HEART ATTACK

Definition :

Heart attack refers to blockage of blood flow to the heart caused by atherosclerosis or thrombosis. Also known as myocardial infarction, where myo means muscle, cardial means heart, and infarction means death of tissue.

Signs of Heart Attack :

• Discomfort or heaviness in the chest.
• Discomfort spreading to the back, jaw, arms, limbs.
• Bloated, fullness or have a choked feeling.
• Extreme weakness, fatigue.
• Abnormal heartbeat.

CAUSES :

A heart attack occurs when one or more of your coronary arteries become blocked. Over time, a coronary artery can narrow from the buildup of various substances, including cholesterol (atherosclerosis). This condition, known as coronary artery disease, causes most heart attacks.

During a heart attack, one of these plaques can rupture and spill cholesterol and other substances into the bloodstream. A blood clot forms at the site of the rupture. If large enough, the clot can completely block the flow of blood through the coronary artery.

Another cause of a heart attack is a spasm of a coronary artery that shuts down blood flow to part of the heart muscle. Use of tobacco and of illicit drugs, such as cocaine, can cause a life-threatening spasm. A heart attack can also occur due to a tear in the heart artery (spontaneous coronary artery dissection).

RISK FACTORS :

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.

Tobacco. Smoking and long-term exposure to secondhand smoke increase the risk of a heart attack.

High blood pressure. Over time, high blood pressure can damage arteries that feed your heart by accelerating atherosclerosis. High blood pressure that occurs with obesity, smoking, high cholesterol or diabetes increases your risk even more.

High blood cholesterol or triglyceride levels. A high level of low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol) is most likely to narrow arteries. A high level of triglycerides, a type of blood fat related to your diet, also ups your risk of heart attack. However, a high level of high-density lipoprotein (HDL) cholesterol (the "good" cholesterol) lowers your risk of heart attack.

Diabetes. Insulin, a hormone secreted by your pancreas, allows your body to use glucose, a form of sugar. Having diabetes — not producing enough insulin or not responding to insulin properly — causes your body's blood sugar levels to rise. Diabetes, especially uncontrolled, increases your risk of a heart attack.

Family history of heart attack. If your siblings, parents or grandparents have had early heart attacks (by age 55 for male relatives and by age 65 for female relatives), you may be at increased risk.

Lack of physical activity. An inactive lifestyle contributes to high blood cholesterol levels and obesity. People who get regular aerobic exercise have better cardiovascular fitness, which decreases their overall risk of heart attack. Exercise is also beneficial in lowering high blood pressure.

Obesity. Obesity is associated with high blood cholesterol levels, high triglyceride levels, high blood pressure and diabetes. Losing just 10 percent of your body weight can lower this risk, however.

Stress. You may respond to stress in ways that can increase your risk of a heart attack.

Illegal drug use. Using stimulant drugs, such as cocaine or amphetamines, can trigger a spasm of your coronary arteries that can cause a heart attack.

A history of preeclampsia. This condition causes high blood pressure during pregnancy and increases the lifetime risk of heart disease.

A history of an autoimmune condition, such as rheumatoid arthritis or lupus. Conditions such as rheumatoid arthritis, lupus and other autoimmune conditions can increase your risk of having a heart attack.

DIAGNOSIS :

• ECG . The ECG (also known as EKG or electrocardiogram) can tellhow much damage has occurred to your heart muscle and where ithas occurred. In addition, your heart rate and rhythm can bemonitored.
• Blood tests. Blood may be drawn to measure levels of cardiac enzymes that indicate heart muscle damage. These enzymes are normally found inside the cells of your heart and are needed for their function. When your heart muscle cells are injured, their contents -- including the enzymes -- are released into your bloodstream. By measuring the levels of these enzymes, the doctor can determine the size of the heart attack and approximately when the heart attack started. Troponin levels will also be measured. Troponins are proteins found inside of heart cells that are released when they are damaged by the lack of blood supply to the heart. Detecting troponin in the blood may indicate a heart attack.

ELECTROCARDIOGRAM (Heart Attack)

ECHOCARDIOGRAPHY OF HEART ATTACK

Echocardiography. Echocardiography is an imaging test that can be used during and after a heart attack to learn how the heart is pumping and what areas are not pumping normally. The "echo" can also tell if any structures of the heart (valves, septum, etc.) have been injured during the heart attack.

Cardiac catheterization.Cardiac catheterization, also called cardiac cath, may be used during the first hours of a heart attack ifmedications are not relieving the ischemia or symptoms. The cardiac cath can be used to directly visualize the blocked artery and help your doctor determine which procedure is needed to treat the blockage.

TREATMENT :

Drugs or surgery are normally used to treat heart attacks!

Drugs used during a heart attack may include:

• Aspirin to prevent blood clotting that may worsen the heart attack
• Other antiplatelets, such as Brilinta, Effient, or Plavix, to prevent blood clotting
• Thrombolytic therapy ("clot busters") to dissolve any blood clots in the heart's arteries
• Any combination of the above

ALTERNATIVE TREATMENTS :

During or shortly after a heart attack, you may go to the cardiac cath lab for direct evaluation of the status of your heart, arteries, and the amount of heart damage. In some cases, procedures (such asangioplasty or stents) are used to open up your narrowed or blocked arteries.

If necessary, bypass surgery may be performed in the days following the heart attack to restore the heart muscle's supply of blood.

Treatments (medications, open heart surgery, and interventional procedures, like angioplasty) do not cure coronary artery disease. Having had a heart attack or treatment does not mean you will never have another heart attack; it can happen again. But, there are several steps you can take to prevent further attacks.

STATISTICS :

• In 2008, over 616,000 people died of heart disease.
• In 2008, heart disease caused almost 25% of deaths—almost one in every four—in the United States.
• Heart disease is the leading cause of death for both men and women. More than half of the deaths due to heart disease in 2008 were in men.
• Coronary heart disease is the most common type of heart disease. In 2008, 405,309 people died from coronary heart disease.
• Every year about 785,000 Americans have a first coronary attack. Another 470,000 who have already had one or more coronary attacks have another attack.
• In 2010, coronary heart disease alone was projected to cost the United States $108.9 billion. This total includes the cost of health care services, medications, and lost productivity.

REFERENCE :

http://www.mayoclinic.org/diseases-conditions/heart-attack/basics/risk-factors/con-20019520

http://www.webmd.com/heart-disease/guide/heart-disease-heart-attacks?

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