Heart Attack

A Heart Attack occurs when blood flow to the heart muscle is interrupted. This deprives the heart muscle of oxygen, causing tissue damage or tissue death.

Causes

A Heart Attack may be caused by:
  • Thickening of the walls of the arteries feeding the heart muscle (coronary arteries)
  • Accumulation of fatty plaques in the coronary arteries
  • Narrowing of the coronary arteries
  • Development of a blood clot in the coronary arteries

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
  • Sex: Male
  • Increased age
  • Obesity
  • Smoking
  • High blood pressure
  • Sedentary lifestyle
  • High blood cholesterol (specifically, high LDL cholesterol, and low HDL cholesterol)
  • High blood triglycerides
  • Diabetes
  • Stress
  • Family members with heart disease

Symptoms

Symptoms include:
  • Squeezing, heavy chest pain, especially with:
    • Exercise or exertion
    • Emotional stress
    • Cold weather
    • A large meal
  • Pain in the left shoulder, left arm, or jaw
  • Shortness of breath
  • Sweating, clammy skin
  • Nausea
  • Weakness
  • Loss of consciousness
Unusual symptoms of Heart Attack (may occur more frequently in women):
  • Stomach pain
  • Back pain
  • Confusion
  • Fainting

Diagnosis

If you think you are having a heart attack, call 911 immediately. You need emergency medical care.
Tests may include:
Blood Tests – to look for certain substances found in the blood within hours or days after a heart attack. Blood tests will be repeated every 6-8 hours to track the progressive elevation of certain enzymes that indicate heart muscle damage.
Urine Tests – to look for certain substances found in the urine within hours or days after a heart attack
Electrocardiogram (EKG) – records the heart's activity by measuring electrical currents through the heart muscle. Certain abnormalities in the EKG occur when there is significant blockage of the coronary arteries and/or damage to the heart muscle. The EKG will be repeated to track the progression of these changes.
Echocardiogram – uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart
Stress Test – records the heart's electrical activity under increased physical demand
Thallium Stress Test – thallium is used to scan the myocardium, the middle layer of the heart
Nuclear Scanning – radioactive material is injected into a vein and observed as it is absorbed by the heart muscle
Electron-beam CT scan – a type of x-ray that uses a computer to make pictures of the heart and surrounding structures
Coronary Angiography – x-rays taken after a dye is injected into the arteries; to look for abnormalities in the arteries

Treatment

Treatment may include:
  • Oxygen
  • Pain-killing medications (such as morphine)
  • Nitrate medications
  • Atropine
  • Beta-blocking and/or ACE inhibitor medications
  • Anti-anxiety medications
  • Clot-busting agents: within the first six hours after a heart attack, you may be given medications to break up blood clots in the coronary arteries.
  • These include:
  • Tissue plasminogen activator (tPA)
  • Streptokinase
  • APSAC
Surgery
Surgeries for people with severe blockages in their coronary arteries may include:
  • Coronary bypass graft
  • Atherectomy
  • Balloon angioplasty with or without stenting
Physical or Rehabilitative Therapy
During recovery from a heart attack, you may need physical or rehabilitative therapy to help you regain your strength.
Psychotherapy or Antidepressant Medication
Some people have depression after suffering a heart attack. If you do, psychotherapy and/or antidepressant medications may help relieve depression.

Prevention

Preventing or treating coronary artery disease may help prevent a Heart Attack.
  • Maintain a healthy weight.
  • Begin a safe exercise program with the advice of your doctor.
  • If you smoke, quit.
  • Eat a healthful diet, one that is low in saturated fat and rich in whole grains, fruits, and vegetables.
  • Appropriately treat high blood pressure and/or diabetes.
  • Ask your doctor about taking a small, daily dose of aspirin. It has been shown to decrease the risk of heart attack.
  • Ask your doctor about taking cholesterol-lowering medications.
  • Ask your doctor about taking nitrate medications if you have angina due to coronary artery disease.
  • Ask your doctor about taking medication to improve heart function, such as:
    • Beta-blockers
    • Ace-inhibitors
    • Calcium-channel blockers
    • Digitalis-type drugs