What is a Heart Attack?

When someone experiences a heart attack, it means blood flow to a section of their heart muscle has suddenly become blocked or severely reduced. And since the heart muscle requires oxygen and nutrients to live, if blood flow doesn’t get restored quickly, the affected part could become damaged or die. A heart attack is, therefore, a medical emergency and may even be fatal in some cases.

A heart attack, or myocardial infarction (MI), is often a result of coronary artery disease, also called ischemic heart disease or coronary heart disease.

CAD is a cardiovascular disease that occurs due to plaque buildup in the arteries that supply blood to your heart. According to the World Health Organization (WHO), cardiovascular diseases are the world’s leading cause of death.

Heart Attack Symptoms

Some people don’t show any symptoms when experiencing a heart attack. Those that do may experience:

• Chest discomfort: feels like pressure, tightness, fullness, squeezing, or pain in the center of your chest. Chest discomfort is the most common symptom of myocardial infarction in both sexes.
• Upper body discomfort: the discomfort can spread to one or both your arms, neck, jaw, stomach, or back.
• Shortness of breath: this can be your only symptom, or it can occur along with chest discomfort.
• Other possible signs: some people may experience nausea/vomiting, indigestion, a cold sweat, or lightheadedness.

Note: women are more likely than men to experience shortness of breath, nausea or vomiting, fatigue, and jaw or back pain.

If you suspect you might be having a heart attack, call for emergency medical help immediately or have someone drive you to the nearest hospital.

As you wait, take nitroglycerin if prescribed or take aspirin if recommended by your doctor or the emergency personnel. But always call for emergency medical care first.

Watch Video: 7 Heart Attack Warning Signs you should Never Ignore

Causes of Heart Attack

A heart attack mainly results from the buildup of cholesterol-containing fatty deposits called plaque in the coronary arteries. Over time, your arteries become narrowed, interrupting blood flow to the heart and triggering a heart attack.

Part of the plaque may also rupture, causing a blood clot to form around its surface. The blood clot can become large enough to block the flow of oxygen-rich blood to part of the heart muscle. Myocardial ischemia, in turn, can lead to a heart attack.

Aside from coronary artery disease, a heart attack can also occur due to coronary artery spasm. A coronary artery spasm is a sudden, severe constriction of the muscles in a coronary artery wall.

Spasms temporarily reduce or completely restrict blood flow to your heart, which could result in myocardial infarction. A coronary artery may spasm due to:

• Smoking tobacco
• Abusing stimulants, such as cocaine, methamphetamine (crystal meth), and amphetamines (e.g., Adderall)
• Exposure to cold temperatures
• Extreme emotional stress

Risk Factors of Heart Attack

The American Heart Association estimates that nearly every 40 seconds, someone in the US experiences a heart attack. So what increases your risk of coronary heart disease and heart attack, in particular?

Your risk of suffering a heart attack becomes higher if you:

• Smoke or are exposed to secondhand smoke regularly.
• Have high blood pressure as it can damage your coronary arteries, interrupting the flow of blood.
• Are 45 or older if a man and 55 and above or in your postmenopause years if a woman. And in general, the death rate of women who suffer a heart attack in old age tends to be higher.
• Have high LDL cholesterol levels and low HDL cholesterol levels, which encourage plaque formation in your arteries.
• Are a man. Men tend to be at a greater risk for heart attack than women, including women who have reached postmenopause.
• Have diabetes, particularly type 2 diabetes, which has similar risk factors for CAD. The likelihood of an adult with diabetes dying of heart disease is 2 to 4 times higher than that of adults without the condition.
• Are obese or overweight because the excess weight worsens other risk factors of coronary heart disease.
• Have a family history of heart disease, especially if a sibling or parent developed a cardiovascular disease early in life, i.e., before turning 55 for the men or 65 for the women. Heredity-wise as well, African-Americans have a higher risk of heart disease than Caucasians.
• Don’t exercise regularly. Physical inactivity is associated with high blood cholesterol, high blood pressure, and obesity, which are risk factors for heart attack.
• Are stressed. Stress can lead you to adopt habits that put you at risk for heart attack, such as smoking and overeating unhealthy foods (e.g., highly processed foods).
• Drink alcohol excessively. High alcohol intake can increase your blood pressure and triglyceride levels. It can also increase your risk of cardiomyopathy, stroke, and other diseases.

Heart Attack Diagnosis

Doctors diagnose a heart attack based on a patient’s signs and symptoms, medical history, family history, and test results. Diagnostic tests for a heart attack include:

• Electrocardiogram (EKG / ECG): detects and records your heart’s electrical activity to show whether a heart attack has occurred or is developing.
• Blood tests: a heart attack causes heart muscle cells to die or get damaged, resulting in the leakage of proteins in your blood. Blood tests to check for these proteins determine whether you’ve had a myocardial infarction and the extent of the damage.

If you’re having a heart attack or have had one, your doctor may perform additional tests. These include:

• Cardiac catheterization: examines the inside of your coronary arteries using a contrast dye injected through a catheter and X-ray imaging to show where there are blockages.
• Chest X-ray: checks whether your heart has enlarged and if there’s fluid accumulating in your lungs following myocardial infarction.
• Echocardiography: an imaging test that uses ultrasound, i.e., high-frequency sound waves, to check your heart’s structure and whether your heart is functioning normally.

Heart Attack Treatment

Heart attack treatment depends on the type of myocardial infarction you suffered. The two kinds being:

• An ST-elevation myocardial infarction (STEMI): complete blockage of one of your coronary arteries. Treatment of this type of heart attack involves medical therapy using clot-dissolving drugs, percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), or a combination of treatments.
• A non-ST elevation myocardial infarction (NSTEMI): partial blockage of a coronary artery. Treatment mainly involves the use of blood thinners, i.e., medicines that prevent blood from clotting. However, your doctor may recommend further treatment, including medical therapy, PCI, or CABG.

Types of medications doctors prescribe to treat a heart attack.

• Antiplatelet agents: prevent platelets from sticking together (platelet aggregation), which inhibits blood from clotting and keeps existing clots from becoming larger.
• Anticoagulants: inhibit or reduce blood clot formation in your arteries.
• Angiotensin-converting enzyme (ACE) inhibitors: expand your blood vessels to lower blood pressure, easing the strain on your heart. They work by reducing the production of angiotensin II.
• Beta-blockers: decrease your heart’s output andcause it to beat at a slower rate, reducing your blood pressure.
• Cholesterol-lowering medications: statins are the most prescribed drugs for lowering cholesterol levels. They include atorvastatin (Lipitor), lovastatin (Altoprev), and pravastatin (Pravachol).
• Nitroglycerin: treats or prevents angina (chest pain) by dilating the blood vessels to improve blood flow to the heart.
• Vasodilators: relax the smooth muscles of your arteries and veins, widening them. As a result, the supply of oxygenated blood to your heart increases, and its workload reduces.

Surgical and Other Medical Procedures

Percutaneous Coronary Intervention (PCI)

The procedure combines coronary angioplasty and stenting. Coronary angioplasty involves threading a thin tubing (catheter) with a deflated balloon to a blocked coronary artery through a blood vessel in your groin or wrist.

Once in position, the balloon is inflated, opening up the blocked artery and restoring blood flow. A small wire mesh tube called a stent is almost always inserted into the just unblocked artery to help keep it open long-term.

Coronary Artery Bypass Grafting (CABG)

In some cases, your medical team may recommend coronary artery bypass grafting. A surgeon takes a healthy vein or artery from another part of your body and connects it above or below the clogged or narrowed artery to bypass it.

Consequently, rerouting the flow of blood to your heart muscle. You may require more than one bypass graft, depending on how many of your coronary arteries are blocked.

PCI and CABG (spelled cabbage) are the most commonly used techniques to restore oxygen and blood supply to part of the heart. However, there are other cardiac procedures your doctor may recommend, including:

• Laser angioplasty
• Heart transplant
• Atherectomy
• Heart valve replacement surgery
• Minimally invasive heart surgery

Heart Attack Complications

Experiencing a heart attack could lead to complications ranging from mild to severe. These include:

• Arrhythmia: means your heartbeat is either too fast, too slow, or irregular.
• Heart failure: a condition where your heart does not pump blood as it should. Symptoms include breathlessness, fatigue, and swollen limbs.
• Cardiogenic shock: this is a medical emergency that occurs due to your heart’s inability to supply enough blood to your body organs. Symptoms include cold hands and feet, breathing problems, confusion, and reduced or no urge to urinate.
• Cardiac arrest: a sudden loss of heart function caused by an electrical imbalance, whose main symptom is the loss of consciousness.
• Risk of a second heart attack: 1 in 5 people suffer a repeat heart attack within five years.
• Anxiety and depression: worrying about suffering another myocardial infarction and the stress of adjusting to a new lifestyle can affect your mental health.

Preventing Heart Attack

Anyone can suffer a heart attack, regardless of their age. However, you can reduce your risk when you:

• Adopt a heart-healthy lifestyle that includes eating a heart-healthy diet, weight maintenance, engaging in physical activity regularly, quitting smoking, and managing stress.
• Manage conditions that are risk factors for coronary artery disease. These include diabetes, high blood pressure, and high blood cholesterol.
• Keeping a Healthy Weight.