Myocardial Infarction (Heart Attack)

Heart Attack

A heart attack can occur anytime - at work or play, while you are resting or in the middle of a strenuous workout. Heart attacks occur very suddenly, but the stage is set for them over many years. In fact, coronary heart disease causes more premature deaths than any other disease known to mankind. The heart attack or myocardial infarction is the most common serious illness, suffered by men and women not only in be developed world, but also in the developing world.

What is a Heart Attack?

A heart attack is a result of two processes. One is the gradual and slow narrowing of the coronary arteries which supply the heart muscle with blood (hardening of the arteries); the second is a sudden and abrupt blockage of the artery due to the development of a blood clot (coronary thrombosis) in the narrow artery. The result is a sudden cut off in the nutrients and oxygen supply to the heart muscle. The tissue, hence, gets damaged and the heart muscle is replaced by scar tissue. Luckily, the heart has considerable reserve capacity, as a pump, and so a small amount of damage may not interfere with the ability of the heart to pump reasonable amounts of blood around the body. Thus, a patient can often recover well and return to a fairly normal life.

What are the Symptoms of a Heart Attack?

The heart attack is an urgent message from your heart that it is starved for oxygen and part of the muscle is starting to die. This lack of oxygen causes a variety of symptoms and they may not be felt as pain. Typically, rest and nitroglycerine give incomplete, temporary or no relief at all.

What Should be Done if a Heart Attack Occurs?

A heart attack is a medical emergency. It is one of the most serious threats to life. The first priority treatment for most patients, is the relief from pain. However, with recent advances in the medical management involving new techniques, the use of clot dissolving treatment (thrombolytic therapy) or balloon angioplasty (PTCA) in early hours after the heart attack and with sophisticated nursing care in a high dependency area (Coronary Care Unit - CCU), the early and late complications could be significantly reduced. Life threatening cardiac rhythm disorders occur within a span of the first few hours and are readily amenable to electrical treatment in a CCU setting with a general availability of thrombolytic (clot breaking) agents.

Time Equals Heart Muscle

During a heart attack, the reduced blood flow (ischemia) caused by a blood clot, results in damage to the heart muscle. The muscle begins to die in a spreading formation within the area of ischemia, limiting the heart's ability to pump. Your goal is to get to the hospital during the "golden hour" to keep permanent damage down to a minimum. Your doctor's goal is to stabilize your condition and allow blood to flow again to the starved heart muscle. Therefore, the need to rush to a hospital with a 24-hour cardiac care facility is even more important nowadays. Limiting the size of heart damage by opening up the blocked artery, using either thrombolytic agents (viz, drugs like Streptokinase and tPA) or balloon angioplasty within the first few hours of the heart attack has made a major difference to survival of patients in recent years.

Arriving at the Hospital

If you get to the hospital within the "golden hour," your chances for a full recovery greatly improve. Your doctor will decide on the best way to treat your heart attack and relieve your symptoms.

Tell Them, "I Think I'm having a Heart Attack"

When you arrive at the hospital, tell them you think you're having a heart attack, so you will get immediate attention. You may be given medications to relieve pain, stabilize your heart rhythm, improve your breathing and lower your blood pressure. If it is not a heart attack, you will be treated for your discomfort.

Recovering in the Hospital

The time required for recovery depends on:

Expect to be hospitalized for one to two weeks to evaluate the damage, help you rest while your heart heals, and treat any complications. You will have blood tests, ECGs (electrocardiograms) and possibly a stress test. Based on the results of these tests and your symptoms, your doctor may recommend angiography, angioplasty or surgery . Often, however, medications will be enough for proper treatment. Once the initial few days are over without complications, further problems are less frequent with the passage of time. The risk of recurrence of myocardial infarction is greatly diminished by adopting healthy habits and taking medicines, such as Aspirin and Beta-blockers - the secondary prevention of myocardial infarction.

Road to Recovery

The final responsibility for heart attack lies with you. Only you can make your lifestyle change-changes in eating, smoking and exercise habits that will help protect against cardiovascular diseases. A little prevention can have a big payoff - a longer, healthier, more active life. Your doctor will discuss this further with you when he sees you in the follow-up clinic.

Heart-Healthy Lifestyle

Healthy lifestyle measures are important preventive measures in the fight against cardiovascular disease. These include: