Heart Attack

What Is Heart Attack?

Heart attack occurs when one or more coronary arteries (blood vessels supplying blood to the heart) are blocked by buildup of cholesterol and other substances. The medical term for heart attack is myocardial infarction. Heart attack is a serious medical condition. Any delay in seeking medical help will have a negative impact on survival and heart function. Adapting to a healthy lifestyle can reduce risks of developing heart attack.

Symptoms of Heart Attack

Many people experience some of these symptoms during a heart attack:

chest pressure and discomfort
chest pain extending to shoulder, arm, and back
shortness of breath at later stages
pain in the upper abdomen
sweating, fainting, nausea, and vomiting

Some people also experience warning signs, for example recurrent chest pain, hours or days before a heart attack. However, some people even do not have any symptoms during a heart attack. It is advised to seek medical help immediately, if you suspect you are having a heart attack.

How Is Heart Attack Diagnosed?

The following medical tests and procedures help doctors to diagnose heart attack:

History and physical examination: Your doctor will ask you about your medical history and symptoms (e.g. chest pain and shortness of breath). You doctor will also perform a careful physical examination.
Electrocardiogram (EKG or ECG): This test records the heart's rhythm, frequency of beats, and electrical conduction. An electrocardiogram may reveal a previous heart attack or one in progress.
Blood tests: Blood samples will be taken to determine the possible damages in your heart. The doctor may learn from the results about the severity and prognosis of heart attack.

Your doctor will act immediately to treat your condition if you have a heart attack in progress. The following tests may also be used:

Chest x-ray: This test determines whether there is excessive fluid built up around the lungs.
Echocardiography (Echo): This test is to measure the heart structure and function. This technique is noninvasive, safe, reliable, and reproducible.
Coronary angiography: This medical procedure uses special dyes to image coronary arteries under x-ray. During this procedure, a thin flexible tubing (catheter) will be inserted into an artery in your arm or groin (upper thigh), and threaded into the coronary arteries. And a special dye will be injected. Your doctor will be able to determine the sites and severity of blood flow blockage. In the same time, your doctor may also perform angioplasty and stenting.

Risk Factors for Heart Attack
There are several factors that can increase the probability of developing heart attack. The major risk factors include:

Coronary heart disease
High blood cholesterol levels
High blood pressure
Past heart attack
Age
Diabetes
Overweight
Stress
Chronic kidney disease

Prevention and Treatment of Heart Attack

Medications and surgical procedures have saved many lives.

Nitroglycerin dilates blocked coronary artery and improves blood supply to the heart temporarily.
Blood-thinning (anticoagulant) medications include Aspirin, Plavix, and heparin. These medications prevent blood clotting and enable blood flow to the heart tissue. They are often given immediately after a heart attack by emergency personnel.
Thrombolytics help dissolve the blood clot that blocks blood flow to the heart. They are administered in the early treatment phase after heart attack.
Statins and Beta blockers may be prescribed by your doctor to prevent future heart attacks and Heart Failure. These medications help lower blood cholesterol levels and limit damage to your heart.
Coronary angioplasty is a procedure that opens blocked coronary artery and increases blood flow to the heart tissue. In this procedure, a long thin tube (catheter) is inserted through an artery in your leg or groin and guided to the heart. The special balloon equipped on the catheter will be inflated to open up the blocked blood vessel. A procedure, called stenting, is often performed at the same time to place a mesh tube (stent) in the blood vessel to open the blocked area.
Coronary artery bypass grafting (CABG) may also be performed. In this open-chest surgery, a healthy artery or vein from the body is used to bypass the blocked portion of the coronary artery. It creates a new path for blood flow to the heart.

Importantly, preventing heart attack from happening obviously is superior to treatment. Indeed, you can take control of some the risk factors to decrease the chance of heart attack. Even you have had heart attack before, you still can take some steps to reduce the chances for this catastrophic event to happen again:

Control coronary heart disease: Coronary heart disease, like heart attack, is also caused by buildup of cholesterol and other substances in the arteries that supply blood to the heart. A completely blockage of one of the arteries can cause a heart attack. Read Coronary Heart Disease for more information about this disease.
Monitor blood cholesterol: Many people are unaware that their cholesterol level is too high, since high blood cholesterol itself does not cause symptoms. A healthy lifestyle helps to keep your cholesterol levels in the normal ranges (Table 1) and reduces the chance of getting heart attack. A blood test called Lipid Panel, done after overnight fasting, tells you about your blood cholesterol levels. Everyone aged 20 years and older should measure blood cholesterol levels at least once every 5 years. A healthy lifestyle helps to keep your cholesterol levels in the normal ranges (Table 1).

Table 1. Blood Cholesterol Levels

Blood Cholesterol Level Category

Total Cholesterol

Less than 200 mg/dL Normal

200 – 239 mg/dL Borderline High

240 mg/dL and above High

LDL Cholesterol

Less than 100 mg/dL Optimal

100 – 129 mg/dL Near Optimal

130 – 159 mg/dL Borderline High

160 – 189 mg/dL High

190 mg/dL and above Very High

HDL Cholesterol

60 mg/dL and above Desirable

Triglycerides

Less than 150 mg/dL Normal

150 – 199 mg/dL Borderline High

200 – 499 mg/dL High

500 mg/dL and above Very High

Monitor blood pressure: High blood pressure is also a risk factor for heart attack. Monitoring blood pressure at home can be helpful for controlling high blood pressure. Read High Blood Pressure to find out more about how lifestyle changes that can lower your blood pressure.
Eat a healthy diet. Consider the Dietary Approaches to Stop Hypertension (DASH) for an overall eating plan. The DASH diet plan emphasizes fruits, vegetables, and low fat dairy foods. It includes whole grains, poultry, fish, and nuts, but has reduced amounts of fats, red meats, sweets, and sugared beverages. Eating a DASH diet can help decrease high blood pressure and reduce risk of developing heart attack.
Eliminate trans fat intake and limit saturated fat intake: Consumption of saturated fat and trans fat raises blood cholesterol levels, and increases the risk of heart attack. Olive oil, peanut oil, and soybean oil are healthier alternatives.
Reduce sodium intake: Another key to healthy eating is choosing foods lower in sodium. The current recommendation for a healthy individual is to consume less than 2.4 grams (2,400 milligrams) of sodium a day. Reducing sodium intake can help reduce risk of developing high blood pressure and coronary heart disease.
Be physically active: Even moderate physical activity is beneficial for your overall health. If you have coronary heart disease, consult your doctor for the physical activities that best fit your condition.
Maintain a healthy weight: Overweight puts your heart with extra workload. If you are overweight, your dietitian can help you work toward your ideal weight.Even a small weight loss can reduce blood pressure and/or prevent high blood pressure in many overweight people (those with a Body Mass Index of 25 or greater).
Stop smoking: Smoking can damage blood vessels, raise blood pressure, and increase the risk of developing heart attack. If you smoke, your doctor may recommend a quit smoking program for you.
Limit alcohol: If you drink, limit alcohol consumption to no more than two drinks per day for men and no more than one drink per day for women.

Facts about Heart Attack

Heart attack is often caused by underlying coronary heart disease. The American Heart Association estimates that 1 million American adults have had heart attack (Table 2).

Table 2. Heart Attack in Different Ethnic Groups in the US

Ethnic Group Men (%) Women (%)

Blacks(non-Hispanic) 4.3 2.2

Mexican American 3.0 1.1

Whites (non-Hispanic) 4.3 2.1

All 4.3 2.2

In every 34 seconds, an American will have a heart attack.
Every year, heart attack kills 12,000 people in the US.
Heart attack is also a major risk factor for Heart Failure and stroke.
Healthy lifestyle factors are related to lower risks of heart attack.