Heart 
Attack
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topics above to see more information. A heart attack (or myocardial infarction) occurs when a coronary artery, one of the blood vessels that supply oxygen-rich blood to the heart muscle, becomes blocked. The area of heart muscle that does not receive blood begins to die after a period of time if blood flow (and thus oxygen supply) does not increase enough to meet the muscle's energy needs. Angina is similar except that coronary blockage reverses enough to allow sufficient blood flow to the heart muscle before permanent damage occurs. In some cases, individuals may have a heart attack from causes other than the blockage of a coronary artery. However, the cause of heart muscle damage is the same. An area of the heart does not receive adequate oxygen-rich blood and the heart muscle dies. The other causes can include cocaine overdose, blood vessel spasms (known as Prinzmetal's angina), and severe anemia. The vast majority of heart attacks are caused by blood vessel blockage. The seriousness of a heart attack depends on how much of the heart muscle is affected and in some cases the specific location. Often the surrounding healthy muscle keeps working, allowing the heart to keep pumping while the injured muscle heals and recovers some of its strength. The death of heart muscle may result in weakening of the heart (called congestive heart failure), heart valve damage, and irregular heartbeats (called dysrhythmia).
The signs of a heart attack can be subtle and hard to identify. Many people don't recognize the symptoms even when they are in the middle of a major heart attack. The amount of time that passes before you receive treatment can mean the difference between life and death. Learn about the symptoms of heart disease and your own risk factors. Get help immediately even if you are not sure you are having a heart attack. A heart attack feels different to different people. The typical symptoms of a heart attack include heavy chest pain or tightness, often radiating to the left arm or left shoulder, accompanied by shortness of breath, sweating, and nausea. Even if you have already had a heart attack, a second one may not feel the same. You may feel pain in any of the areas of the body shown below. Or you may feel pain only in your arms, jaw, or back. Other warning signs of a heart attack include dizziness, fainting, sweating, nausea, or weakness. These symptoms ( without chest pain) are more likely to occur in patients older than 70 years. Patients with diabetes tend to have heart attacks that do not present with the classic symptoms of chest pain or tightness. If you suspect that you are having a heart attack, call 911 (or the emergency number in your area) for prompt medical treatment. Remember, a heart attack does not always cause severe chest pain!
Although a person cannot control their sex, age or family history many other factors can be modified. Getting prompt treatment for a heart attack can be lifesaving. If you experience one or more symptoms of a heart attack, act quickly and take the following steps:
At the hospital, the emergency medicine staff will determine if you have had a heart attack by:
A heart attack may be immediately confirmed if certain changes (along with symptoms you are experiencing) are present on your EKG. Sometimes a heart attack may take a while to show up on your EKG and in your blood tests. For some people a heart attack cannot be reliably diagnosed using only an EKG. Newer tests for chemicals released by damaged heart muscle (cardiac isoenzymes) have greatly improved diagnostic accuracy in such situations. Nevertheless, these chemical tests may take upto several hours to tell the doctor whether or not a heart attack is occurring. If the emergency department staff suspects you are having a heart attack they will hook you up to a heart monitor, place catheters in several of your veins, and give you additional oxygen through a tube attached under your nose. Certain medicines will be given to you in an attempt to stop the heart attack. Medications
Angioplasty If you do not have a good response to clot dissolving mediations you may require more invasive treatment . Such treatment consists of a coronary angiogram in which dye is injected into the coronary arteries to determine the location of the blockage(s). With this information a cardiologist may perform angioplasty (called PCTA). In this procedure a plastic tipped balloon catheter is threaded from an artery in your arm or groin into the effected coronary artery. The balloon tip is then inflated to re-expand the narrowed artery. For angioplasty to be performed a patient must be in a hospital equipped to do these procedures and have the ability to perform coronary artery bypass surgery in case complications develop with the PCTA procedure. If you are in a hospital that does not have these facilities available (most don't) you will need to be transferred to one that does. Bypass Surgery In rare instances emergency coronary artery bypass surgery (CABG) is required in a person having a heart attack that has failed to respond to clot dissolving medications or balloon angioplasty. A CABG involves replacing blocked coronary arteries using either saphenous veins from your lower leg or internal mammary arteries from your breast bone. This procedure is more commonly done electively (not emergently) in people suffering from gradually worsening severe coronary artery disease with angina symptoms who have not responded optimally to mediations or PCTA.
Other Sites/ Resources American Heart Association @ http://www.americanheart.org National Heart, Lung, and Blood Institute @ http://www.nhlbi.nih.gov American Academy of Family Physicians @ http://www.familydoctor.org
Doctors Corner INternet Group, Inc. 1997-2004 Statement
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