Heart Condition: Heart Attack
What is a Heart Attack?
A heart attack is a life-threatening event that occurs when the coronary artery (the artery that supplies blood to the heart) is suddenly blocked. As a result, the heart muscle doesn’t get the oxygen it needs and becomes damaged. If left untreated, the heart muscle will begin to die.
The main job of the heart is to pump blood around your body and deliver essential oxygen and nutrients to your cells. Your heart muscle also needs its own supply of oxygen and nutrients and it gets this from coronary arteries. Sometimes, fatty deposits build up within the artery walls and form plaque. This build-up of plaque is called atherosclerosis. If the plaque breaks, a blood clot forms in this area and may block the coronary artery. This causes the heart muscle to be starved of blood and causes a heart attack.
How do you recognise if someone is having a heart attack?
Warning signs may not be what you think. They can vary from person to person, and they may not always be sudden or severe. It is vital to get treatment fast to limit damage to your heart.
Don’t delay – call 999 or 112 immediately if you think you or anyone else is having a heart attack.
Heart attack symptoms
These are the most common warning signs of a heart attack. You may have just one of these symptoms, or a combination:
- Pain & Discomfort: you may feel pain or discomfort in your chest that feels like your chest is being crushed or squeezed tightly. People sometimes mistake this for indigestion.
- Spreading Pain: this pain may then spread to your left or right arm and your arms may feel heavy or useless.
- Upper Body Pain: the pain may also spread to your neck, jaw, back or shoulders and you may have a choking feeling in your throat.
- Shortness of Breath: you may feel short of breath, sick, weak, light-headed or dizzy.
- Anxiety: you may also have an overwhelming feeling of anxiety.
- Heart disease is the most common cause of death in Ireland.
- 6,000 people have heart attacks in Ireland each year but many of these can be prevented.
- Irish women are 6 times more likely to die from cardiovascular/heart disease than from breast cancer.
- 80% of all heart disease is preventable through lifestyle change and modifying the risk factors associated with heart disease.
What are the risk factors for heart attack?
Risks you can’t change…
Age: men age 45 or older and women age 55 or older are more likely to have a heart attack than are younger men and women.
Gender: men are at risk for heart attacks much earlier in life than women. Oestrogen offers women protection from heart disease until after menopause, when this hormone drops.
Family History: your risk of heart attack increases if any close family members, that is parents or siblings, have had a heart attack (by age 55 for male relatives and 65 for female relatives).
Race and Ethnicity: people of African Caribbean and South Asian origin have a much higher risk of heart disease.
Risks you can change…
High Blood Pressure: high blood pressure can do silent damage to the blood vessels leading to the heart.
High Blood Cholesterol: a high level of Low-Density Lipoprotein (LDL) or ‘bad cholesterol’ increases the chances of getting a heart attack.
Smoking: smoking is a major risk for heart disease and doubles the risk of heart attack.
Lack of Physical Activity: Physical inactivity may be as harmful as cigarette smoking. Currently, only 1 in 3 Irish adults are achieving the recommended level of physical activity. Regular physical activity lowers blood pressure, reduces stress and strengthens the heart muscle.
Being Overweight/Obese: can raise your bad cholesterol levels, blood pressure and increase your risk of Type 2 diabetes.
Diabetes: not producing enough insulin can cause your blood sugar levels to rise which can, in turn, increase the likelihood of you getting a heart attack.
How is a Heart Attack Diagnosed?
Once you get to the hospital, the medical team will ask you questions regarding the type of pain and various symptoms you had as well as how long they lasted. They may then conduct a number of tests to determine the diagnosis.
- An electrocardiograph (ECG) measures and records the rhythm and electrical activity of your heart. The ECG helps confirm whether or not you have had a heart attack, what type of heart attack you have had and helps in determining the best treatment for you.
- Some enzymes or proteins leak in to your blood if damage to your heart has occurred. Blood tests will test for the presence of these enzymes (e.g. troponin).
- A chest X-ray may be taken and can show if your heart has become enlarged or if there is fluid around your heart. It can also check for additional complications such as a build-up of fluid around the lungs.
- Some people may also have an echocardiogram (ECHO) which uses sound waves to build up a picture of the inside of your heart. This test provides information on the pumping action of the heart, shows if there is any scarring and checks that the valves are working properly. It also identifies what area of the heart has been damaged by the heart attack.
- A coronary angiogram involves inserting a thin tube (catheter) in to one of the blood vessels in your groin or in your arm. Dye is then injected into the tube which makes your coronary arteries show up on an X-ray. Your doctor can then see if there is any blockage or narrowing of the arteries which will also help identify what treatments you may require.
How is a heart attack treated?
If you have been diagnosed with a heart attack, the medical team will work to restore blood flow through the coronary arteries as soon as possible. The sooner treatment is given, the more heart muscle that is saved. Each person will be treated according to their own circumstance as not everyone’s experience of heart attack is the same. Treatment may take the form of medication and/or surgical procedure.
The main reasons for taking the medicines prescribed to you are to:
- Help prevent another heart attack
- Help reduce risk factors such as high blood pressure or high cholesterol levels
- Help reduce the risk of heart failure (this is where the heart muscle is not able to pump blood around the body as well as it used to).
There are different types of medication you may have to take during and after a heart attack, including:
- ACE Inhibitors: this medication lowers blood pressure and relieves the stress on your heart.
- Anticlotting & Anticoagulant Medication: this type of medicine prevents unwanted blood clots forming which can narrow or block your coronary arteries.
- Beta Blockers: these help to relax the heart muscle, slow the heart rate and reduce blood pressure. They can also help with relieving chest pain and discomfort, preventing another heart attack and treat irregular heart beats (arrhythmia).
- Statins: this medication controls and lowers blood cholesterol which can then reduce the risk of another heart attack.
Coronary Angioplasty: if an angiogram shows that the artery is narrowed or blocked then an angioplasty will be carried out to open up the artery. This involves inserting a tiny wire with a sausage shaped balloon into the blocked artery. Once the balloon is in position, it is inflated so that it pushes the clot and plaque to one side and opens up the artery. In addition, a stent may also be placed into the opened artery. A stent is a small tube of stainless steel mesh which, once in place, allows blood to flow back in to the part of the heart muscle that had its blood supply cut off.
Coronary Artery Bypass: in some cases, you may have to have a coronary artery bypass. This surgery is necessary when there is extensive narrowing of your arteries. It involves taking a healthy blood vessel from your arm, leg or chest which is then connected to the blocked artery. This means it diverts the flow of blood around the blocked artery via a new path and improves blood flow to the heart muscle.
How can future heart attacks be prevented?
Most people recover from a heart attack in about 6-10 weeks. However, treatments and medication do not cure coronary heart disease. If you have already had a heart attack, then you are in danger of having another one in the future. Following your return home from hospital your aim should be to keep your heart as healthy as possible to reduce this risk. You can do this by taking your medication, following the medical advice you received from the cardiac care team in the hospital, having regular check-ups with your doctor and making positive lifestyle changes.