Heart Attack

A heart attack occurs when the blood supply to part of the heart muscle itself — the myocardium — is severely reduced or stopped. The reduction or stoppage happens when one or more of the coronary arteries supplying blood to the heart muscle are blocked. This is usually caused by the buildup of plaque (deposits of fat-like substances), a process called atherosclerosis. The plaque can eventually burst; tear or rupture, creating a “snag” where a blood clot forms and blocks the artery. This leads to a heart attack.

If the blood supply is cut off for more than a few minutes, muscle cells suffer permanent injury and die. This can kill or disable someone, depending on how much heart muscle is damaged. Sometimes a coronary artery temporarily contracts or goes into spasm. When this happens, the artery narrows and blood flow to part of the heart muscle decreases or stops. We’re not sure what causes a spasm. A spasm can occur in normal-appearing blood vessels as well as in vessels partly blocked by atherosclerosis. A severe spasm can cause a heart attack. The medical term for heart attack is myocardial infarction.

A heart attack is also sometimes called a coronary thrombosis or coronary occlusion. RISK FACTORS There are several risk factors for heart disease; some are controllable, others are not. Uncontrollable risk factors include: Male sex Older age Family history of heart disease Post-menopausal Race (African Americans, American Indians, and Mexican Americans are more like to have heart disease than Caucasians) Still, there are many risk factors that can be controlled. By making changes in your lifestyle, you can actually reduce your risk for heart disease.

Controllable risk factors include: Smoking High LDL, or “bad” cholesterol and low HDL, or “good” cholesterol Uncontrolled hypertension (high blood pressure) Physical inactivity Obesity (more than 20% over one’s ideal body weight) Uncontrolled diabetes Uncontrolled stress and anger. Some heart attacks are sudden and intense — the “movie heart attack,” where no one doubts what’s happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren’t sure what’s wrong and wait too long before getting help.

Here are signs that can mean a heart attack is happening: Chest discomfort: Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain. Discomfort in other areas of the upper body: Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach. Shortness of breath: May occur with or without chest discomfort. Other signs: These may include breaking out in a cold sweat, nausea or lightheadedness.

Women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain. First Aid for a heart attack Recognize the signs & symptoms of a heart attack Comfort & reassure the victim Have the victim stop whatever they were doing and sit or lie in a comfortable position Summon emergency medical help quickly If the victim becomes unconscious, be prepared to perform CPR [IF YOU ARE TRAINED TO DO SO] Treatments of heart attacks include:

Anti–platelet medications to prevent formation of blood clots in the arteries Anti–coagulant medications to prevent growth of blood clots in the arteries Clot–dissolving medications to open blocked arteries Supplemental oxygen to increase the supply Medications to prevent abnormal heart rhythms The primary goal of treatment is to quickly open the blocked artery and restore blood flow to the heart muscle, a process called reperfusion. Once the artery is open, damage to heart muscle ceases, and the patient becomes. By minimizing the extent of heart muscle damage, early reperfusion preserves the pumping function of the heart.

Optimal benefit is obtained if reperfusion can be established within the first four to six hours of a heart attack. Delay in establishing reperfusion can result in more widespread damage to heart muscle and a greater reduction in the ability of the heart to pump blood. Patients with hearts that are unable to pump sufficient blood develop heart failure, decreased ability to exercise, and abnormal heart rhythms. Thus, the amount of healthy heart muscle remaining after a heart attack is the most important determinant of the future quality of life and longevity. References Whooley,M A .

DeJonge P. Vittinghoff,E. Otte,C . Moos,R. Carney,R M (2008) Depressive Symptoms, Health Behaviors, and Risk of Cardiovascular Events in Patients With Coronary Heart Disease. Retrieved on December 5,2008 from http://web. ebscohost. com/ehost/detail? vid=5&hid=22&sid=991a83f4-cd3c-4f15-906a-2bcafb182287%40sessionmgr9 Kotz,D (2008) A Better Way to Screen for Cardiovascular Disease? Retrieved on December 5, 2008 from http://web. ebscohost. com/ehost/detail? vid=5&hid=22&sid=991a83f4-cd3c-4f15- 906a2bcafb182287%40sessionmgr9&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=f5h&AN=35205554.

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