Heart attacks and related conditions are the number one killer of patients in the US and Canada each year with more than a million Americans deaths per year. It is also known as a myocardial infarction or an acute MI and results in permanent, irreversible damage to the heart muscle because of blockage of the coronary arteries. The coronary arteries are the arteries that provide oxygen and blood to the heart muscle. When they become blocked with cholesterol plaques, they are at higher risk of thrombus or blood clots and tissue death. The heart muscle does not often have duplication of arteries to the same heart area so that blockage means heart death. The amount of heart muscle damage depends on where the thrombus occurs and how many arteries are affected.
The coronary arteries collect fat, cholesterol, triglycerides and calcium, which leads to a hard plaque blocking the artery in a concentric way. When they become severely narrowed, the clots are more likely to occur, especially if the plaque ruptures and triggers platelet aggregation. The circulation is cut off by the blockage and heart muscle begins to die. You can also have relatively normal coronary arteries but have coronary spasm that effectively blocks off the circulation to the heart muscle.
Heart attack symptoms are variable depending on the person. Diabetics may have few or no heart attack symptoms. Usual symptoms include pressure in the chest that radiates to the back, jaw or neck, the feeling that someone is sitting on your chest, pain that feels like indigestion or heartburn, nausea, vomiting, sweating or dizziness. Anxiety and weakness can be symptoms some people experience. If the symptoms last longer than a half hour, you need to seek medical attention. If you have nitro-glycerine tablets and if three tablets do not take care of the pain, call 911.
If you are prompt about getting medical attention, you have the chance of having an angioplasty with stent placement. This can save heart muscle. You can also have clot buster medication that will also open up the vessel and can save heart damage to the muscle. You need to be treated within one to two hours for best treatment of heart attack.
Doctors can do many different tests to see whether or not there is a heart attack going on. The first test you want to have done is an ECG or EKG. This is an electrocardiogram that looks at damage or stress on the heart's electrical activity. You can repeat the ECG to look for progression of the heart attack. The other good test is a blood CPK and CPK-MB band test. CPK-MB is released when the heart muscle is damaged and can be checked serially to check for ongoing heart damage. It isn't something that shows up right away, however, so you need to use the ECG to best take care of the heart attack before the CPK-MB shows up as too high. The LDH level also defines heart damage and is done in a serial fashion. A heart catheterization can be done soon after symptoms and signs occur that also serve the dual purpose of opening up the arteries via angioplasty.
Doctors are prompt in treating heart attacks. Aspirin is given at the scene or in the ambulance. TPA or other clot busters can be given as soon as the diagnosis of heart attack is made. Clot busters are followed by giving Coumadin in order to keep the blood thin until the heart attack heals. Later, aspirin or Plavix, an antiplatelet drug is used to prevent further thromboses in the coronary arteries.
The cardiac catheterization laboratory is an important place when it comes to a heart attack It can assess how much damage is being done and can crack open areas of plaque. Thrombi can be removed and other areas of the heart at risk can be treated at the same time. In some cases, it can indicate that an emergency bypass surgery is necessary. All blockages of the heart can be treated using a heart bypass surgery.
Further heart attacks can be prevented by taking cholesterol-lowering medication, lowering the blood pressure and preventing clot formation with anti-platelet medications. Sometimes anti-arrhythmic medication is used to prevent common arrhythmias that can occur after a person has a heart attack.