Heart Attack
Heart attack is death and damage to the heart muscles resulting from a blood clot blocking off a heart artery. The clot in the heart artery blocks the supply of blood, oxygen, and nutrients to the heart muscle. Without blood and oxygen, the heart muscle cells will die within one hour. Unless the blood supply to the heart muscle is restored within one hour, the muscle cells will not recover. Some recovery of some of the cells may occur if their blood supply is restored within six hours. After 12 hours, the cells cannot recover. This is the reason why it is crucial for patients with heart attacks or suspected heart attacks to phone for an emergency ambulance so that the diagnosis can be confirmed and the condition treated immediately.
Sudden death, due to a fatal heart rhythm abnormality, may occur even when there is little muscle damage. This is why it is not helpful to describe heart attacks as big or small or major or minor. All heart attacks are potentially fatal. However, the more muscle damaged, the greater the probability that the patient will develop heart failure and also the risk of death.
A thin layer of fat (plaque) in a heart artery can cause big problems since its inside wall may get inflamed and the top surface of the layer of fat may crack. This is called a “ruptured plaque” of fat. The crack in the surface of the fat layer causes a blood clot to form at the site of the crack. The blood clot may, if big enough, and if not broken down or dissolved by the body’s own clot dissolving mechanism, block off the artery completely. If no blood and oxygen get to the heart muscle cells, they die. This is called a heart attack.
Heart Attack Symptoms
What are the symptoms of heart attack? Here the symptoms are:
- Severe chest pain (pressure, heaviness, or a squeezing sensation).
- Sickness and vomiting.
- Feeling short of breath.
- Collapsing and blacking out; the fact is 50% who black out never wake up.
The symptoms of a heart attack last at least 20 minutes, and usually more than an hour. The pain in the chest may also be felt in the throat, jaws, and arms or only in these areas.
Common in Older People Instead Of Younger People
Heart attacks are more common in older people and very uncommon in young people (under 40 years of age). They are more likely to occur in people who have angina and in those who have one or more cardiovascular risk factors. Anything that increases the amount of work the heart does, for example, exertion, sudden stress, and emotional upset and arguments can cause a heart attack. Sudden increases in the heart rate and blood pressure can cause layers of fat in a heart artery to crack. No obvious cause is found in most patients.
Heart Attack Can Suddenly Occur
Heart attack often occurs without warning in people who have never had any chest pain and who were previously very fit and active, as well as in people who have had angina for a long time. Some heart attacks may be “silent,” causing no symptoms at all. They may be recognized only when an ECG (electrical recording of the heart) is done for other reasons (check-up or before an operation). Silent heart attacks are more common in the elderly and in diabetics because they have a reduced sensitivity to pain.
Patients’ Chance to Survive From Heart Attack
Thirty percent of people who have a heart attack die before reaching hospital. This is usually because the normal heart rhythm changes into an abnormal heart rhythm called ventricular fibrillation, sometimes it is called a “VF arrest”. Sometimes the heart just stops beating and there is no electricity in the heart muscle, this condition is called an “asystolic” which means no heart action or cardiac arrest.
After 10 minutes, with the heart stopped, there is very little chance of restarting the heart, even if the patient had an arrest in the hospital. The longer the heart is in the abnormal rhythm, the less likely it is that the patient can be resuscitated (brought back to life), and the less likely that other organs of the body will be saved and able to function. So, the abnormal heart ventricular fibrillation rhythm (not to be confused with the common and usually harmless, atrial fibrillation), has to be converted back to normal within a minute or two.
Around 10% of patients who reach the hospital, usually will die in the hospital. The risk of dying is greatest in the elderly, those who have had a lot of damage to their heart, and those with cardiovascular risk factors, or who get a chest infection, a clot in their lungs (pulmonary embolus), or have bad kidney function.
Young, fit people can have heart attacks but they generally do well afterwards.
Patient’s Future
Most people can get back to a normal life after a heart attack. However, life will never be the same again, it is changed. The risk of a further heart attack is higher once you have coronary disease, but it may be as little as 2–3% per year. Looking at this the other way around, there is more than a 97% chance that nothing bad will happen in a year. With such good odds, patients really need to get on with life.
If patients have been left with a damaged heart and get breathless going up stairs, then they almost certainly need additional medicines for the heart and may have to adjust to a different pace of life. In addition, people who have been left breathless by a heart attack are more likely to end up in the hospital again. These days most people who have heart attacks are assessed during the first hospital admission to find out if further heart attacks are likely or not, and advised to have surgery or a stent if the risk is high.
Close Remarks
This is the blog’s first post in which tells about heart attack generally. For specific things related to heart attack will be published in the next posts, just follow the up dates.
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