The heart is a muscular pump that works throughout your life to keep blood circulating through the entire body. It has high demands in terms of oxygen and nutrients and this is supplied to the heart muscle by the coronary arteries. When the coronary arteries are blocked, oxygen and food cannot reach the heart muscle.Without the necessary supply. the heart muscle is suffocated and the dies. This is known as a heart attack or myocardial infarction (MI).
Causes of a Heart Attack
Coronary artery blockage, either partial or complete, may be caused by a number of factors, many of which are related to diet and lifestyle. Eating a diet high in fatty foods, cigarette smoking and a lack of exercise are the main contributing factors to blockage of the coronary arteries. There may be a family history and coupled with other conditions like a higher than normal blood cholesterol level, you are at risk of a heart attack.
Hypercholesterolemia or high blood cholesterol is the most common cause of coronary artery occlusion (blockage). The cholesterol sticks to the wall of the blood vessels forming plaques that narrow the passage inside the blood vessel. If blood cells start to stick to these plaques, they will form blood clots that will eventually block the remaining space in the blood vessel. This can happen quite suddenly and while you may experience some chest pain (angina) initially, a heart attack can strike quite quickly without any warning.
At times, a spasm of the blood vessel causes narrowing which can also lead to a heart attack. This is not as common as a blockage but can be just a life threatening.
The following factors are considered as high risk for having a heart attack.
- Cigarette smoking.
- Age – men over 45 years and women over 55 years.
- Lack of physical activity.
- High blood pressure (hypertension).
- High cholesterol levels.
- Family history of heart attacks.
- Excessive use of stimulants including illegal drugs.
Signs and Symptoms of a Heart Attack
The signs and symptoms of a heart attack may at times be mistaken for other conditions like panic attacks or heartburn (acid reflux). If you are at risk of having a heart attack then you should always treat any persistent chest pain seriously and rush off to the emergency room.
The signs and symptoms may vary in intensity and sensation from person to person but usually includes the following :
- Chest pain – fullness, squeezing, stabbing pain – may be intermittent or constant.
- Pain intensity increases over a short period of time and becomes more frequent.
- Pain referred down the arm (usually the left arm), shoulder, back, jaw and/or upper abdomen.
- Difficulty breathing or shortness of breath.
- Nausea and vomiting.
- Dizziness or fainting spells.
A heart attack patient may also experience anxiety, have clammy skin and feel very tired.
Treatment, Prevention & Surgery
A heart attack patient needs emergency care and should be rushed to a hospital immediately. If a patients stops breathing or if the pulse cannot be detected, CPR (cardiopulmonary resuscitation) may have to be commenced.
Depending on the severity of the heart attack, your doctor may prescribe medication such as blood thinners or blood pressure lowering drugs. Aspirin is often used as it prevents blood clotting. Once the patient is stabilised, they will have to spend a few days in hospital. Blood tests to check on the heart muscle enzyme levels will be conducted and together with an angiogram, your doctor will decide if further procedures will be necessary like heart surgery.
Surgery or surgical procedures may be necessary depending on the severity of the case. These procedures are invasive but essential. It is sometimes done before a heart attack occurs if your cardiologist finds that your arteries are dangerously narrow.
Angioplasty & Stent
An angioplasty is often done in emergency situations or in cases where bypass surgery is not necessary. A thin catheter is inserted into the coronary artery and a balloon is inflated within the artery. This opens up the artery and a metal mesh is inserted at that point of the artery. This metal mesh is known as a stent and keeps the coronary artery open.
Coronary Artery Bypass Surgery
This procedure is necessary for more severe cases. Here the blood vessels of the heart are rerouted around the area of the complete or partial blockage. This ensures that a blood supply to the heart can be maintained through an alternative route. A heart bypass surgery may be referred to by the number of occlusions that have to be overcome. For example a double bypass means an alternative route has to be found for two occlusions whereas a triple bypass refers to three problem areas. This procedure will be done by a cardiothoracic surgeon and can be quite costly. The total cost including the doctor’s fees, operating theatre time and hospital stay can cost up to R150,000 (2009).