Heart Attack (Acute Myocardial Infarction)

What is a Heart Attack (also called an Acute Myocardial Infarction or MI)?

A heart attack is a complete blockage of blood flow in a coronary artery. The blockage prevents oxygen-rich blood from reaching part of the heart muscle. Usually a blood clot or piece of plaque (fatty deposits called atherosclerosis) causes the blockage in the heart artery. When blood cannot reach this part of the heart muscle, the muscle may become permanently damaged. The faster you get to a hospital for treatment, the less damage to your heart. If you wait too long, the condition can be fatal.

More than one million Americans have a heart attack every year. Better treatment options and community awareness have decreased mortality rates over the years. Yet, lack of recognition or a disregard for the warning signs of a heart attack is still a major cause of death.

In the event of a heart attack, every second counts.

What are the warning signs and symptoms of a heart attack?

The warning signs and symptoms of a heart attack are gender-specific, meaning men and women have very different feelings and experiences when a heart attack is occurring. These warning signs are described below:

Men typically experience the following common warning signs of a heart attack:

• Moderate to severe chest pain
• Dizziness
• Shortness of breath
• Nausea
• Radiating pain in the arms and chest

Women may have symptoms that differ from men. While chest pain is often a key warning sign of a heart attack, some women who have a heart attack do not experience chest pain. A woman's pain, may be in the back, arm, neck, shoulder, and/or throat. Also, women will typically have more "non-pain" symptoms than men. These include vomiting, nausea, fatigue and shortness of breath.

It is also surprisingly common for people to experience no symptoms at all. This is especially true of diabetics and those over the age of 75. We recommend that these individuals visit their family physician and/or cardiologist on a regular basis to continually monitor their health.

Do not ignore the warning signs of a heart attack. If you or someone you know is experiencing any of the above symptoms, immediately call 9-1-1 because it is quite possibly signaling a heart attack.

How is a heart attack evaluated?

A heart attack is evaluated using several different methods, but most often your doctor will order a simple test called an electrocardiogram (EKG). This test monitors the electrical activity within the heart and can aid your doctor in determining if your condition is angina or if you are actually having a heart attack. The doctor may also order blood tests that can determine if there is damage to the heart muscle.

Other possible tests your doctor may order to evaluate a possible heart attack are:

• Laboratory testing, i.e. heart enzymes
• EKG
• Stress Test
• Nuclear Test
• Echocardiogram
• Coronary (heart) Angiography

If your doctor determines that you are having a heart attack (or have already had one), he or she will quickly stabilize the condition in several ways.

What are the treatment options for a heart attack?

If you are experiencing the symptoms of a heart attack, e.g. chest pain, shortness of breath, etc., call 9-1-1 immediately. Delaying your arrival at the hospital can increase your risk of dying. Do not drive yourself or someone else having a heart attack.

Take one regular strength (preferably non-coated) aspirin or 4 baby aspirin, and chew the aspirin(s) to increase absorption into your system. The aspirin works to thin the blood, allowing more oxygen-rich blood to get through the narrowed artery to your heart. Aspirin has proven to reduce fatality by about 25% in heart attack victims.

If someone you know is having a heart attack, call 9-1-1 and have them chew and swallow an aspirin. If they are unconscious, first call 9-1-1, and then begin mouth-to-mouth resuscitation (CPR) to provide oxygen to the brain, heart, and the rest of the body. If you are unfamiliar with how to perform CPR, the emergency personnel on the phone line can assist you until help arrives.

Upon arrival to the hospital, if you have not already taken an aspirin, a doctor may instruct you to chew an aspirin right then. An electrocardiogram (EKG) will be done immediately to determine if a heart attack is occurring, or has already happened. If the diagnosis is a heart attack, the doctor will promptly begin treatment to open the blockage, and get much needed oxygen-rich blood to your heart.

Procedures

There are a variety of procedures that can treat and stabilize the lining of the coronary arteries. These procedures include:

• Acute Angioplasty
• Balloon Angioplasty
• Coronary Stenting
• Coronary Artery Bypass Surgery
• Thrombolytic Therapy

Medications

There are several medications your doctor can prescribe if you are having a heart attack. Here are some possibilities:

• Anticoagulants (blood thinners) such as aspirin
• Nitroglycerin which dilate the blood vessels to increase blood flow
• Adrenergic Receptive Blockers (Beta blockers) help regulate the heart beat and decrease oxygen demand, lower B/P, protect against heart attack and heart failure
• Angiotensin Converting Enzyme (ACE) Inhibitors dilate blood vessels to increase blood flow, guard against arteriosclerosis (plaque in the arteries), help strengthen heart muscles, lower blood pressure (B/P)
• Calcium channel blockers decrease heart contractility and spasms, dilate arteries, help to treat high B/P and angina
• Statins lower cholesterol

Prevention

If you have been diagnosed with a heart attack, it is extremely important to make lifestyle changes that reduce the risk factors which have contributed to your heart disease. Making such changes can maintain, and in many cases, reverse the damage done to your heart. For more information about prevention of cardiovascular disease, please click here.

Changing your lifestyle to reduce your risk factors is one of the most important steps you can take to improve your overall cardiovascular condition.