Heart Attack

Overview

A heart attack is a life-threatening, medical emergency that requires prompt treatment. It results in permanent damage to the heart or even lead to the death of the person. It is caused by blocked coronary arteries, which result from the buildup of plaque. Some heart attacks do not exhibit the classic “shooting chest pain” symptom and can cause atypical symptoms such as pain in the teeth, back and jaw.

Time is crucial for treatment, and treatment plans range from medications to open heart surgery (in severe cases of heart attacks). An individual can prevent this medical concern by implementing a healthy lifestyle, taking prescribed medications religiously, scheduling regular medical checkups, quitting tobacco and alcohol, and managing underlying health conditions such as hypertension, diabetes and high cholesterol.

What is Heart Attack?

A heart attack or myocardial infarction is a fatal medical condition that occurs when there is a deprivation of blood supply to some parts of the heart muscle. This insufficient blood flow can primarily be caused due to a blockage in the heart's arteries (resulting from the build-up of a sticky substance), eventually leading to the death of the heart muscle. Not seeking immediate medical attention can result in irreversible heart damage or even death in some cases.

Types of Heart Attack

Heart attack is mainly classified into 3 categories, including the following:

ST-Segment Elevation Myocardial Infarction (STEMI): This heart attack type is characterised by a long interruption to the blood flow or a complete blockage in a coronary artery. This prolonged deprivation of blood supply can damage the heart extensively. Treatment is required promptly to unblock the affected artery.

Coronary Spasm (or Unstable Angina): In this type of heart attack, an individual may experience the symptoms of the medical condition despite the tests revealing no signs of damage being caused to the heart. This condition may still restrict the blood supply to the heart, increasing one's chances of having a heart attack.

Non-ST-Segment Elevation Myocardial Infarction (NSTEMI): It is a type of heart attack which is characterised by minimal loss of blood supply. A blood test may reveal this coronary damage when an ECG fails to diagnose the issue. This is a medical emergency and requires prompt treatment to prevent it from progressing to a STEMI.

Symptoms of Heart Attack

The symptoms of a heart attack involve

• angina or chest pain
• insomnia
• heart palpitations
• stomach discomfort or nausea
• feeling dizzy or lightheaded
• anxiety

Individuals who are assigned female at birth may notice discomfort or chest pain that mimics indigestion. They may also experience fatigue, insomnia, nausea, sharp pain in the abdomen, shoulder or back and shortness of breath to a greater extent than individuals who are assigned male at birth.

Other symptoms include cold sweat, heartburn, and discomfort or pain in the jaw, upper belly, teeth, back, shoulders and arm.

Causes of Heart Attack

The most common cause of a heart attack involves blockage in one of the blood vessels that are responsible for supplying blood to the heart. This blockage is caused by plaque, a sticky substance that builds up on the inner lining of arteries known as atherosclerosis. A large amount of this build-up occurring from the blood vessels to the heart leads to coronary heart disease. This plaque when deposited inside the coronary arteries, can cause an aneurysm, rupture or even blood clots.

With the blood clot blocking the artery, the heart muscle is deprived of blood and this results in a heart attack. However, in many cases, a heart attack can also occur without a ruptured plaque. It may be caused due to rare medical concerns (such as narrowing of blood vessels), coronary artery spasms, eating disorders, traumas that cause coronary artery rupture, obstruction developing in any part of the body, and anomalous coronary arteries.

Other medical conditions that lead to a heart attack involve low blood pressure or conditions that deprive the heart of receiving sufficient blood for a prolonged period. Heart attack can also be caused due to coronary thrombosis or spontaneous coronary artery dissection (SCAD).

The risk factors for heart attack involve a family history of heart diseases or a similar medical concern, increasing age, people assigned male or female at birth (between the ages of 45 - 50 or more), unhealthy lifestyle choices (addiction to alcohol, smoking, consuming a diet rich in fatty foods and lack of exercising), and certain health conditions such as diabetes, high cholesterol, eating disorders and a medical history of preeclampsia.

Diagnosis of Heart Attack

A patient is often diagnosed with a heart attack in an emergency room environment. A doctor may also perform a physical examination on patients exhibiting symptoms. This is followed by checking the patient's pulse rate, blood pressure, and blood oxygen levels and listening to the lung and heart sounds.

Furthermore, the doctor will recommend tests such as blood tests, electrocardiogram (ECG or EKG), echocardiogram, heart computed tomography (CT) scan, heart catheterisation, coronary angiogram, exercise stress test, heart magnetic resonance imaging (MRI) test, or nuclear heart scans (positron emission tomography or PET scans).

Treatment for Heart Attack

The treatment for heart attack involves promptly restoring the flow of blood to the impacted heart muscle. A doctor may recommend a range of treatment plans, involving medication or even surgery. Supplemental oxygen is often provided to patients who face difficulty breathing or have low blood oxygen levels.

Medications may often include aspirin and different blood-thinning medications, anti-arrhythmia medications, clot-busting (thrombolytics) medications, nitroglycerin, beta-blockers, morphine or other pain medications, statins (to stabilise the plaque and reduce cholesterol), and antihypertensives (to control blood pressure).

To restore blood circulation to the affected heart muscle, a medical expert may also recommend angioplasty or percutaneous coronary intervention (PCI). In this process, the artery is wide-opened with a catheter to restore the blood flow. In patients who have fatal coronary artery blockages, doctors may recommend a coronary artery bypass grafting (CABG) or an open-heart surgery (also called bypass surgery). This process involves using a blood vessel from different body parts to create a detour for blood flow.

Prevention of Heart Attack

While several factors that lead to a heart attack cannot be changed, some preventive measures can help lower the risk of heart attack. This involves scheduling a checkup with a healthcare provider at least once a year, exercising regularly for 30 minutes, quitting tobacco consumption, reducing stress, eating a nutritious or plant-based diet, managing health conditions such as high blood pressure and diabetes, taking the prescribed medications, and maintaining an ideal body weight. An individual who has already had a heart attack may be recommended a cardiac rehabilitation program by a doctor, as this will reduce the risk of recurring heart attacks.

Myths and Facts About Heart Attack

Following are some myths and facts related to heart attack:

Myth 1: Hearts Attacks Only Happen to Older People
Fact: While the risk increases with age, heart attacks can happen at any age, even in young people, especially if they have medical conditions such as high cholesterol, diabetes or high blood pressure.

Myth 2: Heart Attack Symptoms are Always Characterised by Shooting Chest Pain
Fact: While chest pain is a common symptom of heart attack, an individual may also experience pain in the jaw, neck, back, or arms, shortness of breath, nausea, lightheadedness and cold sweat.

Myth 3: Having a Heart Attack Means Immediate Death
Fact: Time is crucial for treating heart attacks. Although not immediately, but delay in heart attack treatment can result in death. Hence, taking quick action and seeking medical attention promptly is imperative to save lives.

Myth 4: Stress is the Main Cause of Heart Attacks
Fact: While stress can be one of the causes of heart attack, it can occur because of other underlying conditions such as diabetes, obesity, high cholesterol, hypertension, smoking, family history and a sedentary lifestyle.