Heart Attacks

Basic information about Heart Attacks

Every year, tens of thousands of people survive from heart attack, go back to work and enjoy a normal life. You have every reason to be confident of a full recovery. Your heart is healing and with each passing day you'll get stronger and more active. The following questions and answers will help you better understand what has happened to you and how you get started on the road to recovery.
 What is a heart attack?
Your heart muscle needs oxygen to survive. A heart attack occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely (View an animation of blood flow). This happens because coronary arteries that supply the heart muscle with blood flow can slowly become narrrow from a buildup of fat, cholesterol and other substances that together are called plaque. This slow process is known as atherosclerosis . When a plaque in a heart artery breaks, a blood clot forms around the plaque. This blood clot can block the blood flow through the heart muscle. When the heart muscle is starved for oxygen and nutrients, it is called ischemia. When damage or death of part of the heart muscle occurs as a result of ischemia, it is called a heart attack or myocardial infarction (MI). About every 34 seconds, someone in the United States has a myocardial infarction (heart attack).
Why didn't I have any warning?
Atherosclerosis has no symptoms. One reason there may be no warning signs is that sometimes when a coronary artery becomes narrowed, other nearby vessels that also bring blood to the heart sometimes expand to help compensate. The network of expanded vessels is called collateral circulation and helps protect some people from heart attacks by getting needed blood to the heart. Collateral circulation can also develop after a heart attack to help the heart muscle recover.
Is my heart permanently damaged?
When a heart attack occurs, the heart muscle that has lost blood supply begins to suffer injury. The amount of damage to the heart muscle depends on the size of the area supplied by the blocked artery and the time between injury and treatment. Damage to the heart muscle from a heart attack heals by forming scar tissue. It usually takes several weeks for your heart muscle to heal. The length of time depends on the extent of your injury and your own rate of healing. The heart is a very tough organ. Even though a part of it may have been severely injured, the rest keeps working. But because your heart has been damaged, it may be weaker and can't pump as much blood as usual. However, with proper treatment after a heart attack and lifestyle changes, further damage can be limited or prevented
Will I recover from my heart attack?
The answer is most likely yes. The heart muscle begins to heal soon after a heart attack and usually takes about eight weeks. Scar tissue may form in the damaged area, and that scar tissue does not contract or pump as well as healthy muscle tissue. That means that extent of damage to the heart muscle can impact how well the heart pumps blood throught the body. The degree of loss of function depends on the size and location of the scar tissue. Most heart attack survivors have some degree of coronary artery disease (CAD) and will have to make important lifestyle changes and possibly take medication to prevent a future heart attack and lead a full, productive life
Is all chest pain a heart attack?
No. One very common type of chest pain is called angina, or angina pectoris. It's a recurring discomfort that usually lasts only a few minutes. Angina occurs when your heart muscle doesn't get the blood supply and oxygen that it needs. The difference between angina and a heart attack is that angina attacks don't permanently damage the heart muscle. Often angina occurs during exercise or emotional stress when your heart rate and blood pressure increase and your heart muscle needs more oxygen
What are the different medical terms for a heart attack?
Myocardial infarction – The damaging or death of an area of the heart muscle (myocardium) resulting from a blocked blood supply to that area; medical term for a heart attack.
Coronary thrombosis – Formation of a clot in one of the arteries that conduct blood to the heart muscle. Also called coronary occlusion.
Coronary occlusion – An obstruction of a coronary artery that hinders blood flow to some part of the heart muscle. A cause of heart attack.
 Are there other causes of heart attack besides blockage?
Sometimes a coronary artery temporarily contracts or goes into spasm. When this happens the artery narrows and blood flow to part of the heart muscle decreases or stops. We're not sure what causes a spasm. A spasm can occur in normal-appearing blood vessels as well as in vessels partly blocked by atherosclerosis. A severe spasm can cause a heart attack
 Is a heart attack the same as cardiac arrest?
No. But a heart attack can cause a cardiac arrest. Heart attacks are caused by a blockage that stops blood flow to the heart. Cardiac arrest is caused when the heart's electrical system malfunctions. In cardiac arrest (also called sudden cardiac death or SCD), death results when the heart suddenly stops working properly. This is caused by abnormal, or irregular, heart rhythms (called arrhythmias). The most common arrhythmia in cardiac arrest is ventricular fibrillation. This is when the heart's lower chambers suddenly start beating chaotically and don't pump blood. Death occurs within minutes after the heart stops. Cardiac arrest may be reversed if CPR (cardiopulmonary resuscitation) is performed and a defibrillator is used to shock the heart and restore a normal heart rhythm within a few minutes
Some heart attacks are sudden and intense — the "movie heart attack," where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening:
 Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
Shortness of breath with or without chest discomfort.
Other signs may include breaking out in a cold sweat, nausea or lightheadedness.
As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain
Even if you're not sure it's a heart attack, have it checked out (tell a doctor about your symptoms). Minutes matter! Fast action can save lives — maybe your own. Don't wait more than five minutes

Symptoms of heart attack

You may be experiencing cardiovascular problems if you notice that ordinary physical activity causes you to experience the following symptoms:
Undue fatigue
Palpitations --- the sensation that your heart is skipping a beat or beating too rapidly
Dyspnea --- difficult or labored breathing
Chest pain --- chest pain or discomfort from increased activity
    Angina pectoris also called stable angina or chronic stable angina
    Unstable anginaChest pain
Angina is chest pain or discomfort caused when your heart muscle doesn't get enough oxygen-rich blood. It may feel like pressure or squeezing in your chest. The discomfort also can occur in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion.
But, angina is not a disease. It is a symptom of an underlying heart problem and is usually a symptom of coronary heart disease (CHD).There are many  types of angina, including acute coronary syndrome, angina pectoris, chest pain, coronary artery spasms, microvascular angina, Prinzmetal's angina, angina inversa, stable or common angina, unstable angina and variant angina. View an animation of angina.
Angina occurs when the heart muscle does not get the blood it needs to function properly. This usually happens because one or more of the coronary arteries is narrowed or blocked, also called ischemia.Symptoms of Stable Angina - The pain or discomfort:
    Occurs when the heart must work harder, usually during physical exertion
    Doesn't come as a surprise, and episodes of pain tend to be alike
    Usually lasts a short time (5 minutes or less)
    Is relieved by rest or medicine
    May feel like gas or indigestion
    May feel like chest pain that spreads to the arms, back, or other areasSymptoms of Unstable 
    Angina - The pain or discomfort:
    Often occurs while you may be resting, sleeping, or with little physical exertion
    Comes as a surprise
    May last longer than stable angina
    Rest or medicine usually do not help relieve it
    May get worse over time
    Can lead to a heart attack
Likely procedures
If you've had a heart attack, you may have already had certain procedures to help you survive your heart attack and diagnose your condition.
Thrombolysis: Many heart attack patients have undergone thrombolysis, a procedure that involves injecting a clot-dissolving agent to restore blood flow in a coronary artery. This procedure is administered within a few (usually three) hours of a heart attack.
Coronary Angioplasty/ Coronary artery bypass graft surgery (CABG): If thrombolysis treatment isn't done immediately after a heart attack, many patients will need to undergo coronary angioplasty or coronary artery bypass graft surgery (CABG) later to improve blood supply to the heart muscle.
By following these simple steps you can reduce all of the risk factors for heart disease, heart attack and stroke.
Stop smoking
If you smoke, quit. If someone in your household smokes, encourage them to quit. We know it's tough. But it's tougher to recover from a heart attack or stroke or to live with chronic heart disease. Commit to quit. We're here to help if you need it
Choose good nutrition
A healthy diet is one of the best weapons you have to fight cardiovascular disease. The food you eat (and the amount) can affect other controllable risk factors: cholesterol, blood pressure, diabetes and overweight. Choose nutrient-rich foods — which have vitamins, minerals, fiber and other nutrients but are lower in calories — over nutrient-poor foods. A diet rich in vegetables, fruits, whole-grain and high-fiber foods, fish, lean protein and fat-free or low-fat dairy products is the key. And to maintain a healthy weight, coordinate your diet with your physical activity level so you're using up as many calories as you take in.
Reduce blood cholesterol
Fat lodged in your arteries is a disaster waiting to happen. Sooner or later it could trigger a heart attack or stroke. You've got to reduce your intake of saturated fat, trans fat and cholesterol and get moving. If diet and physical activity alone don't get those numbers down, then medication may be the key. Take it just like the doctor orders. Here's the lowdown on where those numbers need to be:
Total Cholesterol: Less than 200 mg/dL
LDL (bad) Cholesterol:
        If you're at low risk for heart disease: Less than 160 mg/dL
        If you're at intermediate risk for heart disease: Less than 130 mg/dL
        If you're at high risk for heart disease (including those with existing heart disease 
        or diabetes): Less than 100mg/dL
HDL (good) Cholesterol: 40 mg/dL or higher for men and 50 mg/dL or higher for women
    Triglycerides: Less than 150 mg/dL
Lower high blood pressure
It's the single largest risk factor for stroke. Stroke is the No. 4 killer and one of the leading causes of disability in the United States. Stroke recovery is difficult at best and you could be disabled for life. Shake that salt habit, take your medications as recommended by your doctor and get moving. Those numbers need to get down and stay down. Your goal is less than 120/80 mmHg
Be physically active every day
Research has shown that getting at least 30 minutes of physical activity on 5 or more days of the week can help lower blood pressure, lower cholesterol and keep your weight at a healthy level. But something IS better than nothing. If you're doing nothing now, start out slow. Even 10 minutes at a time may offer some health benefits. Studies show that people who have achieved even a moderate level of fitness are much less likely to die early than those with a low fitness level
Aim for a healthy weight
Obesity is an epidemic in America, not only for adults but also for children. An epidemic is when a health problem is out of control and many people are affected by it. Fad diets and supplements are not the answer. Good nutrition, controlling calorie intake and physical activity are the only way to maintain a healthy weight. Obesity places you at risk for high cholesterol, high blood pressure and insulin resistance, a precursor of type 2 diabetes — the very factors that heighten your risk of cardiovascular disease. Your Body Mass Index (BMI) can help tell you if your weight is healthy. 
Manage diabetes
Cardiovascular disease is the leading cause of diabetes-related death. People with diabetes are two to four times more likely to develop cardiovascular disease due to a variety of risk factors, including high blood pressure, high cholesterol, smoking, obesity and lack of physical activity.
Reduce stress
Some scientists have noted a relationship between coronary heart disease risk and stress in a person's life that may affect the risk factors for heart disease and stroke. For example, people under stress may overeat, start smoking or smoke more than they otherwise would. Research has even shown that stress reaction in young adults predicts middle-age blood pressure risk.
 Limit alcohol
Drinking too much alcohol can raise blood pressure and lead to heart failure or stroke. It can contribute to high triglycerides, produce irregular heartbeats and affect cancer and other diseases. It contributes to obesity, alcoholism, suicide and accidents. The risk of heart disease in people who drink moderate amounts of alcohol (an average of one drink for women or two drinks for men per day) is lower than in nondrinkers. However, it's not recommended that nondrinkers start using alcohol or that drinkers increase the amount they drink