Heart attack

Alternative Names

Heart attack, MI, Myocardial infarction

What is Heart attack

A heart attack is a condition characterizing by blocked supply of blood and oxygen to part of the heart. In most cases, people with heart attack wait 2 hours or more after their symptoms begin before they seek medical help. This delay can be fatal. Quickly seeking treatment for a heart attack may prevent much or all of the permanent damage a heart attack can cause.

Signs and symptoms

The most common symptoms of heart attack are:

• Pressure, a feeling of fullness or a squeezing pain in the center of your chest that lasts for more than a few minutes
• Pain extending beyond your chest to your shoulder, arm, back or even to your teeth and jaw
• Increasing episodes of chest pain
• Prolonged pain in the upper abdomen
• Shortness of breath
• Sweating
• Impending sense of doom
• Fainting
• Nausea and vomiting
• Heartburn or abdominal pain
• Clammy skin
• Lightheadedness or dizziness
• Unusual or unexplained fatigue

Possible complications

Heart attack can cause the following complications:

• Abnormal heart rhythms (arrhythmias). If your heart muscle is damaged from a heart attack, electrical "short circuits" can develop that cause abnormal heart rhythms. It can lead to death.
• Heart failure. The amount of damaged tissue in your heart may be so great that the remaining heart muscle can't do an adequate job of pumping blood out of your heart. This decreases blood flow to tissues and organs throughout your body and may produce shortness of breath, fatigue, and swelling in your ankles and feet. Heart failure may be a temporary problem that goes away after your heart, which has been stunned by a heart attack, recovers over a few days to weeks. However, it can also be a chronic condition resulting from extensive and permanent damage to your heart following your heart attack.
• Heart rupture. Areas of heart muscle weakened by a heart attack can rupture, leaving a hole in part of the heart. This rupture is often fatal.
• Valve problems. Heart valves damaged during a heart attack may develop severe, life-threatening leakage problems.

What causes

The main cause of a heart attack is a severely narrowed or completely blocked coronary artery that causes a decrease in oxygen and nutrients to the heart. Our heart dies without oxygen and nutrients.

In many cases, blocked coronary artery is caused by a blood clot in people with coronary artery disease (heart disease). In rare cases, the underlying cause is a spasm in a coronary artery that completely closes the artery.

Prevention

You may avoid heart attack by taking the following steps:

• It is highly recommended to stay in touch with friends and family. It is proved that people with poor social support are more exposed to have heart disease. You should learn the ways to control feelings of anger and hostility, because these emotions may increase your heart attack risk.
• You may assess your heart attack risk profile and make appropriate changes to diet and lifestyle early.
• You should talk with your doctor about taking an aspirin daily, because it significantly reduces the risk of developing heart attack.

Treatment

The main aim of medication therapy is to break up or prevent blood clots, prevent platelets from gathering and sticking to the plaque, stabilize the plaque and prevent further ischemia. The medications should be given as soon as possible (within 30 minutes from the start of heart attack symptoms) in order to decrease the amount of damage to the heart muscle. The longer the delay in starting these drugs, the more damage that occurs and the less benefit they can provide.

Medications given right after the start of a heart attack include the followings:

• aspirin
• thrombolytic therapy ("clot busters")
• heparin
• other antiplatelet drugs
• any combination of the above

Other drugs, given during or after a heart attack lessen your heart's work, improve the functioning of the heart, widen or dilate your blood vessels, decrease your pain and guard against any life-threatening heart rhythms. Your doctor will prescribe the medications that are the best for you.