Heart Attack

A heart attack occurs when blood flow to the heart muscle is interrupted. Oxygen can't get to the heart muscle, causing tissue damage or tissue death.

A heart attack may be caused by:

• Accumulation of fatty plaques in the coronary arteries
• Development of a blood clot in the coronary arteries
• Embolism that affects the coronary arteries
• Narrowing of the coronary arteries
• Spasm of the coronary arteries
• Thickening of the walls of the arteries feeding the heart muscle (coronary arteries)

These factors increase your chance of developing heart attack. Tell your doctor if you have any of these:

• Diabetes
• Family members with heart disease
• High blood cholesterol (specifically, high LDL cholesterol, and low HDL cholesterol)
• High blood pressure
• High blood triglycerides
• Increased age
• Obesity
• Sedentary lifestyle
• Sex: male
• Smoking
• Stress

Symptoms include:

• Squeezing, heavy chest pain, especially with:
  • A large meal
  • Cold weather
  • Emotional stress
  • Exercise or exertion
• Anxiety , especially feeling a sense of doom or panic without apparent reason
• Loss of consciousness
• Nausea
• Pain in the left shoulder, left arm, or jaw
• Shortness of breath
• Sweating, clammy skin
• Weakness

Unusual symptoms of heart attack (may occur more frequently in women):

• Back and shoulder pain
• Confusion
• Fainting
• Stomach pain

If you think you are having a heart attack, call 911 right away.

Tests may include:

• Electron-beam computed tomography (EBCT) —a type of x-ray that uses a computer to make detailed pictures of the heart, coronary arteries, and surrounding structures; may be helpful if you are at immediate risk of coronary artery disease
• Blood tests—to look for certain enzymes found in the blood within hours or days after a heart attack
• Coronary angiography —uses dye and x-rays to look for narrowing or blockage in the coronary arteries
• Echocardiogram —uses high-frequency sound waves (ultrasound) to examine the size, shape, function, and motion of the heart
• Electrocardiogram (EKG) —records the heart's activity by measuring electrical currents through the heart muscle, changes can show if there is blockage or damage
• Nuclear scanning—uses radioactive material to show areas of the heart muscle where there is diminished blood flow
• Stress test —records the heart's electrical activity under increased physical stress, usually done days or weeks after the heart attack
• Urine tests—to look for certain substances found in the urine within hours or days after a heart attack

Treatment includes:

• Clot-dissolving agents (thrombolytics)—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 include those that block the function of platelets (called platelet IIb/IIIa receptor blockers).
• Anti-anxiety medications
• Aspirin and other antiplatelet agents
• Beta-blocking and/or ACE inhibitor medications (frequently given)
• Cholesterol-lowering medications (eg, statin drugs)
• Nitrate medications
• Oxygen
• Pain-relief medications (such as morphine)

Preventing or treating coronary artery disease may help prevent a heart attack.

• Ask your doctor about taking a small, daily dose of aspirin.
  • Although most people are able to tolerate such a low dose of aspirin, even this small amount can rarely lead to serious bleeding, particularly from the gastrointestinal (GI) tract .
  • Aspirin may not work as well when combined with other pain medications.
• Begin a safe exercise program . Follow your doctor's advice.
• Eat a healthful diet . Your diet should be low in saturated fat and rich in whole grains, fruits, and vegetables.
• If you smoke, quit .
• Maintain a healthy weight .
• Treat high blood pressure , diabetes and high cholesterol .
• Manage stress .