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HEART ATTACK

HEART ATTACK

A heart attack occurs when the flow of blood to the heart is blocked. The blockage is most often a buildup of fat, cholesterol, and other substances, which form a plaque in the arteries that feed the heart (coronary arteries).
 
Sometimes plaque can rupture and form a clot that blocks blood flow. The interrupted blood flow can damage or destroy part of the heart muscle.
A heart attack, also called a myocardial infarction, can be fatal, but treatment has improved dramatically over the years. It's crucial to call 911 or emergency medical help if you think you might be having a heart attack.

 

What are the symptoms of a Heart attack?

The major symptoms of a heart attack are:
  • Chest pain or discomfort. Most heart attacks involve discomfort in the center or left side of the chest that lasts for more than a few minutes or that goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain.
  • Feeling weak, light-headed, or faint. You may also break out into a cold sweat.
  • Pain or discomfort in the jaw, neck, or back.
  • Pain or discomfort in one or both arms or shoulders.
  • Shortness of breath. This often comes along with chest discomfort, but shortness of breath also can happen before chest discomfort.
Other symptoms of a heart attack could include unusual or unexplained tiredness and nausea or vomiting. Women are more likely to have these other symptoms.

 

 

Causes

There are a few cardiac conditions that can cause heart attacks. One of the most common causes is plaque buildup in the arteries (atherosclerosis) that prevents blood from getting to the heart muscle.

Heart attacks can also be caused by blood clots or torn blood vessels. Less commonly, a heart attack is caused by a blood vessel spasm.

 

Risk factors

Several factors can put you at risk for a heart attack. Some factors you can’t change, such as age and family history. Other factors, called modifiable risk factors, are ones you can change.
Risk factors that you can’t change include:
  • Age - If you’re over age 65, your risk for having a heart attack is greater.
  • Sex - Men are more at risk than women.
  • Family history - If you have a family history of heart disease, high blood pressure, obesity, or diabetes, you’re more at risk.
  • Race - People of African descent have a higher risk.

Modifiable risk factors which you can change include:

When to see a Doctor

Act immediately. Some people wait too long because they don't recognize the important signs and symptoms. Take these steps:
  • Call for emergency medical help. If you suspect you're 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 drive you to the nearest hospital.
    Drive yourself only if there are no other options. Because your condition can worsen, driving yourself puts you and others at risk.
  • Take nitroglycerin, if prescribed to you by a doctor. Take it as instructed while awaiting emergency help.
  • Take aspirin, if recommended. Taking aspirin during a heart attack could reduce heart damage by helping to keep your blood from clotting.
    Aspirin can interact with other medications, however, so don't take an aspirin unless your doctor or emergency medical personnel recommend it. Don't delay calling 911 to take an aspirin. Call for emergency help first.

 

What to do someone else might be having a heart attack

If you see someone who's unconscious and you believe is having a heart attack, call for emergency medical help. Then check if the person is breathing and has a pulse. If the person isn't breathing or you don't find a pulse, only then should you begin CPR.
Push hard and fast on the person's chest in a fairly rapid rhythm — about 100 to 120 compressions a minute.


If you haven't been trained in CPR, doctors recommend performing only chest compressions. If you have been trained in CPR, you can go on to opening the airway and rescue breathing.
 


Diagnosis


A diagnosis of a heart attack is made by a doctor after they perform a physical exam and review your medical history. Your doctor will likely conduct an electrocardiogram (ECG) to monitor your heart’s electrical activity.
They should also take a sample of your blood or perform other tests to see if there’s evidence of heart muscle damage.

Tests and treatments

If your doctor diagnoses a heart attack, they’ll use a variety of tests and treatments, depending on the cause.


Your doctor may order a cardiac catheterization. This is a probe that’s inserted into your blood vessels through a soft flexible tube called a catheter. It allows your doctor to view areas where plaque may have built up. Your doctor can also inject dye into your arteries through the catheter and take an X-ray to see how the blood flows, as well as view any blockages.


If you’ve had a heart attack, your doctor may recommend a procedure (surgery or nonsurgical). Procedures can relieve pain and help prevent another heart attack from occurring.
Common procedures include:

  • Angioplasty. An angioplasty opens the blocked artery by using a balloon or by removing the plaque buildup.
  • Stent. A stent is a wire mesh tube that’s inserted into the artery to keep it open after angioplasty.
  • Heart bypass surgery. In bypass surgery, your doctor reroutes the blood around the blockage.
  • Heart valve surgery. In valve replacement surgery, your leaky valves are replaced to help the heart pump.
  • Pacemaker. A pacemaker is a device implanted beneath the skin. It’s designed to help your heart maintain a normal rhythm.
  • Heart transplant. A transplant is performed in severe cases where the heart attack has caused permanent tissue death to most of the heart.
Your doctor may also prescribe medications to treat your heart attack, including:
  • aspirin
  • drugs to break up clots
  • antiplatelet and anticoagulants, also known as blood thinners
  • painkillers
  • nitroglycerin
  • blood pressure medication

Complications

Complications are often related to the damage done to your heart during a heart attack, which can lead to:
  • Abnormal heart rhythms (arrhythmias). Electrical "short circuits" can develop, resulting in abnormal heart rhythms, some of which can be serious, and may lead to death.
  • Heart failure. A heart attack might damage so much heart tissue that the remaining heart muscle can't pump enough 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.
  • Sudden cardiac arrest. Without warning, your heart stops due to an electrical disturbance that causes an abnormal heart rhythm (arrhythmia). Heart attacks increase the risk of sudden cardiac arrest, which can cause death without immediate treatment.

Prevention

It's never too late to take steps to prevent a heart attack — even if you've already had one. Here are ways to prevent a heart attack.
  • Taking medications can reduce your risk of a subsequent heart attack and help your damaged heart function better. Continue to take what your doctor prescribes, and ask your doctor how often you need to be monitored.
  • Lifestyle factors. You know the drill, maintain a healthy weight with a heart-healthy diet, don't smoke, exercise regularly, manage stress, and control conditions that can lead to a heart attack. This includes conditions such as high blood pressure, high cholesterol, and diabetes.
 
 

What can I do to recover after a heart attack?

 
If you’ve had a heart attack, your heart may be damaged. This could affect your heart’s rhythm and its ability to pump blood to the rest of the body. You may also be at risk for another heart attack or conditions such as stroke, kidney disorders, and peripheral arterial disease (PAD).
You can lower your chances of having future health problems following a heart attack with these steps:
  • Physical activity—Talk with your health care team about the things you do each day in your life and work. Your doctor may want you to limit work, travel, or sexual activity for some time after a heart attack.
  • Lifestyle changes—Eating a healthier diet, increasing physical activity, quitting smoking, and managing stress—in addition to taking prescribed medicines—can help improve your heart health and quality of life. Ask your health care team about attending a program called cardiac rehabilitation to help you make these lifestyle changes.
  • Cardiac Rehabilitation—Cardiac rehabilitation is an important program for anyone recovering from a heart attack, heart failure, or other heart problem that requires surgery or medical care. Cardiac rehab is a supervised program that includes. 
    • Physical activity
    • Education about healthy living, including healthy eating, taking medications as prescribed, and ways to help you quit smoking
    • Counseling to find ways to relieve stress and improve mental health

A team of people may help you through cardiac rehab, including your health care team, exercise, and nutrition specialists, physical therapists, and counselors or mental health professionals.
 



What lifestyle changes are needed after or before a heart attack?
To keep heart disease from getting worse and to head off another heart attack, follow your doctor's advice. You might need to change your lifestyle. Here are some changes you can make that can cut your risk and put you on the path to a healthier life:


Stop smoking: Smoking dramatically raises your risk of both heart attacks and strokes. Talk to your doctor about how to quit. You'll also be doing your friends and family a favor, since secondhand smoke can also lead to heart disease.

Keep a healthy body weight: If you're overweight or obese, you don't have to get thin to reduce your risk for a heart attack or stroke. If you lose 5% to 10% of your weight, you'll improve your cholesterol numbers and lower your blood pressure and blood sugar levels.


Follow an exercise plan: Moderate physical activity lowers your chances of a heart attack. It also can reduce your blood pressure and LDL or "bad" cholesterol, raise your HDL or "good" cholesterol, and help you stay at a healthy weight.


Aim for 30 minutes of exercise that gets your heart pumping at least 5 days a week. Brisk walking or swimming are some good choices. On the other 2 days, do strength training, like lifting weights. If you've got a tight schedule, break your exercise routine into small chunks.


Eat a heart-healthy diet: Fill your plate with different kinds of fruits, veggies, beans, and lean meats, such as poultry without the skin. Also up your intake of whole grains like oatmeal, quinoa, brown rice, and fish, (especially those with omega-3 fatty acids, such as salmon, trout, and herring).


Avocados, olive oil, and flaxseeds also have omega-3s, as do some nuts and seeds. Fat-free or low-fat dairy products such as milk, yogurt, and cheese also are better choices for your heart health than higher-fat versions.

Cut back on unhealthy foods: Stay away from processed or prepared foods that often are high in salt and added sugar. They're also filled with preservatives. Avoid fatty beef, butter, fried foods, and palm oil. All are high in saturated fats.


Skip sugary drinks like sodas and fruit punch, which can lead to weight gain. So can packaged baked goods such as cookies, cakes, and pies. They are high in trans fats and can raise your cholesterol levels.


Limit alcohol: If you don't drink already, don't start. If you do drink, limit how much you drink. The recommendation is no more than one drink a day if you are a woman and no more than two a day if you are a man. Drinking raises your heart rate and blood pressure. It also increases the level of fat in your blood and can cause weight gain.
 
Get regular checks of your cholesterol, blood pressure, and blood sugar (glucose) levels. If you have diabetes, make sure it’s controlled. Keeping a check on these numbers can help you be more aware of the changes you need to make to keep these levels within normal limits.


Control stress: You may feel anxious or frustrated at times. Make sure you open up to your family and friends about what’s going on. Support groups can help you learn how others adjusted to life after a heart attack or stroke.
You may want to talk to a mental health professional or ask your doctor about a stress management program. You can also reduce stress with plenty of physical activity and mind-body practices like meditation.


Pay attention to your symptoms: Don't just hope they'll go away. See your doctor if you feel anything unusual, like shortness of breath, changes in your heart rhythm, or extreme tiredness. Also, watch for pain in your jaw or back, nausea or vomiting, sweating, or flu-like symptoms.


Bottom line
Improving your heart health after a heart attack depends on how well you stick to your doctor’s treatment plan. It also depends on your ability to identify potential problems.


Knowing your risk factors and making lifestyle changes can help you become a survivor and enjoy your life.

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