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Heart Attack
Overview

heart attack can be a very frightening thing. Even the thought of having one is a source of worry for most people. Heart attacks are the leading cause of death in the United States affecting both men and women. There are over 610,000 deaths due to heart disease each year and that amounts to one out of four deaths. Every year, 735,000 Americans suffer from heart attacks.

Lowering risk factors and early intervention can help lower these numbers and save lives. Part of this is educating people on prevention. This article will help you understand more about heart attacks, risk factors, diagnosis, and treatment. Also included are lifestyle and prevention tips.

A heart attack, also known as a “myocardial infarction” is the blockage of blood supply and oxygen to the heart muscle. This causes the heart tissue to die off. The blockage happens in the coronary arteries, the main blood vessels leading to the heart muscle.

Once the heart tissue dies, there is no way of bringing it back or repairing the damage. You can have one or several heart attacks and they can be fatal if not treated right away. Symptoms of a heart attack should never be ignored or attempt treatment at home. This is a medical emergency and if you or someone you know has symptoms call 9-1-1 right away.

What Causes Heart Attacks

Heart attacks are caused by blockage to the coronary arteries. This is caused by a buildup of cholesterol and deposits of plaque. It happens over time from a condition known as, coronary artery disease.
When a heart attack occurs, the plaque buildup in the artery breaks open and cholesterol leaks out. Your body tries to heal the rupture by building up a blood clot in the area which further blocks off the blood flow.
You may also have a coronary artery spasm that pinches off the blood flow. This can be caused by street drug use and smoking.
Lastly, heart attacks can happen due to the heart muscle tearing. This often happens due to acute trauma or blow to the heart. This is known as, coronary artery dissection.

Heart Attacks Risk Factors

 Heart Attacks Risk Factors

There are many risk factors for heart attacks. Many are also very reversible with good lifestyle choices. Risk factors include:

Age. Heart attacks tend to rise after the age of 45 in men and 55 in women.
Smoking. The use of tobacco or even breathing second hand smoke increases heart attack risk.
High Cholesterol. If you have a low level of HDL “Happy Cholesterol” or high density lipoprotein and a high level of LDL, low density lipoprotein then you are at a high risk for heart attack. You also need to watch your triglyceride levels that are related to a high-fat diet.
Hypertension. High blood pressure mixed with other health conditions speeds up the process of arterial damage.
Genetics. A history of heart disease in your family (direct relatives) increases your risk of heart attack.
Diabetes. If you do not produce enough insulin your body does not control your blood sugar levels. Elevated blood sugar over time damages blood vessels and arteries and can lead to a heart attack if left untreated or poorly controlled.
Obesity. If you are overweight, you most likely have high cholesterol and are at higher risk for diabetes and high blood pressure. All of these can raise the risk for a heart attack. It is advised people who are overweight try to lose at least 10 percent of their body weight.
No Exercise. Exercise can help keep your weight in a healthy range, keep the heart pumping effectively, lower cholesterol and lower blood pressure. People who exercise have a much lower risk for heart disease overall.
Preeclampsia in Pregnancy. Women who suffer from preeclampsia in pregnancy are at a higher risk for heart disease over the course of their lifetime.
High Stress. Increased stress levels increases inflammation in the body and this includes inside the blood vessels.
Autoimmune Disorders. Autoimmune disorders occur when your body attacks itself. Disorders like lupus and arthritis increase inflammation in the body and the immune system can attack delicate organs like, the heart.
Amphetamine Use. Methamphetamine and cocaine can stress the heart and cause coronary spasms and lead to heart attacks, even in younger people.

Heart Attack Symptoms

Please note that the symptoms of heart attacks can be vague. Women also experience them differently than men do. If you have any of the following symptoms and you feel like something isn’t right, get emergency medical attention:
Chest Pain/Chest Discomfort. One of the most prominent symptoms of a heart attack is chest pain or even tightening in the chest. This is usually felt on the left side of the chest and can even radiate to the back. It may come and go or persist. Some people think it is heartburn and ignore the pain. It may feel like:

Fullness
Pain
Squeezing
Pressure

Some people describe it as feeling like a “toothache.” It is very important to have any chest pain evaluated right away.
Radiating Discomfort/Upper Body. Chest pain may radiate to the jaw, neck, should, or your upper abdomen. It may also radiate down the left arm.
Trouble Breathing. You may feel like you can’t get your breath and feel winded. This occurs without any type of physical activity that normally makes you short of breath.
Nausea. Women commonly feel this symptom and it is often their only symptom, but both men and women may experience nausea with a heart attack.
Cold Sweats. You may feel clammy and break out in cold sweats, even if the weather is cold and you don’t feel hot.
Dizziness. Feeling lightheaded or dizzy for no apparent reason can be a sign of a heart attack.
Fatigue. Excessive fatigue, especially for days prior to other symptoms could be the onset of a heart attack. This symptom is also very common in women prior to a heart attack.
Impending Doom. Feeling like something very bad is about to happen.
The combination of two, three or more of the above symptoms raises the possibility that you are having a heart attack.

How is a Heart Attack Diagnosed?

If you have one or more of the above symptoms and it is new for you, you need to get emergency medical help. Time can save your life. The following tests are used to diagnose a heart attack:
Electrocardiogram – EKG Even if you are in the ambulance en route to the hospital, you will be hooked up to an EKG to check your heart rhythm. Certain rhythms can show that you are having a heart attack right away. It can also show if you have had a heart attack previously.
Laboratory Tests. Your blood will be checked for certain proteins that are by-products of the heart muscle damage. Tests for this include; troponin levels, Creatine Kinase, myoglobin, tests for blood clotting. Elevated levels can help doctor’s diagnose a heart attack.
Angiogram/Catheterization of the Heart. If your EKG is abnormal and your blood tests show possible heart damage, you will most likely be sent for an angiogram. The doctor will pass a catheter through an artery in your groin up into the arteries around the heart muscle. Dye will be injected and the doctor can see the arteries on a screen to see if they are blocked. You will be given a sedative to help you tolerate the procedure.
If you only have minor blockage, the doctor can even perform minor treatments during the procedure. You will have to apply pressure on your upper thigh to prevent bleeding for approximately 15-20 minutes and then there is about a six hour recovery time.

Heart Attack Treatment

The first line of treatment during a heart attack is plain aspirin. Always have a bottle of aspirin in your house if you are at risk for a heart attack. If you have to call 9-1-1 the operator may have you take an aspirin while waiting on the ambulance. If you do not have aspirin at home, the EMT’s may give you some once they make contact with you. This will stop blood clotting and help improve blood flow since aspirin is a blood thinner. Once you reach the hospital and after diagnosis, the following treatments will be given:
Nitroglycerin. When you arrive at the hospital, they may place a nitroglycerin tablet under your tongue to help relax your blood vessels and improve blood flow. If you had a heart attack, these may be prescribed for you to use at home if you have re-occurring symptoms after discharge. You will be instructed on when and how to use them.
Thrombolytic Drugs. The doctor’s may not wait until after all the tests to give you these drugs. This is because they need to be given very early on. If the doctor’s truly believe you are having a heart attack, these will be given soon after your arrival to the hospital. They can quickly dissolve blood clots and increase blood flow so the heart muscle gets oxygen. When given early, it decreases damage to the heart muscle and can save your life.
Antiplatelet Drugs. These are another very powerful type of blood thinner that can be given to stop blood clotting, reduce the size of blood clots you already have, and prevent new ones from forming. After diagnosis, you may be given a “platelet inhibitor.”
Injectable Blood Thinners. There are injectable blood thinners that you may be given in your IV in the hospital, and some that you can use at home for a few weeks to keep your blood thin while you recover.
Pain Medications. During your hospital stay, you may be given pain medications in your IV. The doctor may send you home with a prescription for pain medication to help make you comfortable.
Blood Pressure Medication. The doctor may give you blood pressure medications like; beta blockers and ACE inhibitors to help relax the blood vessels and bring blood pressure down. This reduces the workload of the heart to aid recovery.
Stents and Angioplasty. During the heart catheterization, the doctor can place a balloon to open up the artery and increase blood flow to the heart. They can insert a stent to keep the artery open long-term.
Coronary Artery Bypass Grafting – CABG. If the blockage to your heart cannot be relieved with a stent and you are at risk for more severe heart damage, you may need bypass grafting surgery. They harvest a vein from your leg or thigh area and graft it into the blood vessels leading to the heart. This will improve the blood flow to your heart. You may need one or more to get good blood flow.
This type of open heart surgery has improved tremendously in recent years and many people go home from the hospital days after surgery. The benefits of the surgery far outweigh the risk of death and life expectancy for people who have CABG is lengthened over people who do not have the surgery.

Lifestyle Changes after a Heart Attack

Quit Smoking
Keep your blood pressure and cholesterol in normal range. If you have diabetes, maintain strict control of your blood sugar.
Keep your appointments, especially if you are on blood thinners
Get regular exercise such as; walking, swimming or riding a bike
Keep your weight in a healthy range
Stay on a “heart healthy” eating plan that is low in; Tran’s fats, saturated fat and low cholesterol. You will also need to lower your salt intake.
Reduce alcohol intake. No more than one drink daily for women, and two drinks daily for men.
Reduce stress in your life. Stress can increase inflammation in the blood vessels. Find ways to deal with stressful situations like; meditation, yoga, taking time for yourself or reducing your workload.

Alternative Medicine for Heart Attacks

Make sure you talk to your doctor about using natural supplements or alternative medicine. Your medical treatments are very important to help your heart recover and there can be drug interactions with herbal supplements. Some alternative treatments that can complement your medical treatment include:
Keep in mind that there is no medical proof that supplements can prevent heart attacks, but may lower your risk when used prior to a heart attack. They may help; lower cholesterol, keep blood pressure in normal range, manage diabetes, and thin the blood. If you are on blood thinners, use caution with some supplements. Some natural alternative therapies include:
Vitamin B6, B12, and Folic Acid. Taking 25 to 100 mg daily of vitamin B5, 2 to 100 mcg daily of B12, and 400 mcg daily of folic acid may help lower the levels of the amino acid homocysteine. Higher levels of this amino acid may increase the risk of blood vessel disease linked to heart attacks and strokes.

Beta-Sitosterol. This plant based sterol may help lower cholesterol levels by stopping its absorption in your intestinal tract. Studies have shown that people who use this may have lower LDL levels in the body.

Omega-3 Fatty Acids. Taking 1,000 to 4,000 mg daily may help reduce inflammation in the body and thus lowering formation of plaque in the arteries. They may also lower triglyceride levels and blood pressure. This should not be used without your doctor’s consent if you are already on blood thinners. You can get daily requirements from just eating fatty cold water salmon at least twice weekly.
Co-Q10. This may help prevent blood clot formation and increase antioxidants. Taking them near the time a heart attack occurs may help prevent recurrent heart attacks.
Psyllium. This form of high fiber that is most often used as a laxative, may help reduce cholesterol levels and keep your blood sugar stable.

Garlic. Garlic is a natural blood thinner and anti-inflammatory. Taking 900 mg daily may help reduce blood clot formation and get rid of arterial plaques. It should not be used in conjunction with blood thinners.

Heart Attack Prevention

If you have any risk factors for heart disease, you should practice a healthy lifestyle to help prevent heart attacks. Making changes now can possibly save your life in the future. Follow these helpful prevention tips to reduce your risk:
Live and Eat Healthy
Get Plenty of Exercise. Even if it just means incorporating a daily walk. Your body needs exercise to keep off excess weight and burn off fats and calories. It also keeps your heart strong.
Quit Smoking and Stay Away from Second Hand Smoke. Do not let people smoke in your home or your car. It is better for everyone and your heart will thank you.
Lose Excess Pounds. Being overweight puts you at risk for diabetes, heart disease, and strains your heart. If you start eating a “heart healthy” diet, you can lose some extra pounds just by eating healthier.
Eat Plenty of Whole Grains, Fresh Fruits and Vegetables. Choose lean meats, beans, and fish for proteins. Only use fat-free or reduced fat dairy. Reduce your intake of saturated fats, cholesterol, Tran’s fats, refined sugar, and salt.
Take Care of High Risk Health Conditions
If you have diabetes, hypertension, or high cholesterol, take the needed steps to bring them under control. You may need to take medications to help, but once you start eating healthier and exercising some of these conditions are reversible.
Make a commitment to your body to take care of it and it will take care of you!

Heart Attack Complications and Prognosis

The prognosis for someone after having a heart attack is good if healthy lifestyle changes are made and you adhere to your doctor’s treatment plan. There is always an increased chance for a second heart attack and an abnormal heart rhythm that could be potentially fatal.
Complications from heart attacks include:
Irregular Heart Beat. Damage to your heart muscle can cause a malfunction in the electrical system. This can cause irregular heartbeats known as “arrhythmia.” These can sometimes cause death. Certain heart medications can help regulate the heartbeat.
Heart Rupture. The muscle in the heart can rupture during a heart attack if the blockage is severe. This is most often fatal.
Valve Damage. Valves can become stressed, weakened, and leaky after a heart attack. This can be life-threatening if left untreated.
Heart Failure. If too much of your heart muscle becomes damaged from a heart attack, it may lose its ability to pump blood effectively. This may heal after a heart attack or turn into a long-term condition.

Bibliography

Centers for Disease Control. (2015, August 10). Heart Disease Facts. Retrieved from Centers for Disease Control: https://www.cdc.gov/heartdisease/facts.htm
Mayo Clinic. (2014, November 15). Heart Attack: Causes. Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/heart-attack/basics/causes/con-20019520
National Heart, Lung, and Blood Institute. (2013, December 17). What Are The Symptoms of a Heart Attack? Retrieved from National Institute of Health: https://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/signs
University of Maryland Medical Center. (2014, August 12). Heart Attack. Retrieved from University of Maryland Medical Center: https://umm.edu/health/medical/ency/articles/heart-attack

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