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Heart Attacks:
Your guide to symptoms, risk factors, treatment, recovery

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1.What is a Heart Attack?

Like all other parts of our body, the heart also requires a good supply of oxygen to perform well. 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. This causes cardiac ischemia, a condition 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 myocardial infarction.

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2.What causes a Heart Attack?

A heart attack is caused due to damaged coronary arteries in the heart. Coronary arteries get blocked due to several reasons, and this leads to a lack of oxygen supply in the heart. This condition is known as coronary artery disease, which is the main cause of most heart attacks.

In other cases, a heart attack occurs when the plaque formed in the heart ruptures to allow 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.

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3.Early Symptoms of Heart Attack

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 do 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 which involves pressure and tightness. This feeling may extend to arms, neck, jaws and areas at the back.
  • A feeling of nausea, heartburn, indigestion and abdominal pain
  • Cold sweat
  • Tiredness
  • Sudden dizziness and lightheadedness
  • Shortness of breath

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4.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 to have a heart attack.

Few risk factors that can be controlled are -

Smoking - Long term exposure to tobacco smoke can cause heart disease.

Obesity - Overweight can cause serious health hazards due to high cholesterol levels, high triglyceride levels, high blood pressure and diabetes. By exercising regularly to reduce weight can lower the risk of a heart attack.

Stress - Increased stress develops unwanted pressure on the heart that increases the chances of cardiac arrest.

High blood pressure - If you are suffering from high blood pressure, it is important to monitor it frequently and keep it under control through proper medications.

Diabetes - Increase of blood sugar level and an insufficient supply of insulin can damage several organs in the body, including the heart.

Diet - It is important to eat a balanced diet every day, which includes fresh fruits and vegetables. Excessive intake of oily food leads to heart diseases.

Alcoholic - Excessive intake of alcohol is a risk factor for heart attack.

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5.Heart Attacks 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 small 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 a heart attack in men is because of the thick walls in the interior chambers which restricts the rise of blood pressure level causing stress to build up in the heart which leads to a heart attack.

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6.Heart Attacks in Women

heart attacks in women

A woman's heart is usually smaller when compared to men because of thin walls in the interior chambers. Women's hearts pump faster than that of men's. It pumps 10% lesser blood with every heartbeat. The heart rate increases and pumps out more blood when a woman is under stress. 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

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7.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 and this shows signs of a heart attack.

Echocardiogram - Sound waves are passed through your heart from a device called transducer which is held against your chest. This procedure captures video images of the heart. Images obtained from an echocardiogram helps in identifying the damage accurately.

Coronary catheterization (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 - The heart muscle damage can be identified by a blood test. The blood 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. You will be asked to walk on a treadmill while you are attached to electrodes from an ECG machine during this test. Another way to monitor stress is through a nuclear stress test, which is 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 will lie on a table inside a doughnut-shaped machine. An X-ray tube present inside the machine rotates around the body to capture detailed images of the heart and chest. This helps the doctor to diagnose the problem easily. The extent of damage from a heart attack can be seen clearly in these images.

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8.Treatment of Heart attack

treatment of heart attacks

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

Angioplasty - This procedure is done to remove plaque buildup in blood vessels, which helps in opening the blocked artery with the help of a balloon-shaped instrument.

Stent - The artery is kept open after angioplasty 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 is a replacement surgery which is done to repair or replace defective valves of the heart for it to pump blood efficiently.

Heart Transplant - A heart transplant is considered as 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 up blood vessels and enhance blood flow to the heart. It also relieves chest pain.
  • Blood thinners such as antiplatelet and anticoagulants
  • Pain killers
  • Drugs to break up clots
  • Aspirin
  • Blood pressure medication

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9.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 smoking 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.

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10.Understanding 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 failures can be treated well and reversed if diagnosed at an early stage. Healthy lifestyle changes and nutritional diet can bring back a quality life. There are different types of heart failures which 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 functions and pumps out blood normally. However, the ventricles of the heart 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 go unnoticed in heart failure as they are very mild and gentle. Heart failure worsens over time and can lead to serious health hazards. It is important to seek medical help if you are suffering from one or more of the symptoms given below.

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

Causes for heart failure- There are several medical conditions that damage heart muscles and there are certain lifestyle habits that 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 - Increase in blood sugar levels damages several internal organs, including the heart.
  • High blood pressure - Increased blood pressure forces the heart to pump faster than usual to cause heart diseases.
  • Kidney Disease- 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.

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11.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 easily recovered through lifestyle changes, heart medications and monitoring.

Class 2 - Symptoms such as discomfort while working out and performing other physical activities, feeling of 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 and palpitations, or shortness of breath. You would prefer staying at rest more often. The treatment at this point gets complicated. You will require immediate medical attention and doctors advice for quick recovery.

Class 4 - Fatigueness and palpitations increase even at rest and includes breathlessness. The condition of the heart is not recoverable at this stage. Palliative care options can improve the quality of life and pain killers can reduce shooting pain.

Prognosis - Myocardial infarction (heart attack) is a serious 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 10 years. The prognosis is better for younger patients with lesser coexisting medical problems.

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12.Heart Attack FAQs: All Your Concerns Addressed.

Q.   How is smoking related to a heart attack?

  1. Most smokers get a heart attack which is directly related to their smoking habit. The nicotine consumed during smoking causes many health issues which include-
  • Lack of oxygen supply to the heart
  • Increased blood pressure and heart rate.
  • Clotting of blood.
  • Damage to cells that line coronary arteries and other blood vessels.

Q.   If I am on medication to treat heart disease, does that mean I am no longer at risk of a heart attack?

  1. No, this means you are working towards lowering your risk of future heart attacks. Having said that, some of the causes resulting in heart attacks may be hereditary or genetic. Heart attacks in these instances can still occur. It is best to speak with your doctor on what you can to minimise the risk as much as possible.

Q.   Do all heart attacks have the same symptoms?

  1. Most heart attacks start slowly and build up gradually over a few minutes. Heart attacks can be anticipated as mild discomfort or pain, including pressure,tightness, fullness or radiating pain to the neck, jaw, or arm, and is usually associated with shortness of breath, nausea, sweating and paleness. People with diabetes and women may not have the typical symptoms of chest discomfort and may have only a few of the associated features (such as shortness of breath or nausea)

Q.   What is a myocardial infarction?

  1. Myocardial infarction is the medical term for heart attack.

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13.Road to Recovery and Aftercare

Cardiac health depends upon lifestyle habits too. To have a healthy heart one has to lead a disciplined lifestyle along with 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 to recover from a heart attack.

Emotional Health - It is normal 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.

Get back to normal life - Do not let your emotions to 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 you, join cardiac rehabs which are 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 how to protect and strengthen 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. You will need medical attention if the condition is severe.

Maintain blood sugar levels - Diabetes can cause serious 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 reduces the risk of future heart attacks and heart disease as it strengthens the heart. Exercising is a perfect way to get back to normal life after a heart attack, and it is a great recovery method.

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14.Stories of Hope

  • It is a brilliant hospital that treats all cardiology related diseases. World's best cardiologists are available here who are very patient and kind - Sunil Goli
  • The doctors and nurses are good and treatment is above par. The hospital maintains cleanliness and hygiene - Kishore Hariharan
  • One of the best heart specialist hospitals in Bangalore. Excellent treatment methods with all modern pieces of equipment - Raymond Lazarus
  • Very neat and well maintained. Satisfied with treatments and the charges are very reasonable - Anupama B