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Heart Attack: types, causes, symptoms, diagnosis, treatment

Heart Attack: types, causes, symptoms, diagnosis, treatment


heart attack


What is Heart Attack?

  • The main cause of heart attack is the accumulation of fatty substances in the arteries, which is called Plaques.
  • Our heart needs oxygen and other nutrients to keep beating continuously. But if there is any kind of blockage in the coronary artery, then oxygen-rich blood does not reach our heart, due to which the muscles of the heart start dying so that the heart does not beat properly.
  • In medical parlance, a heart attack is called a myocardial infarction. Which means "death of the muscle of the heart".

    Types of Heart Attack

    There are three types of heart attack:

    1. ST segment elevation myocardial infarction (STEMI) 
    2. Non-ST segment elevation myocardial infarction (NSTEMI)
    3. Coronary Artery Spasm / Unstable Angina

    The "ST segment" is a zig-zag line pattern seen on the electrocardiogram (ECG), which displays your heartbeat.
    1. ST segment elevation myocardial infarction (STEMI) - This occurs when the coronary artery is completely blocked, that's why blood to not reach the heart muscle.
    2. Non-ST segment elevation myocardial infarction (NSTEMI) - In this, the coronary artery is partially blocked.
    3. Coronary Artery Spasm / Unstable AnginaDue to spasm in the coronary artery, it blocks that's why blood does not reach the heart muscle. It can also cause a heart attack. The cause of this problem can be the drug, tobacco addiction, and stress.
    READ ALSO : What is Kidney Stone?

    Causes & Risk factors of Heart Attack

    The following reasons for the heart attack (Myocardial infarction) :

    Causes

    1. Plaques formation in coronary artery - The reason for most myocardial infarction is the formation of plaques in the coronary artery, which is called "atherosclerosis". When this plaque bursts, a blood clot slowly begins to form there. Later, when that clot gets bigger, it starts obstructing the blood flow, so that the blood does not reach the heart and the heart muscle starts dying.
    2. Coronary artery spasm Coronary artery spasms can also cause a myocardial infarction. The cause of this problem can be the drug, tobacco addiction, and stress addiction.

    Risk Factors 

    1. High Blood Pressure - High blood pressure causes damage to the arteries and also increases the chances of formation of the plaques.
    2. High Cholesterol Level This also increases the chances of becoming Plaques.
    3. High Triglycerides Level - Triglycerides are usually deposited in Fatty Tissues, but taking more of it through food causes it to freeze in the arteries, causing plaques to form.
    4. Diabetes - The amount of sugar in the body increases due to diabetes. Due to the high amount of sugar in the blood, it can damage the blood vessels.
    5. Obesity - Obesity can cause high blood pressure, high cholesterol level, high triglyceride level, and diabetes which can also lead to heart disease.
    6. Smoking - Smoking makes the blood thick, which increases the chances of blood clot forming.
    7. Age - The chances of myocardial infarction increase after the age of 45 years in men and 55 years in women.
    8. Family History - If this problem is already present in the family, then there may be a possibility of this problem in the next generation.



    Sign & Symptoms of Heart Attack

    The initial symptoms of a heart attack are :
    • Tightness and pain in the chest. This pain can gradually spread to the throat, jaw, and back.
    • Having problems like indigestion, nausea, heartburn and stomach pain.
    • Shortness of breath.
    • Fatigue
    • Dizziness
    • Cold sweat: sweating due to nervousness.

     Pathophysiology of Heart Attack

    Deposition of fatty substances (cholesterol) on coronary artery walls
    Atherosclerosis: the formation of plaques
    Coronary artery damage from inside due to the bursting of the plaques
    Clotting where coronary artery damage has taken place is known as Thrombus formation.
    Coronary artery block due to formation of thrombus
    Stop blood flow to the heart muscle
    Gradually heart muscles died 
    Myocardial Infarction (Heart attack)


    Prevention of Heart Attack 

    To prevent heart attack, you have to change your lifestyle and adopt some good habits.
    • Eat a low cholesterol diet.
    • Daily exercise.
    • Stop smoking.
    • Maintaining healthy body weight.
    • Stay stress free.
    • If the patient already has diabetes and blood pressure then keep him under control.

    Diagnosis of Heart Attack

    A heart attack can be diagnosed with the help of the following investigatory tests :
    • Electrocardiogram ; ECG - This test measures the electric activity and rhythm of the heart. Electric activity is not normal when there is any kind of error in the heart. Which can predict the possibility of a heart attack.
    • Cardiac Markers - During heart attack, there are some enzymes (Troponin, Myoglobin) in the cells of the heart that are released into your bloodstream. These enzymes point towards the loss of heart muscle.
    • Cardiac Catheterization - During cardiac catheterization, a long thin tube called a catheter is inserted into an artery or vein in your groin, neck, or arm and reaches your heart through your blood vessels. Later the doctor injects a special dye into the coronary artery and an X-ray is taken. This dye glows in X-rays, allowing the blockage to be detected in the coronary artery. 

    Treatment or Management of Myocardial Infarction

    Myocardial Infarction treatments are as follow :

    Pharmacological Management

    • Aspirin To prevent blood clots
    • Heparin Anticoagulants that thin the blood
    • Nitroglycerin Widens the blood vessels so that blood flow can be smooth
    • ACE Inhibitors & Beta-Blockers Medicines to control blood pressure 
    • Some pain-killer medicines

    Surgical Management 

    • Angioplasty / stenting A thin tube is inserted into our blood vessel in it, there is a small balloon inside this tube. This tube is transported through the blood vessel route to the artery of the heart where the artery was narrowed due to plaque formation. The balloon is then inflated causing the narrowed artery to widen. Later a stent (a type of mesh) is put on that place so that the artery does not become compressed again.
    • Coronary Artery Bypass Grafting ; CABG In this, the doctor inserts another artery or vein from inside your body to the place where the blockage took place.
    • Artificial heart valve surgery - In this, the doctor removes the heart valve and replaces it with a mechanical valve or a valve made from cow, pig or human heart tissue (biological tissue valve).
    • Heart Transplant This is done in critical situations when there is no other option left.

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