Heart attack

Chest | Cardiology | Heart attack (Disease)


A heart attack occurs when a blood clot blocks one of the arteries that supply blood to the heart muscle.

Classical symptoms of acute myocardial infarction include sudden chest pain (typically radiating to the left arm or left side of the neck), shortness of breath, nausea, vomiting, palpitations, sweating, and anxiety (often described as a sense of impending doom). If blood flow is not restored to the heart muscle within 20 to 40 minutes, irreversible death of the heart muscle will begin to occur. Muscle continues to die for six to eight hours at which time the heart attack usually is complete. The dead heart muscle is eventually replaced by scar tissue.

Even though the symptoms of a heart attack at times can be vague and mild, it is important to remember that heart attacks producing no symptoms or only mild symptoms can be just as serious and life-threatening as heart attacks that cause severe chest pain. Too often patients attribute heart attack symptoms to indigestion, fatigue, or stress, and consequently delay seeking prompt medical attention.

Causes and Risk factors

The underlying cause of heart attack is coronary heart disease (CHD). CHD is when fatty deposits (called plaque or atheroma) slowly build up on the inner wall of the coronary arteries and cause the arteries to become narrow.

Women may experience fewer typical symptoms than men, most commonly shortness of breath, weakness, a feeling of indigestion, and fatigue. A sizeable proportion of myocardial infarctions (22 - 64%) are silent, that is without chest pain or other symptoms.

Conditions such as high blood pressure, high cholesterol, smoking, family history of heart attacks and diabetes can all increase the chances of having this disease.

If untreated, death can occur, and at times very rapidly. Other complications include heart failure and stroke.

Diagnosis and Treatment

A coronary angiogram can definitively identify the coronary artery blockage. A chest CT scan can demonstrate the blockages. An echocardiogram can also show a poorly functioning heart.

Treatment is aimed at improving the blood flow to the heart, treating life threatening arrhythmias, and maximizing the heart function. Coronary (heart) artery blockages are reduced by the following: clot busting medication, balloon angioplasty, stent placement, surgical bypass, blood thinners and/or anti-platelet medications (aspirin, abciximab, eptifibatide, clopidogrel). When arrhythmias are present they are treated with medications (amiodorone), cardioversion or a pacemaker. Medications for blood pressure and cholesterol are also frequently used. ...

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