What is a heart attack?

Like all other body parts, the heart also requires a good oxygen supply. The coronary arteries fulfil this need and supply oxygen to the heart. Due to unhealthy dietary habits and lifestyle, fatty deposits or plaque develop on the walls of the coronary arteries. Such plaque buildup can turn into blockages over time without appropriate lifestyle changes. Any blockage in the artery prevents blood from reaching parts of the heart muscle. It causes cardiac ischemia, where a portion of the heart is deprived of oxygen. When cardiac ischemia is not noticed or treated for too long, the heart tissues begin to die and cause a heart attack. A heart attack is also called a myocardial infarction.

What causes a heart attack?

Damaged coronary arteries cause a heart attack. Coronary arteries can become blocked for several reasons, leading to a lack of oxygen supply in the heart. This condition is known as coronary artery disease, which is the leading cause of most heart attacks.

In other cases, a heart attack occurs when the plaque in the heart ruptures, allowing cholesterol and other substances into the bloodstream. During the rupture, a blood clot blocks the oxygenated blood supply to the heart. In rare cases, a heart attack is caused by a blood vessel spasm.

Early Symptoms of heart attack

Symptoms of a heart attack vary from one person to another. The symptoms depend on the severity of the disease. Few patients experience these symptoms clearly, which allows them to seek medical help immediately; however, some of them get a sudden cardiac arrest with no symptoms shown.

Here are the signs and symptoms you should watch out for:

Severe or mild chest pain involving pressure and tightness. This feeling may extend to the arms, neck, jaws, and areas of the back.
A feeling of nausea, heartburn, indigestion and abdominal pain
Cold sweat
Tiredness
Sudden dizziness and lightheadedness
Shortness of breath

Are you at risk?

There are several risk factors involved in a heart attack. Some of the risk factors cannot be controlled or modified, such as

Gender - Men are more prone to heart diseases and heart attacks when compared to women.
Family History - A genetic heart disease passed on by ancestors that cannot be controlled or modified can cause a heart attack.
Age - Individuals above the age of 65 are at greater risk of having a heart attack.

A few risk factors that can be controlled are -

Smoking - Long-term exposure to tobacco smoke can cause heart disease.
Obesity - Being overweight can cause serious health hazards due to high cholesterol levels, high triglyceride levels, high blood pressure and diabetes. Exercising regularly to reduce weight can lower the risk of a heart attack.
Stress - Increased stress develops unwanted pressure on the heart, increasing cardiac arrest chances.
High blood pressure - If you have high blood pressure, it is essential to monitor it frequently and keep it under control through proper medications.
Diabetes - An increase in blood sugar levels and an insufficient supply of insulin can damage several organs in the body, including the heart.
Diet - Eating a balanced diet daily, including fresh fruits and vegetables, is essential. Excessive intake of oily food leads to heart disease.
Alcoholic - Excessive intake of alcohol is a risk factor for heart attack.

Heart attack in Men

Men have a higher risk of heart attacks and other acute coronary events, and males are more likely to be affected at a younger age. Males and females older than 70 years of age are equally affected. There is a slight variation in symptoms for a heart attack in a man when compared to that of a woman; however, most of them are common. The main reason behind the increased rate of heart attack in men is the thick walls in the interior chambers, which restrict the rise of blood pressure level, causing stress to build up in the heart, which leads to a heart attack.

Heart attack in Women

A woman's heart is usually smaller than a man's because of the thin walls in the interior chambers. Women's hearts pump faster than that of men's. It pumps 10% less blood with every heartbeat. The heart rate increases and pumps out more blood when a woman is stressed. However, the condition in men is different; when a man is stressed, the arteries of his heart constrict to raise his blood pressure levels. The incidence of heart attacks increases severely in women aged 60-70 years to match that of men. The risk factors that cause a heart attack in women are -

High blood pressure
Diabetes
Fat clogged arteries
Pregnancy
The reduced production of oestrogen hormones after menopause

Diagnosis of a Heart Attack : Essential Tests

A heart attack can be diagnosed through the tests shown below-

Electrocardiogram (ECG) - The electrical pattern of the heartbeat is recorded through electrodes attached to the skin. An injured heart sends irregular impulses, which can be observed on the ECG report, showing signs of a heart attack.
Echocardiogram - Sound waves are passed through your heart from a transducer against your chest. This procedure captures video images of the heart. Images obtained from an echocardiogram help identify the damage accurately.
Coronary catheterisation (angiogram) - A catheter is passed through an artery from the leg or groin to reach the heart. A coloured dye is then passed through the catheter to make the arteries in the heart visible. An X-ray image is taken to observe blockage in the heart.
Blood Test - A blood test can identify heart muscle damage. The test indicates the presence of cardiac enzymes in the blood.
Exercise stress test - Stress levels are monitored to check how your heart and blood vessels respond to exertion after a heart attack. During this test, you will be asked to walk on a treadmill while attached to electrodes from an ECG machine. Another way to monitor stress is through a nuclear stress test, similar to an exercise stress test. However, this involves the injection of dye and special imaging techniques to produce detailed images of the heart and chest.
Cardiac CT or MRI Scan - The patient lies on a table inside a doughnut-shaped machine. An X-ray tube inside the machine rotates around the body to capture detailed images of the heart and chest. It helps the doctor diagnose the problem quickly. The extent of damage from a heart attack can be seen clearly in these images.

Treatment of Heart Attack

Once a heart attack is diagnosed, your doctor takes immediate steps to cure the problem through the following procedures-

Angioplasty - It removes plaque buildup in blood vessels by opening blocked arteries with a balloon-shaped instrument.
Stent - After angioplasty, the artery is kept open with the help of a wire mesh tube called a stent, which is inserted into the artery.
Heart bypass surgery - This surgery is done to divert the blood flow around the blocked arteries.
Heart valve surgery - This replacement surgery repairs or replaces defective valves in the heart so that it can pump blood efficiently.
Heart Transplant - A heart transplant is considered the last option of treatment. This treatment method is selected only when the heart has undergone severe damage due to a heart attack.

Certain medicines also help in treating a heart attack, such as -

Nitroglycerin is given to open blood vessels, enhance blood flow to the heart, and relieve chest pain.
Blood thinners such as antiplatelet and anticoagulants
Pain killers
Drugs to break up clots
Aspirin
Blood pressure medication

Keeping your Heart Healthy

Maintaining a healthy heart is very important to lead a healthy life. Here are a few tips to improve heart health -

Eat healthy and exercise regularly.
Quit smoking and stay away from second-hand smoke, too.
Maintain healthy cholesterol levels.
Monitor blood pressure and sugar levels regularly to keep them under control.
Drink alcohol in moderation.
Manage stress.
Reduce the intake of salt.

Uunderstanding Heart Failure

Heart failure does not mean that your heart has stopped working. It means your heart is not functioning well to its capability. In heart failure, the heart does not pump enough blood as usual. Heart failure can be treated well and reversed if diagnosed early. Healthy lifestyle changes and a nutritious diet can bring back a quality life. There are different types of heart failures, which are classified into two parts-

Heart failure with reduced left ventricular function (HF-rEF)

The lower left chamber of the heart, called the left ventricle, enlarges, which loses the ability to squeeze hard enough to pump the right amount of oxygen-rich blood to the rest of the body.

Heart failure with preserved left ventricular function (HF-pEF)

The heart pumps blood normally. However, the heart's ventricles are stiff and thicker than usual, which doesn't allow the ventricles to relax and does not receive enough blood flow to pump to the rest of the body.

Signs and symptoms of heart failure

Most often, symptoms of heart failure go unnoticed as they are very mild and gentle. However, heart failure worsens over time and can lead to serious health hazards. You must seek medical help if you suffer from one or more of the symptoms below.

Shortness of breath or trouble breathing - You may experience difficulty breathing when you exercise or lie flat on your bed. Shortness of breath happens when fluid backs up into the lungs, or your body isn't getting enough oxygen-rich blood. It will lead to shortness of breath at night and can wake you up suddenly. This condition is severe and needs immediate medical attention.
When you are active, you may experience a constant feeling of tiredness (fatigue) and weakening of your legs. When your heart fails to pump oxygen-rich blood to different body parts, you get tired and experience weakness in your legs.
Dizziness, confusion, difficulty concentrating, fainting- These symptoms occur when the heart is not pumping enough oxygen-rich blood to the brain.
Palpitations, rapid or irregular heartbeats, occur when the heart muscles fail to pump out sufficient oxygen-rich blood with the proper force to muscles and various organs in the body. It can happen after a heart attack or due to a rise in blood potassium levels.
A dry, hacking cough - When the lungs get filled with extra fluid during a heart attack, it leads to a dry and continuous cough.
A bloated or hard stomach, loss of appetite or nausea.

Causes for heart failure

Several medical conditions damage heart muscles, and certain lifestyle habits worsen the condition. Here are a few causes-

Coronary artery disease - It is a condition where the heart does not receive oxygen-rich blood, which leads to a heart attack.
Congenital heart disease - A genetic disorder passed on from ancestors which cannot be prevented.
Diabetes - Increased blood sugar levels damage several internal organs, including the heart.
High blood pressure - Increased blood pressure forces the heart to pump faster than usual, causing heart diseases.
Kidney Disease - The piling up of impurities in the blood due to kidney failure leads to a heart attack.
Smoking - Smoking increases toxic levels in the body and reduces oxygen supply.
Obesity - Excessive weight gain increases cholesterol levels in the blood, which blocks the heart chambers.

Stages And Prognosis

The stages of myocardial infarction are classified into four classes -

Class 1 - Symptoms are not very evident. If diagnosed at this stage, the failure can be quickly recovered through lifestyle changes, heart medications and monitoring.
Class 2 - Symptoms such as discomfort while working out and performing other physical activities, tiredness and shortness of breath are noticed at this stage. If heart failure is diagnosed at this stage, it can be recovered through lifestyle changes, heart medications, and careful monitoring.
Class 3 - At this stage, even mild exercise can cause fatigue, palpitations, or shortness of breath. You would prefer staying at rest more often. Treatment at this point gets complicated. You will require immediate medical attention and doctor advice for quick recovery.
Class 4 - Fatigue and palpitations increase even at rest and include breathlessness. The heart's condition is not recoverable at this stage. Palliative care options can improve the quality of life, and painkillers can reduce shooting pain.
Prognosis - Myocardial infarction (heart attack) is a severe event. Approximately 25% of patients die from the initial event, which means they may die before reaching the hospital or on the first day of the attack. The rest, 25% of patients, die within the next two years, usually due to recurrent MI or complications. About 50% of the initial survivors live for another ten years. The prognosis is better for younger patients with fewer coexisting medical problems.

ROAD TO RECOVERY AND AFTERCARE

Cardiac health depends upon lifestyle habits, too. To have a healthy heart, one must lead a disciplined lifestyle and provide medical support after a heart attack. Your recovery process does not end in the hospital but needs to be continued at home. Here are a few tips for recovering from a heart attack.

Emotional Health - It is expected to feel loneliness, depression, fear, denial and anxiety after a heart attack. Seek help from loved ones or a mental health specialist to overcome these emotions.

Return to everyday life - Do not let your emotions stop you from doing your regular activities. Continue doing your regular activities with the help of your doctor's advice. If you need extra help to motivate yourself, join cardiac rehabs available in many hospitals. Here are a few benefits of cardiac rehab-

They help you to recover sooner than expected.
Staff will give you special tips on protecting and strengthening your heart.
You will be motivated to indulge in activities to improve your heart function.
Cardiac rehabs train patients with exercise to improve heart health.
They also provide moral support for mental health.

Quit Smoking - Smoking is injurious to the entire body. Quit smoking to lead a healthy life. Take nicotine gum, patches, and prescription medicines as an alternative to tobacco. You can also seek help from support groups.

Maintain healthy cholesterol and blood pressure levels -Both conditions cause severe damage to the heart. They may be controlled with a proper diet and healthy lifestyle habits. If the condition is severe, you will need medical attention.

Maintain blood sugar levels - Diabetes can cause severe injuries to health and can cause multiple organ failure. Get your blood sugar levels checked frequently and eat healthy to avoid the hike in blood sugar levels.

Eat a heart-healthy diet - Here are a few diet options for easy recovery

Avoid food with unhealthy fat
Eat 4 to 5 cups of fresh fruits and vegetables every day
Eat fibre-rich food like whole grains
Reduce the intake of salt
Avoid sweets and candies
Say no to processed meat.

Exercise regularly. Exercising strengthens the heart and reduces the risk of future heart attacks and heart disease. It is also a perfect way to get back to normal life after a heart attack and an excellent recovery method.