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| CHIEF DISORDERS OF THE HEART |
Heart Attack
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Heart Attack is an injury to the heart muscle caused by a loss of blood supply. It usually occurs when a blood clot blocks the flow of blood through a coronary artery — a blood vessel that feeds blood to a part of the heart muscle. Interrupted blood flow to the heart can damage or destroy a part of the heart muscle.
CAUSES
* Thickening of the walls of the arteries feeding the heart muscle (coronary arteries)
* Accumulation of fatty plaques in the coronary arteries
* Narrowing of the coronary arteries
* Spasm of the coronary arteries
* Development of a blood clot in the coronary arteries.
RISK FACTORS
* Sex: male
* Increased age
* Obesity
* Smoking
* High blood pressure
* Sedentary lifestyle
* High blood cholesterol (specifically, high LDL cholesterol, and low HDL cholesterol)
* High blood triglycerides
* Diabetes
* Stress
* Family members with heart disease
SYMPTOMS
* Squeezing, heavy chest pain, especially with:
- Exercise or exertion
- Emotional stress
- Cold weather
- A large meal
* Pain in the left shoulder, left arm, or jaw
* Shortness of breath
* Sweating, clammy skin
* Nausea
* Weakness
* Loss of consciousness
* Anxiety, especially feeling a sense of doom or panic without apparent reason.
Unusual symptoms of heart attack (may occur more frequently in women):
* Stomach pain
* Back and shoulder pain
* Confusion
* Fainting
DIAGNOSIS
BLOOD TESTS – to look for certain enzymes found in the blood within hours or days after a heart attack. Blood tests will be repeated every 6-8 hours to track the enzymes’ progressive elevation that indicates heart muscle damage.
URINE TESTS – to look for certain substances found in the urine within hours or days after a heart attack.
ELECTROCARDIOGRAM(EKG) – records the heart's activity by measuring electrical currents through the heart muscle. Certain abnormalities in the EKG occur when there is significant blockage of the coronary arteries and/or damage to the heart muscle. The EKG will be repeated to track the progression of these changes.
ECHOCARDIOGRAM – uses high-frequency sound waves (ultrasound) to examine the size, shape, function, and motion of the heart.
STRESS TEST – records the heart's electrical activity under increased physical demand. A stress test can also be combined with an echocardiography. Patients who cannot exercise may be given a medication intravenously that simulates the effects of physical exertion. A stress test is done usually days or weeks after the heart attack.
NUCLEAR SCANNING – Radioactive material (such as thalium) is injected into a vein and observed as it is absorbed by the heart muscle. Areas with diminished flow, and therefore uptake of the radioactive material, show up as dark spots on the scan.
ELECTRON-BEAM CT SCAN (CORONARY CALCIUM SCAN, HEART SCAN, CT ANGIOGRAPHY) – a type of X-ray that uses a computer to make detailed pictures of the heart, coronary arteries, and surrounding structures. This type of CT scan measures the amount of calcium deposits in the coronary arteries, and based on that and other health information, attempts to determines the risk of heart disease, including heart attacks.
CORONARY ANGIOGRAPHY – X-rays are taken after a dye is injected into the arteries to look for abnormalities (narrowing, blockage) in the coronary arteries.
TREATMENT
Treatment may include:
* Oxygen
* Pain-killing Medications (such as morphine)
* Nitrate Medications
* Antiplatelet Agents
* Beta-blockers
* Aspirin
* Beta-blocking and/or ACE inhibitor medications
* Anti-anxiety medications
* Clot-busting Agents: Within the first six hours after a heart attack, you may be given medications to break up blood clots in the coronary arteries.
* Other medicines that may be given along with clot-busting agents (called Platelet IIb/IIIa receptor blockers)
* Cholesterol-lowering medications
* Anti-anxiety medications
* ACE inhibitors are also frequently given.
SURGERY
Surgeries for people with severe blockages in their coronary arteries may include:
* Coronary Artery Bypass Surgery(CABG)
* Atherectomy
* Balloon angioplasty with or without stenting
PHYSICAL or REHABILITATIVE THERAPY
During recovery from a heart attack, one may need physical or rehabilitative therapy to help regain the strength.
PSYCHOTHERAPY or ANTIDEPRESSANT MEDICATION
Some people have depression after suffering a heart attack. If so, psychotherapy and/or antidepressant medications may help relieve depression.
PREVENTION
Preventing or treating Coronary Artery Disease may help prevent a heart attack.
* Maintain a healthy weight .
* Begin a safe exercise program with the advice of the doctor.
* If smoking, quit .
* Eat a healthful diet , one that is low in saturated fat and rich in whole grains, fruits, and vegetables.
* Appropriately treat high blood pressure and/or diabetes .
* Manage stress .
* Consulting the doctor about taking a small, daily dose of aspirin. It has been shown to decrease the risk of heart attack.
* Consulting the doctor about taking cholesterol-lowering medications.
* Consulting the doctor about taking medication to improve heart function or prevent future heart attacks, such as:
- Beta-blockers
- ACE-inhibitors
- Blood thinning medications
One should always remember when taking aspirin, certain painkillers (eg, ibuprofen), if taken together with aspirin, may put the person at high risk for gastrointestinal bleeding and also diminish the effectiveness of Aspirin.
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| Last Modified :
Tuesday, May 12, 2009 |
Compiled and edited by the Editorial team and
approved by Expert panel of h4heart.com
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