Heart Attack in Men

Definition

A heart attack occurs when an artery that carries oxygen-rich blood to the muscular wall of the heart (myocardium) becomes completely blocked. The resulting lack of oxygen causes tissue to die in the part of the heart supplied by the blocked artery. A heart attack is also called a myocardial infarction (MI).

Causes

Most heart attacks are indirectly caused by coronary artery disease, a form of heart disease. This condition results from atherosclerosis, a condition in which fatty deposits (plaques) build up on the walls of an artery. This narrows the arteries and restricts blood flow to the wall of the heart. A complete blockage of blood flow sufficient to cause a heart attack is usually triggered by an event such as a blood clot forming on a plaque, which often leads to its rupture. Spasm of the artery usually contributes to the blockage.

Risk Factors

The risk factors for having a heart attack are similar to those for developing coronary artery disease.

Uncontrollable risk factors:

• Male age 50+
• African American descent
• Family history of cardiovascular disease

Controllable risk factors:

• Smoking or exposure to secondhand smoke
• High blood pressure
• High levels of low-density lipoprotein (LDL) cholesterol
• Low levels of high-density lipoprotein (HDL) cholesterol
• Sedentary lifestyle
• Diabetes
• Obesity and overweight (especially when focused around the waist)
• Psychological stress
• High blood levels of homocysteine (an amino acid)

Symptoms

Symptoms vary and a patient may experience one or all of the following. In some cases, a patient may experience no symptoms at all. This is especially true for people with diabetes.

Symptoms include:

• Chest pain - crushing, squeezing, burning, heaviness, pressure, or tingling in the chest that lasts more than a few minutes
• Pain that extends into the left arm, neck, and jaw (less often, into the right arm)
• Profuse sweating
• Heart palpitations
• Shortness of breath
• Nausea and vomiting
• Weakness or fatigue
• Fainting
• A fear of impending death

Diagnosis

The following tests may be done to confirm the diagnosis of a heart attack:

Electrocardiogram (ECG) – records the electrical activity of the heart; it is used to see if the heart was damaged and where the damage is located

Blood tests – measure the levels of enzymes in the blood that are released when the heart muscle is damaged

Echocardiogram – uses high-frequency sound waves to visualize the heart's structure and function

Myocardial perfusion scan – uses small doses of a radioactive substance injected into the bloodstream to visualize how well blood is nourishing the heart wall

Treatment

It is imperative for anyone who is experiencing symptoms of a heart attack to receive treatment immediately. Medical attention within the first two hours after the symptoms start can significantly reduce the amount of heart damage. An electric shock using a defibrillator along with intravenous medication may be administered if the heartbeat is dangerously irregular. Supplemental oxygen is usually given to increase oxygen in the blood and minimize tissue damage.

Additional drug and surgical treatments are listed below.

Prevention

To decrease your chances of developing heart disease, and thus having a heart attack, try to do the following:

• Eat a diet low in saturated fat and trans-fatty acids
• Eat plenty of fruits, vegetables, and whole grain foods
• Eat foods containing vitamins B₁₂, B₆, and folic acid
• Maintain a healthy weight
• Exercise regularly
• Quit smoking
• Control diabetes
• Minimize stress
• Take aspirin daily if recommended by your doctor
• Take cholesterol-lowering drugs if prescribed by your doctor
• Drink alcohol in moderation (no more than one to two drinks per day)