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Heart Attack
Medical Questions » Heart Attack
| Name: Heart Attack |
| Also known as: MI; Myocardial Infarct |
| Blockage of the arterial blood supply to heart muscle for sufficient time to cause the affected muscle to die and be replaced by fibrous scar tissue. |
Causes of Heart Attack
Due to part of the heart not receiving sufficient blood. All the blood to the heart muscle passes through three small arteries. If one of these is blocked, one part of the heart muscle cannot obtain sufficient blood and dies. The arteries may be blocked by fatty deposits because the patient is overweight or has high cholesterol levels, by clots or fat globules breaking off from damaged blood vessels elsewhere in the body, or by damage to the artery from high blood pressure. The severity of a heart attack depends on the amount of heart muscle damaged, and its position in the heart. A small amount of damage in a vital area may cause death, while significant damage in a less important area will not be fatal. In angina (see separate entry) the blood supply to the heart muscle is reduced but not completely cut off, so no permanent damage occurs. Angina may lead to a heart attack in some cases. |
Symptoms of Heart Attack
A severe crushing pain is felt in the chest and shortness of breath is experienced. The pain builds up rapidly in waves, and then persists for some time before gradually fading. It may be accompanied by sweating, weakness, anxiety, dizziness, cough, nausea and vomiting. Some heart attacks create minimal discomfort, and may be dismissed by the patient as a passing attack of severe indigestion. |
Tests for Heart Attack
Diagnosed by an electrocardiogram (ECG) and blood tests. These tests may be negative for a couple of hours after the start of a heart attack, so a doctor' s clinical judgment is vital. A chest X-ray and echocardiogram may also be performed. After the initial recovery period, echocardiography, coronary angiography and nuclear scans may be performed to find the cause of the heart attack and to determine further surgical or medical treatment. |
Treatment for Heart Attack
If you feel that someone is having a heart attack, call an ambulance. Once the patient is under the care of a doctor, their chance of survival is good, because medication can be given to stop an abnormal heartbeat, relieve pain and ease the intense anxiety of the patient. Once in hospital, treatment in a coronary care unit will include drugs to break up the blood clot blocking the coronary artery and a complex cocktail of other medications given through a drip into a vein to regulate the functioning of the heart. After a few days, the patient is moved to a normal ward and after 10 to 14 days they can go home for a further six or more weeks rest. The patient will be put on long term medication (eg. beta-blockers and aspirin) to prevent another attack. Gradually increasing levels of exercise are undertaken over many weeks in order to slowly strengthen the heart. If a particular artery can be found to be blocked, coronary artery bypass graft (CABG) surgery may be performed. To prevent a heart attack, keep your weight reasonable, have your blood pressure checked and treated if necessary, avoid excess cholesterol in your diet, exercise regularly, and stop smoking.
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Complications of Heart Attack of its treatment
Long-term complications include angina, an irregular heartbeat, heart failure and a heart aneurysm (see separate entries). |
Likely Outcome of Heart Attack
20% of patients will die within the first hour, a further 10% will die in hospital, 5% will die within three months of leaving hospital and another 3% in every year thereafter. The death rate has been significantly lowered by the use of long term medication. |
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