Heart attack causes, symptoms, prevention and treatment

Heart attack




Heart attack
Heart attack

What is heart attack ?
  • Heart attack is also called myocardial infarction (MI). It occurs when there is compromised (incomplete blockage of coronary artery) blood supply to the heart muscles or complete blockage of coronary artery.
  • The muscles of the heart do not get enough oxygen due blockage .
  • Due to lack of oxygen, the contraction power of heart muscles decreased.
Also read
  1. Identification of heart related and non heart related chest pain in Hindi 
  2. What not to eat after a heart attack
  3. Insomnia (Insomnia) or Sleeplessness Causes and Treatment - Insomnia

Definition of myocardial infarction (MI) or Heart attack

What is the definition of myocardial infarction?
  • The word myocardial is formed from myocardium the middle layer of the heart which makes the contraction in the heart.
  • The word infarction means tissue death.

Types of heart attack 

There are three types of heart attack -
  1. ST segment elevation myocardial infarction or STEMI
  2. Non ST segment elevation myocardial infarction or NSTEMI
  3. Coronary Spasm or Unstable Angina or Silent Heart attack

1. ST segment elevation myocardial infarction or STEMI

What is meant by STEMI?
  • "ST segment" refers to that part of the electrocardiogram (ECG) called the ST segment.
  • In heart attack, part of the ST segment present in the electrocardiogram (ECG) rises above its baseline.
  • In such heart attack , the coronary artery is completely blocked.

2.What is Non ST segment elevation myocardial infarction or NSTEMI

What is NSTEMI?
  • In such heart attack , the portion of the ST segment present in the electrocardiogram (ECG) does not rise above its baseline.
  • The ST segment is below the baseline or is flat.
  • But in this type of heart attack , the "T segment" present in the electrocardiogram (ECG) is inverted. That is called T inversion.
  • In such a heart attack, the coronary artery is not completely blocked, but the blood flow in them is reduced (incomplete blockage).
Note:- Coronary angiogram (CAG) and cardiac markers are required to confirm such type of heart attack 

3.Coronary Spasm or Unstable Angina or Silent Heart attack

What is silent heart attack and what are its symptoms ?
  • This type of heart attack is also called Silent Heart Attack.
  • There is no change in ECG in Unstable Angina, but its symptoms are similar to STEMI.
  • Often this type of heart attack is ignored as acidity or muscle pain.
  • In such a heart attack, there is not much ambush in the coronary artery, but the  risk of heart attack increases again. 
There is no blockage in the coronary artery in silent heart attack , but it causes cramps for some time due to some reason.

Heart attack signs and symptoms






what causes heart attack, causes of heart attack , health tips, heart health tips
How to recognize a heart attack?

1. Chest pain

  • Pain or discomfort in the chest is the typical presentation of heart attack.
  • This pain mainly occurs in the middle of the chest, which feels like chest pressure, tightness or squeezing pain.

Radiation of pain

  • Along with chest pain, this pain usually occurs in the left side (left side chest pain).
  • But it can also spread to the lower jaw, right side chest pain, back, shoulders, and upper abdomen.
  • Often this pain occurs in the middle or left side of the chest and lasts for more than a few minutes.
  • This pain sometimes feels like a burning sensation in the chest.
  • If the pain reaches into the shoulder and left arm along with the chest, the pain may be mainly due to acute myocardial infarction or heart attack .
  • Heart attack pain is always constant and does not change by changing position or posture.
  • Chest pain due to heart attack lasts for 20 minutes or more.
Also read:-
 Identification of heart related chest pain
 Identification of non-heart related chest pain
 What to eat or not to eat after a heart attack
 Insomnia or insomnia causes and treatment - Insomnia

2. Nausea or Vomiting and Fainting

  • Along with chest pain, there may also be complaints of nausea, vomiting and sometimes fainting.
  • The complaint of unconsciousness is due to lack of blood supply to the brain.
Note:- In some patients with heart attack, nausea, vomiting or fainting may also occur without pain, especially in old or sugar patients.

3. Shortness of breath

  • Shortness of breathing with chest pain is very common in heart attack .
  • Breathing complaints are due to lack of oxygen in the muscles or due to the freezing of water inside the lungs.
  •  After MI, the heart muscle becomes weak due to which its contraction capacity decreases.
  • Due to low contraction capacity, the body does not get enough oxygen fluid also accumulates in the lungs, due to which the breathing difficulty arises.
  • Sometimes there is only complaint of breathlessness and not chest pain or other symptoms.
Note: Sometimes there is no complaint of any of the above in a heart attack , especially in old people or in patients with sugar.

Also read :- Difference between Cardiac and Non-Cardiac Chest Pain

What causes heart attack

Why does a heart attack occurs?
  •  The main cause of heart attack is complete blockage or incomplete blockage of the  coronary artery.
  • It is  also called coronary artery disease (CAD ).
  • The blockage can occur in more than one coronary artery.


Atherosclerotic plaque and thrombus formation
Scientific medical illustration of atherosclerosis illustration



Bad cholesterol (LDL) and many other related substances present in the blood begin to accumulate in the coronary artery, which gradually take the form of a large plaque, a process known as atherosclerosis and this plaque is called atherosclerotic plaque  . 
  • The plaque bursts due for some reasons like high blood pressure, smoking or any other reason, and there is accumulation of blood clotting factors that causes the coronary artery to completely blocked. It can happen in a few minutes.
  • Another cause of heart attack is the spasm in the coronary artery, which can be caused by smoking, or other drugs or stress. In this, the coronary artery is not completely closed.
  • Apart from the above, there are other reasons that can cause a  heart attack , although this is not very common. Such as very high fever, very fast heartbeat, very low blood pressure, etc.

What are the risk factors of heart attack?

  • Risk factors are those whose presence increases the chance of disease.
 There are two types of risk factors in heart attack -

1.Modifiable risk factors-

A. Smoking

  •  It is possible to avoid smoking and avoid heart attack .

B. Diabetes

  • By controlling your blood sugar level you can escape from heart attack.

C. Physical Inactivity

  •  Apart from a heart attack, it is possible to avoid all the diseases, from a sustained workout. It is beneficial to workout at least 30 minutes daily.

D. Weight gain -(Weight loss diet plan)

  • Excess of weight can cause all diseases, by controlling it, you can avoid all diseases.
Excessive amount of Cholesterol in the blood is the most common cause of  heart attack  , keeping it under control can prevent  serious disease like heart attack .

2. Non-Modifiable Risk Factors

  • Factors that cannot be changed such as -

A. Age 

  • Age cannot be reduced or increased, the higher your age, the higher your chances of getting coronary artery disease ( CAD ) like - Angina, heart attack etc.

B. Family History

  • If you have a family history that your father, mother, brother, sister first had coronary artery disease then there is chances of CAD you will have more likely. But you can know if there were any risk factors that were harming them, like-
  • Did those people smoke?
  • They were overweighted?
  • Was saturated fat used more in their food? ( Some examples of saturated fat )
  • Was there physical inactivity in them?
  • Was they suffering from diabetes?
If you get the answer yes, then you can reduce the chance of getting heart related disease by changing your lifestyle.

C. Sex

  • There is a higher risk of heart attack in men than women. 

Diagnosis of heart attack

How to recognize a heart attack?
Your doctor may first ask you some questions and while doing your physical examination will check for such risk factors which may cause heart attack .
  1. Inquiry about illness - history taking
  2. Physical examination
  3. Medical Tests

1. Inquiry about sickness - History Taking

  • Knowing the risk factors of a person can be very useful in understanding or controlling the serious causes of heart attack.
  • For example, heart attack is not very common among young people, whose age is below 30 years.
  • Whereas in people who already have a bad habit or disease, such as blood pressure, smoking, dibetes or someone in the family has had a heart attack earlier, heart attack is very common in such people.
  • Apart from this, if the patient's chest pain spreads (radiate) to the neck, back, left hand or jaw, then this pain is most often due to heart attack  .
  • Along with pain, there are also complaints that you are sweating too much or
  • With chest pain, pressure is felt in the chest or
  • If the nature of pain is squeezing, then such pain can be related to heart attack.

2. Physical Examination - Physical Examination

  • After taking the details of the disease and symptoms, the doctor will do your physical examination.
The doctor will check your blood pressure, heart rate, breath etc. in which he may get one or more of the following signs, such as -
  • Abnormal heartbeat
  • Hearing more than two beats - Presence of 3rd or 4th heart sound
  • Sweating too much - Diaphoresis
  • Hypotension or Hypertension
  • Fast or slow heartbeat - Tachycardia or bradycardia
  • Abnormal sound in the heart that is called heart murmurs
  • Pressing or rubbing the the chest pain site with the palm or fist is called  Levine’s Sign . (Pressing or squeezing chest with palm or fist)
  • Restlessness
  • Loss of consciousness or Drowsiness
All these findings or signs can be found in physical examination which point towards a heart attack .

3. Medical tests in heart attack

१. Electrocardiogram (ECG)

  • This is the first test done to diagnose a heart attack .
  • In this, the electrical activity of your heart is recorded on a paper.
  • Muscles of the injured heart do not normally conduct electrical impulses.
  • The ECG can show whether a heart attack has occurred or is in progress.


HEART ATTACK
ECG OF A PATIENT WITH COMPLAIN CHEST PAIN AND SWEATING


2. Blood tests 

A.  Cardiac enzymes

TroponinI and T - Troponin I and T

  • If there is damage to the heart muscle, these special enzymes releases.
  • Excess of these enzymes in the blood is a sign of heart attack or angina.

CK-MB  (creatine kinase myocardial band) 

  • This enzyme also found in the blood more than a quantity is a sign of heart attack or angina.
NOTE - CKMB is also found in high levels in asthma and musculoskeletal damage in addition to heart related disease.

  • Apart from this, complete blood count, liver function test, pancreatic enzymes are also   important in the diagnosis of heart attack .

3. Chest X-ray - Chest X-ray

  • Your doctor may ask for an X-ray to see the size of the heart and the status the lung.

4. Echo-Cardiography

  • This test proves to be very important in such patients who already have a heart related disease.
  • This test shows a video picture of your heart, through this test it shows which part of the heart is injured.
  • This also shows whether the heart function is correct or not.
Apart from these, there are some special types of tests which can be done, these tests depend on the intensity of the disease, such as-

1.Coronary angiogram (CAG)

  • This is a test in which X-rays are used to look at the blood vessels of your heart.
  • Tests are usually done to see if there is any obstruction or decrease in the blood flow of the heart, and how much is it (in percentage).

2. Exercise stress test

  • Through this test it is seen how your heart works during physical activity.
  • Because exercise makes your heart pump harder and faster, this test can reveal problems with the blood flow within your heart.
  • This test usually monitors your heart rhythm, blood pressure, and breathing while walking on tramadil.

3. Cardiac CT scan and MRI 

  • Cardiac CT scans and MRI are also seen to block heart blood vessels and ambush in the heart.

What is the treatment of heart attack - Heart attack treatment

Prevention and treatment of heart attack : -

Immediate treatment - Emergency treatment

If your doctor thinks that you have a heart attack, then he will treat you with the following medicines in an instant.
  • Blood clotting drugs like - Asprin
  • To reduce chest pain and increase blood flow to the heart, such as -  Nitroglycerine
  • Oxygen support
  • After confirmation of a heart attack, your doctor will treat you according to the type of heart attack  .
Your treatment also depends on the time of your symptom like how many hours or days you have had the symptoms of heart attack like:-
  • If you have symptoms of heart attack for 12 hours or less, then you can be treated with blood clot busters such drugs are called Thrombolytic drugs and the procedure is called as Thrombolysation.
  • If you have symptoms for more than 12 hours then your treatment will depend on Angiogram report. After angiogram you may be treated with medicines, stent placement (Angioplasty) or Bypass surgery.

Heart attack treatment with medicine

Medications used in heart attack: -
  • Medications to break blood clots ( Clot Busters )
  • Medications to control blood pressure and increase blood flow to the heart.
  • Blood Thinners or Anti Platelet Drugs
  • Drugs that should control bad cholesterol in the blood called Statins.
Note - Before using any medicine, please consult the doctor.
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Surgical treatment of heart attack

1. Bypass Surgery (CABG / GRAFTING) -

  • In this operation, taking blood vessel from the other part of the body and attaching it to the blocked artery (grafting).

2. Percutaneous transluminal coronary angioplasty/PTCA/PCI(Stent placement) –

  • This is a major heart related surgery in which the blood flow is regularized by placing a spring (stunt) in the blocked artery.
Note:- Whenever you are afraid that you may have a heart attack or have suffered, immediately consult a doctor in emergency.

Prevention from heart attack

The way to avoid heart attack is as follows : -
  1. Regularly consult your doctor |
  2. Apart from this, it is possible to prevent heart attack by changing lifestyle, such as -
  • By reducing use of FAT RICH FOOD such as red meat, fried foods, pastries and cakes, etc. ( Diet chart for heart patients)
  • By regular use of FIBER RICH FOOD.
  • Reduce the use of salt in food.
  • Using fresh and green vegetables. ( What to eat after a heart attack? ..)
  • Daily exercise for at least 30 minutes.
  • Do not smoke.
  • Keeping yourself stress free

Keeping blood pressure, cholesterol, blood sugar under control and regular consultation with the doctor is very important to avoid heart attack.
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