of pain. (Some people have a heart attack without experiencing any of these symptoms.) This is referred to as a "silent" infarct, and it can be confirmed by changes in an electrocardiogram or other hospital tests.)

A Medical Emergency

The majority of heart attack deaths occur within minutes to hours of the onset of symptoms. As a result, when sudden and severe chest pain occurs, an ambulance should be summoned and the individual transported to a hospital. Denying that these symptoms indicate a potentially fatal illness may result in a fatal delay.

The development of abnormal heart rhythms in the hours following a coronary thrombosis attack is a major cause of death. As a result, emergency care focuses on stabilizing the heart rhythm, as well as relieving pain and preventing shock.

An electrocardiograph machine will continuously monitor the rate and rhythm of the heart in the hospital's intensive-care or cardiac-care unit. Blood tests to detect enzymes released by the heart aid in further assessing the infarct, and various medications may be administered. Following a heart attack, mood changes and feelings of apprehension are common, and the patient is frequently given a mild tranquilizer.

Depending on the severity of the attack, the patient may be allowed to leave the hospital in three or four days and discharged in two weeks. Wherever possible, prolonged bed rest should be avoided because it causes a rapid loss of muscle tone and an increase in heart rate upon exertion. Physical activity is gradually increased, and most patients are able to resume their normal activities within a few months.

Long-Term Treatment

Depending on the patient's age and general physical condition, as well as the extent of the heart damage, a variety of approaches to dealing with the underlying coronary artery disease and reducing the risk of another heart attack may be taken.

Lifestyle modifications. There are several steps that can be taken to prevent or slow the progression of heart disease. These include quitting smoking, getting regular exercise, and eating a low-cholesterol diet.

Treatment with drugs. The type of drugs used is determined by the nature of the heart attack and the underlying coronary disease. To lower blood pressure, antihypertensive medications may be prescribed. Other medications may be prescribed to improve heart function, prevent chest pain, or lower blood cholesterol levels.

Other therapies Other treatments, such as coronary bypass surgery, are available. Obviously, their application is dependent on individual requirements.

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