Heart attack, heart attack or myocardial infarction is often a life-threatening and acute disease of the heart. It involves the death (infarction) of heart tissue or heart muscle (myocardium). The subsequent circulatory disturbance (ischemia) leads to the well-known myocardial infarction.
What is a heart attack?
Infographic on the anatomy and causes of cardiovascular diseases such as myocardial infarction. Click image to enlarge. Myocardial infarction refers to a disease of the heart that is life-threatening to humans. It is also colloquially referred to as a heart attack or myocardial infarction. In human medicine, the abbreviation AMI (so-called acute myocardial infarction) is used for heart attack. But what exactly is meant by a heart attack? Part of the heart muscle (called myocardium) dies due to the occlusion of one of the three coronary arteries. This happens due to a circulatory disturbance that occurs regularly over a period longer than 20 minutes. Most often, this occurs due to a blood clot that blocks one of the coronary vessels during a heart attack. The blood can now no longer circulate there. The result is an interruption in the supply of oxygen and nutrients to the heart. If it is not possible to reopen this occlusion of the heart muscle, the part of the heart muscle that should actually be supplied by this vessel dies.
Causes
But what are the causes of a heart attack? In industrialized countries, such a disease of the heart is becoming increasingly common. Related to Germany, about 250,000 people suffer a heart attack every year. A full 50 percent of these newly ill patients die within four weeks of suffering a heart attack. Various risk factors favor a disease of the heart muscle: for example, overweight, lack of exercise, but also the consumption of nicotine. Other age-independent factors may include: Diabetes mellitus (diabetes), high blood pressure, or a family history of heart disease (especially heart disease in close blood relatives). Another increasing risk factor is the level of stress. Sudden stress and/or extreme stress situations that result in a sharp fluctuation in blood pressure can trigger a heart attack. About 40 percent of all heart attacks are registered in the morning (in a period from 6 to 10 a.m.) and especially also on Mondays.
Symptoms, complaints, and signs
Characteristic of a heart attack are sudden onset of pain behind the sternum that rapidly increases in intensity and persists for a prolonged period of time. Often, the pain radiates to the left arm (rarely to the right), shoulder, upper abdomen, or lower jaw. In addition, there is typically a tightness in the chest, shortness of breath, and often dizziness, loss of consciousness, nausea, and vomiting. The patient is pale and cold sweaty, suffering from severe restlessness to the point of fear of death. The level of blood pressure does not allow any definite conclusion to be drawn about a heart attack: it can drop due to the restricted cardiac activity, but can also be elevated as a result of increased secretion of stress hormones. In women, a heart attack is often less obvious and is therefore often not recognized as such, or recognized too late. Chest pain is less common, with shortness of breath, a feeling of pressure in the chest area, nausea and vomiting being the main symptoms. Patients often complain of pain in the upper abdomen, which is often misinterpreted as stomach problems. A fainting spell without further symptoms can also conceal a heart attack. In both sexes, shortness of breath, chest pain, and a feeling of tightness in the chest occurring under exertion for some time before the infarction may indicate the onset of a circulatory disorder of the heart.
Course
Often, a heart attack is based on a narrowing of the coronary vessels, which is called arteriosclerosis. If such a narrowing is blocked by a blood clot, all subsequent heart muscle areas are no longer supplied with blood and oxygen. How do I recognize the occurrence of a heart attack? In most cases, the onset of a heart attack is manifested by chest pain of varying intensity and quality, depending on how the ill person feels it. The feeling of a strong pressure behind the breastbone or a feeling of tightness (anxiety) in the entire area of the chest are typical signs of a heart attack.The pain felt usually also affects the left arm, shoulder, neck, upper abdomen or back. In most cases, this pain lasts for more than 20 minutes. Accompanying symptoms of a heart attack are not infrequently sweating, nausea or even vomiting. The occurrence of dangerous cardiac arrhythmias in the so-called acute phase of a heart attack makes even minor infarctions life-threatening. Particularly in women, other symptoms of a heart attack occur: shortness of breath, general weakness, stomach upset and physical exhaustion.
Complications
Due to myocardial infarction, very severe and life-threatening symptoms and complications occur, which not infrequently lead to the death of the patient. As a rule, even after treatment of the heart attack, the life expectancy of the affected person is greatly reduced. The further complaints depend strongly on how long after the infarction the treatment takes place. With early treatment, the risk of irreversible secondary damage is minimized. During a heart attack, the affected person suffers from severe chest pain and feelings of anxiety. Sweating and panic attacks occur. It is not uncommon for sufferers to vomit and lose consciousness. This can lead to serious injuries as a result of a fall. As the infarction progresses, damage to the brain occurs and tissue throughout the body dies. As a result, regions of the brain can be irreversibly damaged and organs can die. The damage to the brain then leads to restrictions in the patient’s thinking and actions and, if necessary, to restricted movement. The treatment is carried out with the help of medication or by means of a surgical intervention. It is not uncommon, however, for the heart attack to result in the death of the patient if treatment cannot be initiated early enough.
When should you go to the doctor?
Because a heart attack is a medical emergency, emergency medical services should be alerted immediately when it occurs. The affected person is in acute danger of death, which requires immediate action. Without rapid and professional medical care, the patient will die within a short time. Until the emergency physician arrives, the instructions of the rescue service must be followed to ensure the patient’s survival. In particular, adequate ventilation must be ensured to keep consequential damage to a minimum. However, it is advisable to consult a doctor as soon as there are warning signs of a heart attack. If the patient suffers from palpitations, high blood pressure or circulatory problems over a longer period of time, these should be examined and checked in good time. If there is pain in the chest or a pulling sensation in the left upper arm, medical clarification of the symptoms should be sought. If the affected person feels unwell, complains of a general feeling of illness or persistent weakness, it is advisable to consult a doctor. A check-up is recommended if there is a drop in the usual level of performance, a noticeable decline in physical capabilities or a feeling of burnout. If sleep disturbances, concentration problems or disturbances of attention occur, a doctor should be consulted. A feeling of pressure in the chest is considered unusual and should be investigated.
Treatment and therapy
Sharp or tearing pain is described by most patients during a heart attack. However, various treatment options are also available after a heart attack, all of which are (or should be) aimed at relieving the damaged heart muscle, but equally at preventing further expansion of the infarct and restoring blood flow. Of course, the following treatment methods can also be combined with each other to increase the results:
1. blood thinning therapy (often aspirin and heparin are used for this purpose). 2. beta-blockers, which lead to direct relief of the heart muscle. 3. drugs to lower blood pressure, painkillers, sedatives. 4. opening of the vessel occluded by the heart attack can be done by the so-called lysis therapy or by balloon dilatation with the help of cardiac catheterization.
Outlook and prognosis
The prognosis of a heart attack is tied to the timing of medical care. In most cases, the patient must receive immediate emergency as well as intensive medical care to ensure survival.The risk of a fatal outcome is very high in the case of a heart attack. With increasing age, the mortality rate increases immensely. Patients over the age of 75 are three times more likely to die than the average adult. In addition, a heart attack usually leads to lifelong impairments as well as health complaints. In addition to symptoms of paralysis, functional disorders and psychological stress, the patient may lose his or her job and experience severe restrictions in the way he or she leads his or her life. The general way of life must be changed and adapted to the patient’s circumstances. Medical care in the first two hours after the heart attack is crucial for the further course. If the ventricular fibrillation can be stopped and the cardiac arrhythmia corrected, the patient has a good long-term prognosis. If heart failure develops or the coronary vessels are permanently affected, the prognosis worsens. Within two years after a heart attack, approximately 5-10% of patients die from sudden cardiac death. With a healthy lifestyle, optimal diet and avoidance of stress, the outlook improves.
Prevention
How to reduce or prevent the risk of heart attack? The risk of heart attack can be significantly reduced with the help of the following points:
1. one should (have) one’s blood pressure measured regularly. In particular, adults over the age of 40 should have their blood pressure checked at least once a year. Too high a blood pressure puts a strain on the heart. Values below 130 over 80 are considered good. 2. one should eat a healthy diet. A conscious and healthy diet reduces the risk of a heart attack. Saturated fatty acids, especially in animal products such as butter, beans, pork, etc., should be avoided, because they increase the cholesterol level in the blood. 3. one should do sufficient sport. In particular, light endurance sports such as Nordic walking, cycling or swimming reduce the risk of heart attack. 4. if you are overweight, you should reduce your excess weight. Already 10 kilos too much have a negative effect on our health, both the blood pressure and the blood fat values increase. 5. one should give itself a smoking prohibition. Already six cigarettes per day double the risk of a heart attack, so fingers away from it! 6. you should also avoid stress as much as possible. Basically, the body withstands stressful situations quite well, nevertheless, one should not exaggerate it here, because these can lead to high blood pressure.
Aftercare
The most important thing after a heart attack is to avoid further attacks. The patient must be aware that the underlying condition that led to the heart attack is still present. The main cause is usually arteriosclerosis. However, this affects not only the heart but the vessels of the entire body. The elimination of risk factors is therefore one of the most important goals in the aftercare of a heart attack. In most cases, a fundamental change in lifestyle is necessary. The fact that smoking may have to be given up is at the top of the list. Smoking also causes constriction of the already strained vessels and is considered the number one risk factor. Sports and exercise ensure that the body has a better metabolism. Last but not least, a balanced and healthy diet is important after a heart attack. From a medical point of view, blood values should be kept in mind, especially cholesterol levels should be checked regularly. If high blood pressure has also been diagnosed, it should be appropriately controlled with medication, otherwise it can lead to further vascular damage. Diabetes controls should also be carried out by the attending physician. Excluding the risk factors minimizes the risk of another heart attack, but the patient must always be aware that the underlying disease persists and the aforementioned measures must be consistently incorporated into his or her daily life.
Here’s what you can do yourself
An acute heart attack is a life-threatening situation in which the emergency physician must be called immediately. However, patients can help prevent it from happening at all and consult a doctor at the first early warning signs. A heart attack almost always announces itself. Those affected often have chest pains that are described as oppressive and feel a strong pressure behind the breastbone.At the latest as soon as the pain begins to radiate into the left arm or shoulder, a doctor should be consulted. Women often experience somewhat different symptoms. The chest pain is then accompanied by shortness of breath, stomach upset and a feeling of general exhaustion. Heart attack is still a male-dominated disease, which is why many doctors underestimate the risk in women. Female patients who observe the described symptoms in themselves should therefore explicitly point out the possibility of a heart attack. This is especially true if the person belongs to a risk group or if other family members have already suffered a heart attack. Risks that significantly increase the risk of suffering a heart attack include an unhealthy lifestyle, in particular obesity, too little physical exercise, excessive consumption of animal products (meat, sausages, fatty cheese, butter, cream), and regular high alcohol and nicotine consumption. Avoiding these risk factors is the best self-help measure against heart attacks. Those who suffer from high blood pressure should also have it checked regularly by a doctor.