The heart is one of the largest muscles in the body. The wall of the heart, which is called the myocardium , is actually the muscle that circulates the blood by pumping it. During a heart attack, a blocked artery robs this muscle tissue of oxygenated blood. When the lack of oxygen becomes severe enough to cause the death of a large number of cells, it is called a heart attack . In the medical context, a heart attack is referred to as an acute myocardial infarction (MI).
Heart attacks are directly responsible for about 10% of all deaths in Canada each year. This figure represents 50% of all deaths from coronary artery disease. Although a heart attack is a very serious condition, the chances of survival increase dramatically if you manage to get to a hospital without delay.
Causes
All organs need oxygenated blood to maintain their function, and the myocardium (the muscle that forms the lining of the heart) is no exception. The coronary arteries provide it with its own network of oxygen supply. In the case of coronary insufficiency, fatty deposits ( plaque ) form on the internal walls of the coronary arteries, the diameter of which they reduce, and therefore the capacity to carry blood flow to the heart. This process corresponds to the development of atherosclerosis .
Most heart attacks occur when a rupture in the lining of the inner wall of an artery releases the atherosclerotic plaque. The blood then forms a clot on the damaged artery, and its presence can partially or completely block blood flow. If the obstruction becomes large enough, symptoms of a heart attack appear and the heart muscle cells begin to die soon after, this is called a heart attack.
It happens, but rarely, that a spasm of the muscle tissue in the wall of an apparently healthy artery stops the blood flow and causes a heart attack, the cause of which cannot be identified most of the time.
Symptoms and Complications
The majority of heart attack victims experience certain symptoms during the days leading up to the attack. The most common symptom is angina ( chest pain). Chest pain occurs when the heart muscle does not get enough oxygen, a condition called ischemia . It is quite possible that angina will worsen or become more frequent as the heart attack approaches. Other symptoms are likely to occur, such as extreme fatigue and shortness of breath.
People with angina may have difficulty distinguishing between symptoms of angina and pain from a heart attack. Symptoms of a heart attack are usually much more intense and persistent (more than 20 minutes) than those of angina. Rest and medications used to relieve angina only slightly or temporarily relieve symptoms of a heart attack.
A lot of people report that they feel like a warning when a heart attack is imminent. The attack may be preceded by a feeling of chest tightness, pressure, pain and "constriction" of the chest. Pain can also spread to the back, jaw, shoulder or an arm (especially the left arm). The heartbeat may speed up and become irregular. Although chest pain is usually the first symptom, almost 20% of people who have a heart attack have no chest pain.
Other symptoms that may appear include:
- shortness of breath;
- anxiety;
- sweating;
- mental confusion;
- nausea and vomiting;
- temporary changes in vision;
- a feeling of light-headedness.
Almost all people who have a heart attack also have an arrhythmia (irregular heartbeat). Some of these irregular heartbeats are harmless while others can cause serious problems, even death. A heart rhythm disorder called ventricular fibrillation , or VF, can lead to death in about 5 minutes. The left ventricle, which is the heart's main pumping chamber, pulsates unnecessarily instead of sending blood around the body. This dysfunction of the heart is explained by the lack of oxygen supply.
Not all heart attacks are this serious. In fact, a few go unnoticed or are blamed on heartburn or angina. The distinction between a heart attack and heartburn is not as easy to establish as you might first think.- antacids, and referrals can really ease heart attack pain, even if it comes back quickly. Nitroglycerin in aerosols or pills, which people with angina often have with them, can also provide temporary pain relief. However, nitroglycerin does not relieve the chest discomfort caused by most heart attacks. It's up to you to judge and use common sense: if you feel the discomfort is worse than usual, or different, see your doctor.
Diagnostic
A doctor can tell you a lot about the heart, just with a stethoscope, but the standard examination in case of heart attack is the electrocardiogram or ECG. Electrodes are attached to the chest and the electrical signals emitted by the heart are recorded. The different parts of the ECG tracing give information about different areas of the heart, and this graphical recording helps the doctor know if it is persistent damage and locate it.
There is also a blood test that reveals the presence of a heart attack by showing a protein that is released when heart cells die. This test eliminates the possibility of other disorders that are often mistaken for a heart attack, such as the migration of a blood clot into a lung or pneumonia.
Treatment and Prevention
Identifying, and then curbing, risk factors such as smoking, obesity, high cholesterol, and high fat diets is a primary focus of heart attack prevention.
Talk to your doctor about your risk factors and aspects of your lifestyle that you could change, including:
- smoking, which you should consider quitting;
- physical activity which should include regular exercise in the daily routine - this practice will help your body weight loss and lower your cholesterol;
- diet which may require consulting a nutritionist about healthy foods that may help lower your cholesterol.
Anyone who experiences symptoms suggestive of a heart attack should call an ambulance without delay. A variety of effective treatments, including thrombolytic drugs (“clot destroyers”) are available for heart attack victims, but they should be given quickly to be effective. It is reported that 50% of deaths from a heart attack occur within 3 to 4 hours of symptom onset. Depending on which hospital you go to, you may be taken straight to the heart catheterization center for angioplasty , a procedure that involves inserting a tiny inflatable balloon to directly destroy the clot.The main thing is to get to the hospital as quickly as possible. It is one way to increase the chances of survival.
During a heart attack, the primary tasks of the hospital are to stop the damage to heart cells by restoring blood flow, and then to attend to complications such as ventricular fibrillation.ASA * (acetylsalicylic acid) chewable tablet is the first medication a person receives upon entering hospital. Its action helps to hinder the function of platelets, which play an important role in forming a blood clot, and to prevent further blockage of the arteries. Several drugs are usually given to lighten the workload on the heart, dissolve the clot, and prevent more clots from forming. To aid breathing, an oxygen mask is sometimes applied to increase the proportion of oxygen in the blood.
To stop ventricular fibrillation, a device called a defibrillator which consists of a pair of high voltage electrodes is applied to the body to send an electric shock to the heart.
After a heart attack, 1 or 2 days of bed rest are usually needed, but prolonged bed rest can prevent the heart from regaining strength, as the nervousness or depression that it is natural to experience in these circumstances tends to occur. to get worse. Most affected are able to take a few steps from the 3 th day, but they must be careful not produce an intense effort or lifting heavy objects for a few months.
Drug treatment with ASA or clopidogrel is usually given to prevent the blood from clotting. You may also be prescribed other medications such as beta blockers or ACE inhibitors . These drugs help to lighten the workload on the heart while making it easier for blood to flow out of the heart. Cholesterol medications are also important even if your cholesterol levels are in a normal range. Your doctor will make medication recommendations based on your risk of having another heart attack.
If you smoke, your immediate cessation of smoking is of utmost importance. A heart attack is a complication of coronary artery disease, and the best way to prevent it is to avoid risk factors for coronary artery disease, including smoking.
Early treatment of a heart attack aims to restore blood flow and preserve the heart muscle. After a heart attack, you need rehabilitation or post-MI care to help the heart heal and prevent subsequent attacks. Rehabilitation programs for people with heart disease can usually be started in the hospital. Depending on the severity of the heart attack, they may continue for weeks or months after returning home. Post-MI management includes medication, lifestyle changes, and psychological care.
Finally, after a heart attack, some people experience depression or other psychological disorders associated with anxiety or anger. Rehabilitation programs offer help in these areas and provide support and counseling to people who may need it. Although a heart attack is a frightening experience, the majority of those affected can return to their normal activities.
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