Heart Attack Treatment

What is a Heart Attack?

A heart attack or a myocardial infarction happens when the flow of blood (carrying oxygen) to a part of the heart muscle is hampered. This is usually due to a blood clot or a blockage caused by fat and cholesterol buildup in the coronary arteries. These cholesterol-containing deposits are referred to as plaques. At times, the plaque ruptures and forms a clot that blocks the flow of blood and damages a part of the heart muscle.

Types of Heart Attacks

A heart attack can result from one of the types of coronary artery disease. The types of heart attacks can be as follows:

STEMI (ST-segment elevation myocardial infarction)

STEMI heart attacks are severe and require immediate medical attention. This type of heart attack occurs when the coronary artery is entirely blocked, preventing blood from reaching a large part of the heart. This causes progressive damage to the heart muscle, which eventually stops it from functioning. It is a medical emergency. The only investigation required for diagnosis of STEMI is ECG.

NSTEMI (Non-ST segment elevation myocardial infarction)

This type of heart attack occurs when the coronary artery is partially blocked, and the flow of blood is restricted. Here, the cardiac enzymes are elevated, and ECG may or may not show changes. This is also a medical emergency.

Coronary Artery Spasm

Due to specific metabolic changes in the body or any other cause, if the artery of the heart arteries constricts and gets relieved on its own, it is called a coronary artery spasm. This may not cause much damage but may cause severe chest pain to the patient.

Stable Angina

Angina is chest pain caused by reduced blood flow to the heart. Without sufficient oxygen, the heart cannot function properly, which can lead to a heart attack. There are two types of angina: stable and unstable.

Stable angina or angina pectoris is a predictable chest pain pattern. It occurs steadily and is generally triggered by emotional stress or strenuous activity. It occurs when the arteries of the heart gradually occludes over some time.

Unstable Angina

Another type of angina, unstable angina, occurs suddenly and worsens with time, leading to a heart attack. Patients suffering from this form of angina are at an increased risk of having a myocardial infarction. Coronary artery disease is the most common cause of unstable angina.

Heart Attack Symptoms

An individual may experience the following heart attack symptoms:

1. Chest pain (a feeling of squeezing, tightness, heaviness, or pressure across the chest)

2. Pain in other parts of the body- this can be felt as the pain spreads from the chest to the arms, stomach, jaw, neck, and back.

3. Dizziness or light-headedness

4. Shortness of breath

5. Sweating

6. Nausea or Vomiting

7. A sudden feeling of anxiety

8. Wheezing or coughing

Points to Remember:

• While chest pain is often severe, it is possible for some people only to experience minor discomfort.
• Also, even though one of the most common signs of heart attack is chest pain, symptoms may vary from person to person.
• Some people may experience other symptoms, such as jaw and neck pain, nausea, or shortness of breath without chest pain.
• Diabetic patients may not experience typical pain but at times, may present with breathlessness as their primary symptom.
• Don’t wait to get medical help if you experience any of these heart attack symptoms and warning signs of heart attack.
• If you have had a heart attack, it’s important to rest while waiting for an ambulance to avoid any unnecessary strain on the heart.
• If you’re not allergic to aspirin, slowly chew and swallow a 300mg tablet while you wait for the ambulance. Aspirin aids in blood thinning and improves the blood flow to the heart. 

Heart Attack Causes

Heart attacks are caused when the blood supply to the heart is suddenly interrupted. Without treatment, the heart muscles will undergo irreversible damage. Additionally, if a large portion of the heart is impacted in this way, the heart stops beating (also known as a cardiac arrest). The major causes of heart attack causes are:

• Coronary heart disease (CHD)

One of the most common reasons for heart attack, coronary heart disease (CHD) is a condition in which the coronary arteries become clogged with fat deposits such as cholesterol and other substances. It is the leading cause of heart attacks.  The risk of developing coronary heart disease is increased due to the following factors:

1. A high-fat diet

2. Smoking

3. Diabetes

4. High cholesterol

5. Hypertension (high blood pressure)

6. Obesity

• Lack of oxygen (hypoxia)

Lack of oxygen or hypoxia is one of the major causes of heart attacks but is less common than coronary heart disease. If blood oxygen levels reduce due to carbon monoxide poisoning or a loss of optimal lung function, the heart will not receive sufficient oxygenated blood. This will damage the heart muscles, triggering a myocardial infarction.

Heart Attack Risk Factors

Heart attack risk factors include:

1. Age: Men aged 45 and above and women aged 55 and above are more likely to have heart attacks as compared to younger adults.
   
   
   

2. Tobacco use: This includes smoking cigarettes and prolonged exposure to second-hand smoke.
   
   
   

3. Hypertension: Over time, high blood pressure can be accompanied by other conditions such as high cholesterol, obesity, or diabetes and damages arteries that lead to the heart.
   
   
   

4. High cholesterol: A high level of LDL (low-density lipoprotein) or bad cholesterol is most likely to narrow arteries. A high level of triglycerides (blood fats) can also increase the risk of heart attack. The risk of heart attack may drop if the level of good cholesterol or HDL (high-density lipoprotein) is in the standard range.
   
   
   

5. Obesity: Obesity is linked with diabetes, high blood pressure, high levels of triglycerides, and low levels of good cholesterol.
   
   
   

6. Diabetes: The blood sugar levels elevate when the body doesn’t make insulin or can’t use it correctly. High blood sugar or diabetes increases the risk of a heart attack.
   
   
   

7. Metabolic syndrome: Metabolic syndrome is a combination of at least three of the following issues; high blood sugar, low good cholesterol, high triglycerides, hypertension and enlarged waist (central obesity). An individual with metabolic syndrome is twice as likely to develop a heart condition than a person who doesn’t have it.
   
   
   

8. Family history of heart attacks: If a grandparent, parent, or a sibling in your family had a heart attack by the age of 55 for males and 65 for females, you might be at a higher risk of heart attack.
   
   
   

9. Lack of exercise: Leading a sedentary lifestyle and lack of physical activity is associated with a higher risk of heart attack. A consistent exercise routine helps improve heart health.
   
   
   

10. Unhealthy diet: A diet high in salt, sugars, animal fats, trans fats, and processed foods increases the risk of heart attacks. Eating a balanced diet rich in fruits, vegetables, fibre, and healthy oils is essential to mitigate the risk of a heart attack.
    
    
    

11. Stress:  Emotional stress, such as extreme anger and anxiety can increase the risk of a heart attack.
    
    
    

12. Illegal drug use: Amphetamines and cocaine are both stimulants and can trigger a coronary artery spasm that can lead to a heart attack.
    
    
    

13. An autoimmune condition: Autoimmune conditions such as lupus or rheumatoid arthritis can increase the risk of having a heart attack.

Heart Attack Complications

•   Arrhythmia

Arrhythmia is an abnormal heart rhythm that may occur after a heart attack. It causes the heart to beat too slow, fast, or irregularly. It can cause further damage to the heart or even a sudden cardiac arrest. Arrhythmia symptoms include shortness of breath, chest pain, dizziness, and palpitations. Mild arrhythmia can be controlled with medicines such as beta blockers.

• Heart failure

Heart failure can occur after a heart attack due to damage caused to the heart muscle. This usually happens in the left ventricle of the heart. Swelling in the legs and ankles, shortness of breath and fatigue are some of the symptoms of heart failure. Heart failure can be treated with a combination of medicines and, in some cases, with device.

• Cardiogenic shock

A cardiogenic shock occurs when the heart cannot pump enough blood to maintain the functioning of the vital organs. It is potentially life-threatening and requires immediate medical attention. Symptoms of cardiogenic shock must not be taken for granted, and treatment may include medications to support the heart, oxygen therapy, or, in some cases, surgery to improve the heart's functioning.

• Heart rupture

A heart rupture is a serious condition but a relatively uncommon complication of a heart attack. During a heart rupture, the heart’s muscles and valves rupture or split apart. It happens if the heart is significantly damaged during a heart attack and generally occurs soon afterwards. A heart rupture can lead to cardiogenic shock or heart failure. Open heart surgery is usually recommended to repair the rupture.

Diagnosis of Heart Attack

The tests to diagnose a heart attack include:

1. Electrocardiogram (EKG or ECG): The first test to diagnose a heart attack, an ECG records electrical signals as they travel through the heart. It can show whether an individual is having or has had a heart attack.
   
   
   

2. Chest X-ray: A chest X-ray helps assess the condition, and the size of the heart and the lungs.
   
   
   

3. Blood tests: Some heart proteins leak into the blood after the heart damage caused by a heart attack. Blood tests can be done to detect these proteins or cardiac biomarkers.
   
   
   

4. Echocardiogram: An ultrasound that uses sound waves to create heart images. This test shows how blood flows through the heart. It helps detect the area of the heart that has been damaged.
   
   
   

5. Angiogram (coronary catheterization): A catheter (a long and thin tube) is inserted into an artery and guided to the heart. Dye flows through the catheter to help create clear images of the arteries.
   
   
   

6. Magnetic resonance imaging (MRI) or cardiac computed tomography (CT): This test creates images of the chest and heart. CT scans use X-rays, and cardiac MRIs use magnetic fields to create heart images. Both tests help diagnose heart problems and show the severity of heart damage.

Heart Attack Treatment[1] 

• Medications

Medications that are used to treat a heart attack include:

Aspirin/clopidogrel/ticagrelor: These drugs are antiplatelets and the mainstay of treatment for heart attack.

Clot busters (thrombolytics): These medications help break up the blood clots, blocking blood flow to the heart. The sooner a thrombolytic drug is given after a heart attack, the greater the chance of survival. However, today, coronary angiogram and angioplasty are the first line of treatment and thrombolytics are used only if these are not available at a centre.

Beta-blockers: These medicines slow the heartbeat and improve cardiac output.

ACE (angiotensin-converting enzyme) inhibitors: These drugs help reduce the stress on the heart and lower blood pressure. They are prescribed to patients whose heart function has decreased. They are also used to control raised blood pressure and heart failure.

Statins: These drugs help in lowering cholesterol.

· Interventional procedure

The interventional procedure may include Percutaneous Transluminal  Coronary Artery (PTCA) stenting of the coronary artery (also commonly called coronary artery stenting) or Coronary Artery Bypass Grafting (CABG):

Percutaneous Transluminal  Coronary Artery (PTCA)/ Coronary artery angioplasty:

Also known as percutaneous coronary intervention (PCI), it is a minimally invasive procedure that aims to reopen blocked arteries and improve blood flow. It is either done through the artery in the leg or the hand. Catheters are placed through which the arteries of the heart are accessed. The blocked segment is then crossed with a wire. First, the blocked segment is ballooned with a balloon, and finally, a stent is placed in that segment so patency is maintained.

Most of the time, the patient does not require ventilatory support and is usually fit to go home the day after the procedure.

CABG (Coronary Artery Bypass Grafting)

• CABG is a surgical method of treating coronary artery blockage in which a new passage is created by bypassing the blocked segment by opening the chest. The patient requires ventilatory support and may also require heart-lung support during the procedure. Usually, the patient requires 5-8 days of hospitalisation.

How to Prevent Heart Attack?

It is not possible to completely prevent coronary artery disease because of some risk factors that can’t be controlled. However, it’s possible to lower the risk of coronary artery disease and prevent it from getting worse. The nine golden rules in the prevention of coronary artery disease are:

1.      Quit smoking

2.      Control diabetes

3.      Control BP

4.      Maintain healthy weight

5.      Exercise regularly

6.      Consume more fruits & vegetables

7.      Refrain/reduce alcohol intake

8.      Maintain healthy cholesterol levels

9.      Avoid stress

Why Should I Choose Artemis for Myocardial Infarction Treatment?

At Artemis Hospital, Gurgaon, we offer advanced diagnostic and imaging technology and innovative treatment options for heart attack patients. Our team of highly experienced doctors and well-organised facilities make us one of the premier heart care centres in the country. Schedule an appointment today for myocardial infarction treatment at Artemis Hospital, one of the top heart attack hospitals in India.

FAQs

1.  What are the 4 silent signs of heart attack?

Four signs of a silent heart attack are:

1.  Chest pain, fullness or discomfort, pain radiating to jaw and left arm

2.  Breathlessness

3.  Palpitation

4.  Nausea and cold sweats

2.   What is the medical term for a heart attack?

Myocardial infarction is the medical term for a heart attack. It occurs when the flow of blood to the heart is blocked, preventing the heart from getting oxygen, and leading to a heart attack.

3.   How is smoking related to heart attack?

Smoking is one of the major heart attack risk factors. The chemicals inhaled at the time of smoking make an individual more likely to develop atherosclerosis (plaque buildup in the arteries.)

4.  What is the link between cardiac arrest and heart attack?

Heart attack and cardiac arrest are two distinct heart conditions. However, the two conditions are linked in the following ways:

Sudden cardiac arrest can occur after a heart attack or while recovering from a heart attack..

5.   Can an ECG detect a heart attack?

The first investigation done to detect myocardial infarction in acute chest pain is ECG.

6. What is a mini heart attack?

The term mini heart attack is misleading. All heart attacks should be taken seriously. If symptoms are present, you should visit your cardiologist and take appropriate steps as suggested by your cardiologist.

Cardiac Treatments for Every Heart Condition

Cardiac Arrest

Heart Palpitations

Heart Failure