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Heart Attack

Vivian Oputa
Of recent, several young seemingly healthy individuals have died suddenly in their prime. The importance of regular health checks can not be overemphasized. The rates of heart attack over the last 20 years have been increasing for women aged 35 to 54. It makes sense for women to pay attention to their heart health.

A heart attack, also known as myocardial infarction, occurs when there is an interruption in the blood supply to the muscle of the heart leading to injury and damage of the affected tissue. It commonly occurs as a result of a blood clot in the coronary arteries that supply blood to the heart musculature.

In the past, a heart attack was often fatal but with improved treatments and an increased awareness of the signs and symptoms, the majority of people who have had heart attacks survive.

Signs & Symptoms
Heart attacks have varied signs and symptoms and are often not as dramatic as what you’ve seen in the movies. Women, older adults and diabetics tend to have less pronounced symptoms and some people have no symptoms at all.

Warning Signs and Symptoms include:
? Pressure, fullness or a crushing pain in the middle of the chest lasting a few minutes which may radiate to the arms, back, jaw and teeth
? Frequent episodes of chest pain
? Prolonged upper abdominal pain
? Shortness of breath
? Sweating
? Lightheadedness
? Impending sense of doom
? Nausea and vomiting
? Fainting

A heart attack can occur at any time. Some attacks strike suddenly while others present with warning signs hours, days or even weeks in advance. The earliest predictor of a heart attack may be recurrent chest pain triggered by exertion and relieved by rest. This pain is known as Angina. Angina is caused by temporary, inadequate blood flow to the heart and is known as cardiac ischaemia.

The medical term for a heart attack is Myocardial Infarction which literally means heart muscle death (as a result of oxygen lack). Inadequate blood supply leads to the injury of heart muscle cells causing pain and pressure symptoms. It may also lead to irregular heart rhythms which could be fatal. If the blood flow is not restored, the muscle dies and scar tissue forms. If blood flow is restored in good time, heart damage may be limited or prevented.

Coronary artery disease is the major underlying cause of heart attacks. The coronary arteries which supply the heart with oxygen rich blood encircle the heart like a crown. A heart attack occurs when one or more of these vessels become blocked. Such blockages are usually caused by a blood clot formed as a result of years of cholesterol build-up which forms plaques that narrow the vessels known as atherosclerosis. When atherosclerosis develops in the heart, it is known as coronary artery disease.

On rare occasions, a clot inside a diseased heart is dislodged and travels to a healthy or narrowed coronary artery blocking it and causing a heart attack. Another uncommon cause of a heart attack is when there is a spasm of the coronary artery leading to the occlusion of blood supply to heart muscle. Drugs such as Cocaine can cause life threatening spasms.

Risk Factors
These factors know as coronary risk factors increase the chances of having a heart attack as they contribute to the build-up of atherosclerotic plaques in the heart and all over the body. These include:
? Smoking and exposure to second hand smoke damages the arterial walls encourages cholesterol deposits and blood clot formation

? High Blood Pressure over time damages blood vessels thus accelerating atherosclerosis

? High Cholesterol or Triglyceride levels contribute greatly to the formation of atherosclerotic plaques. There is good cholesterol known as high density lipoprotein (HDL) which helps the body clear excess “bad” or low-density lipoprotein (LDL) cholesterol thus lowering the risk of heart attacks

? Obesity is a major risk factor as a high percentage of body fat is associated with high cholesterol levels, high blood pressure and diabetes

? Sedentary Lifestyle or a lack of physical activity contributes to obesity and high cholesterol levels. Regular aerobic exercise improves cardiovascular fitness reducing the risk of heart attack

? Diabetes speeds up atherosclerosis and negatively affects blood cholesterol levels

? Stress and anger can raise blood pressure, encourage smoking and poor eating habits

? Alcohol consumed in moderation helps raise good HDL cholesterol having a protective effect. Conversely, excessive alcohol consumption can raise triglycerides and blood pressure increasing the risk

?  A Family History may indicate a high risk

? Elevated blood Homocysteine, C-reactive protein and fibrinogen levels have recently been found to indicate a high risk of developing a heart attack.

Immediate help should be sought once a heart attack is suspected. Certain tests are carried out to determine if a heart attack has occurred. These include an Electrocardiogram (ECG) and a blood test to check for cardiac enzymes that leak into the blood stream when the heart has been damaged. Other tests which may be carried out include a chest X-ray, Nuclear Scan, Echocardiogram and Angiogram

Complications
Complications are related to the extent of damage during a heart attack. This damage can lead to Arrhythmias or abnormal heart rhythms which may be fatal, Heart failure when there is extensive damage to the heart musculature compromising its ability to pump blood around the body, Heart rupture when damaged muscle is so weak it ruptures leading to fatal bleeding and Valve problems as a result of damage which may lead to life threatening leakage problems.

Treatment
Every minute counts during a heart attack. In the emergency room, the doctor may give Aspirin which inhibits blood clotting to maintain blood flow through a narrowed artery. Restoration of blood flow is important to prevent extensive damage. Thrombolytics are given to dissolve clots and re-establish blood flow.

Other drugs include blood thinners, pain relievers, Nitroglycerin, beta blockers and cholesterol lowering drugs. Some cases require procedures such as Coronary angioplasty and Coronary artery bypass surgery.


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