Heart Attack: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

A heart attack occurs when there is a major decrease in or blockage of the heart's blood flow. The blockage in the heart's (coronary) arteries is frequently caused by the buildup of fat, cholesterol, and other substances. Plaques are deposits that have a high fat and cholesterol content. The process of plaque buildup is known as atherosclerosis.

Occasionally, a plaque may break, forming a clot that inhibits blood flow. Insufficient blood flow can cause damage or even the destruction of part of the heart muscle.

Causes Of Heart Attack

Coronary artery disease is the primary cause of heart attacks. Coronary artery disease is the blockage of one or more coronary arteries in the heart. This is usually caused by deposits called plaques, which are composed of cholesterol. Blood flow to the heart can be decreased by plaques that restrict the arteries.

A blood clot in the heart may result from a plaque break. A heart (coronary) artery blockage, either partial or total, can result in a heart attack. Whether an electrocardiogram (ECG or EKG) reveals any particular abnormalities (ST elevation) that call for immediate, invasive treatment is one approach to categorize heart attacks. These heart attack kinds may be described by your healthcare professional based on the results of an electrocardiogram (ECG).

• An ST elevation myocardial infarction is often indicated by an immediate total blockage of a medium- or large-sized cardiac artery (STEMI).
• A non-ST elevation myocardial infarction is frequently indicated by a partial blockage (NSTEMI). On the other hand, a complete blockage occurs in certain patients with non-ST elevation myocardial infarction (NSTEMI).

Blocked arteries are not the cause of every heart attack. Additional reasons consist of:

• Coronary artery spasm. This is a severe, unblockable blood vessel squeezing. Usually, smoking or other risk factors have caused the artery to harden prematurely or to develop cholesterol-based plaques. Other names for coronary artery spasms include Prinzmetal's angina, variant angina, and vasospastic angina.
• Certain infections. Viral infections, including COVID-19, have the potential to harm cardiac muscle.
• SCAD stands for spontaneous coronary artery dissection. A rip inside a cardiac artery is the source of this potentially fatal disease.

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Symptoms Of Heart Attack

Different heart attacks may present with different symptoms. Some people only have mild symptoms. Some people have significant symptoms. Heart attack symptoms often include:

• Chest pain that may feel as though it's pushing, squeezing, hurting, or tightening
• Radiating pain or discomfort to the upper abdomen, shoulder, neck, mouth, teeth, or even the back
• Sweating
• Heartburn or indigestion
• Sudden lightheadedness or dizziness
• Vomiting
• Lack of breath

Unusual symptoms in women might be sudden, severe neck, arm, or back discomfort. Some heart attacks come on suddenly. Many people do, however, experience symptoms and warning signs several hours, days, or weeks ahead of time. 

Persistent chest tightness that does not subside with rest also known as angina may be a sign of more serious problems. A brief interruption in the heart's blood flow causes angina.

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Risk Factors Of Heart Attack

Risk factors for heart attacks include:

• Age. The risk of having a heart attack is higher in men and women over 45 and 55 than in younger generations.
• Smoking. This covers both long-term secondhand smoke exposure and smoking. Give up smoking.
• High BP. The arteries that lead to the heart might get damaged over time by excessive blood pressure. An additional risk factor is high blood pressure that coexists with other medical disorders including diabetes, obesity, or high cholesterol.
• High triglycerides or cholesterol. Most likely, arteries will constrict due to elevated levels of low-density lipoprotein (LDL) cholesterol, also known as the "bad" cholesterol. The risk of a heart attack is further increased by elevated levels of triglycerides, a kind of blood fat. If the "good" cholesterol, known as high-density lipoprotein or HDL, is within the normal range, your chance of having a heart attack may decrease.
• Being overweight
• Diabetes. When the body either cannot produce enough of the hormone insulin or cannot use it properly, blood sugar levels increase. An elevated blood sugar level raises the chance of a heart attack.
• Metabolic syndrome. Combinations of elevated blood pressure, low good cholesterol, elevated triglycerides, elevated blood sugar, and expanded waist (central obesity) are responsible for this condition. Your risk of developing heart disease is doubled if you have metabolic syndrome compared to not having it.
• Heart attack history in the family. You may be more vulnerable if an older sibling, parent, grandmother, or husband has a heart attack before the age of 55 for men and 65 for women.
• Inadequate physical activity. Heart attacks are more common in people who have sedentary lifestyles (low physical exercise). Elevate heart health with regular activity.
• Unhealthy food intake. The risk of cardiac attacks is increased by a diet heavy in sweets, animal fats, processed foods, trans fats, and salt. Consume a lot of fruits, veggies, fiber, and good fats.
• Stress. Extreme emotional stress, such as rage, can make a person more likely to have a heart attack.
• Use of drugs without authorization. Amphetamines and cocaine are stimulants. They may set off a coronary artery spasm, which may result in a heart attack.
• Preeclampsia in the past. High blood pressure during pregnancy is brought on by this disorder. The chance of developing heart disease grows with time.
• An autoimmune disease. An increased risk of heart attack might result from having a medical illness like lupus or rheumatoid arthritis.

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Diagnosis Of Heart Attack

Ideally, during routine examinations, a medical professional would examine you for heart attack risk factors.

A cardiac arrest is frequently identified in an emergency. Healthcare professionals will treat your heart attack right away if you've already had one or are about to have one. You can be questioned on your medical history and symptoms if you can respond to queries.

A heart attack diagnosis involves checking the patient's temperature, pulse, and blood pressure. Tests are performed to measure heart rate and assess general heart health.

Examinations

Exams used to identify a heart attack comprise:

• ECG stands for electrocardiogram. The electrical impulses that pass through the heart are recorded during this initial diagnostic test for heart attacks. Electrodes, or sticky patches, are affixed to the chest and occasionally the arms and legs. Signals are captured as waves that may be seen on a screen or printed on paper. If you are having or have had a heart attack, an electrocardiogram (ECG) can provide this information.
• Blood examinations. After a heart attack, some cardiac proteins gradually seep into the circulation. These proteins (cardiac markers) can be detected via blood testing.
• Chest radiograph. The size and health of the heart and lungs are seen on a chest X-ray.
• Echocardiography. The heartbeat is visualized by sound waves, or ultrasonography. Blood flow through the heart and its valves can be seen using this test. If you think you may have heart damage, an echocardiography can help you determine this.
• Coronary angiography, or catheterization. The heart is reached by inserting a long, thin tube called a catheter into an artery, commonly in the leg. When pictures are taken during the test, dye is pumped into the catheter to improve the visibility of the arteries.
• Cardiac computed tomography (CT). These examinations produce pictures of the chest and heart. CT scans of the heart employ X-rays. 
• MRI. A magnetic field and radio waves are used in cardiac MRI to produce pictures of your heart. You typically recline on a table that slips inside of a lengthy piece of equipment that resembles a tube for both examinations. Heart issues can be diagnosed with any test. They can be used to illustrate how severe cardiac damage is.

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Treatment Of Heart Attack

Following are mentioned some of the treatment options for heart attack:

Drugs

Among the drugs used to treat a heart attack are:

• Aspirin. The aspirin lowers thrombogenicity.
• Thrombolytics or fibrinolytics, are sometimes known as clot busters. When blood clots obstruct the heart's blood supply, these medications assist in breaking them up. The less damage to the heart and the higher the likelihood of survival, the earlier a thrombolytic medication is administered following a heart attack.
• Additional blood-thinning medications. An intravenous (IV) injection of the medication heparin may be administered. Blood becomes less sticky and less prone to clot when heparin is added.
• Nitroglycerin. This drug enlarges blood vessels. It facilitates better cardiac blood flow. Angina, or abrupt chest discomfort, is treated with nitroglycerin. It is administered intravenously, as a swallowable tablet, or as a pill beneath the tongue.
• Morphine. When nitroglycerin doesn't reduce chest discomfort, this medication is used.
• Beta-blockers. These drugs lower blood pressure and slow the pulse. Beta-blockers can reduce the severity of myocardial damage and prevent further myocardial attacks. They are given to the majority of individuals who are having a heart attack.
• Medications referred to as angiotensin-converting enzyme (ACE) inhibitors for the treatment of hypertension. These drugs reduce heart workload and blood pressure.
• Statins. These drugs help lower dangerous cholesterol levels. A high level of low-density lipoprotein (LDL) cholesterol can clog arteries.

Surgery

If you have had a heart attack, you may require medical attention or surgery to clear a blocked artery. Treatment options for heart attacks include the following procedures and surgeries:

• Stenting and coronary angioplasty. To unclog cardiac arteries, this surgery is performed. Another name for it is percutaneous coronary intervention (PCI). This treatment is commonly performed during a procedure known as a cardiac catheterization to discover blockages if you have experienced a heart attack. A thin, flexible tube called a catheter is guided to the constricted portion of the heart artery by a cardiac physician (cardiologist) during an angioplasty. In order to assist expand the blocked artery and enhance blood flow, a small balloon is inflated. During angioplasty, the artery may be treated with a tiny wire mesh tube, or stent. The artery is kept open in part by the stent. It lessens the chance that the artery may narrow once again. A drug that helps keep the arteries open is coated on certain stents.
• CABG stands for coronary artery bypass grafting. That's open cardiac surgery. To open up a new blood artery in the heart, a surgeon removes a healthy blood vessel from another area of the body. The coronary artery that is constricted or obstructed is thus circumvented by the blood. When a person has a heart attack, it might be performed as an emergency operation. Occasionally, it is performed a few days later, once the heart has somewhat healed.

Cardiovascular Rehabilitation

A customized exercise and education program called cardiac rehabilitation shows patients how to take better care of their hearts following heart surgery. It emphasizes heart-healthy eating, exercise, stress reduction, and a gradual return to regular activities. Heart rehabilitation is often provided by hospitals, beginning in the hospital. Usually, the program lasts for several weeks or months after you are back home.

Following a heart attack, those who go to cardiac rehab often live longer and are less likely to experience problems or another heart attack. Consult your healthcare practitioner if cardiac rehab is not advised for you while you're in the hospital.

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Prevention Of Heart Attack

Even if you've previously experienced a heart attack, there's always time to take preventative measures. Some of the measures are mentioned below:

• Maintain a healthy way of living. Avoid smoking. Eat a heart-friendly diet and stay within a healthy weight range. Exercise frequently and control your stress.
• Manage other medical issues. Diabetes and high blood pressure are two diseases that might make heart attacks more likely. Find out from your doctor how frequently you should be checked out.
• Follow the directions on prescriptions. Prescription medications may be recommended by your physician to safeguard and enhance your cardiac health.
• In order to assist someone who is experiencing a heart attack, it's also a good idea to correctly learn CPR. A certified first-aid course that teaches CPR and automated external defibrillator (AED) usage is something you should think about taking.

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Complications Of Heart Attack

Damage to the heart muscles frequently results in consequences from heart attacks. A heart attack may cause the following possible complications:

• Arrhythmias are irregular or unusual heartbeats. Damage from a heart attack may alter the electrical impulses that pass through the heart, resulting in variations in the heartbeat. There are several that might be fatal and significant.
• Shock cardiogenic. The heart becomes suddenly and unexpectedly unable to pump blood, leading to this uncommon ailment.
• Heart failure. A heart's ability to pump blood may be severely compromised by myocardial injury. Both acute and chronic heart failure are possible.
• Inflammation is known as pericarditis, which affects the sac-like tissue that surrounds the heart. A malfunctioning immune system reaction can occasionally be brought on after a heart attack. Also known as post-cardiac injury syndrome, Dressler syndrome, or postmyocardial infarction syndrome.
• Cardiac arrest. It happens suddenly and the heart stops. abrupt cardiac arrest is brought on by an abrupt alteration in the heart's signals. This fatal illness is more likely to occur after a heart attack. If treatment is delayed, it may result in mortality (sudden cardiac death).

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