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HEART ATTACK

What is a heart attack?

A heart attack, also known as myocardial infarction, is when the blood flow to the heart has stopped for a long enough period of time that part of the heart is either damaged or dead.

What causes a heart attack?

The heart’s arteries are responsible for bringing blood and oxygen into various chambers of the heart. The heart needs a constant supply of both to be healthy. The result of a blockage or a blood clot in one of these arteries is a heart attack. When the heart does not receive enough oxygen or blood it becomes damaged and eventually dies. Blockages to the heart are most commonly caused by a build-up of plaque. This hard substance, made up mostly of cholesterol, calcium and proteins, sticks to the walls of the arteries. This hardening of the arteries via plaque is also known as atherosclerosis.

Heart attacks occur in one of two ways:

  •  when the atherosclerosis has almost completely blocks the flow of oxygen and blood into the heart ;
  •  when platelets in the blood surround a lone piece of plaque causing a clot to form in the artery.

The severity of the heart attack depends on which chamber was being supplied by the clogged artery and how much time has passed between the attack and treatment. Unfortunately heart attacks happen to people of all ages at any time of the day or night. You could be in the middle of a workout or sleeping at night. Because heart attacks do not discriminate it is important to be aware of the risk factors that may lead to one. Some factors may be controlled and some cannot be controlled.

Controllable factors include:

  •  Your diet. The foods you put in your body have a direct impact on your heart. Foods that are high in fiber, low in sugar and salt and lean proteins are best. Foods that are high in fat and sugar lead to coronary artery disease (when plaque build-up causes your heart’s arteries to narrow).
  •  Maintaining healthy cholesterol and blood pressure levels and a healthy BMI (the ratio of your body’s fat to muscle). All of these may be controlled through exercise, diet and in extreme cases medication.
  •  Not smoking and limiting the amount of alcohol consumed.
  •  Doing 30 minutes of exercise each day.
  •  Finding healthy ways to deal with stress.

Uncontrollable factors include:

  •  Age and gender—older people have a higher incidence of heart disease. Pre-menopausal women are at a slightly decreased risk of heart disease than men and women who are post-menopausal.
  •  Genetics—if your parents had coronary artery disease your predisposition is higher than someone who has no family history of heart disease.
  •  Race—studies have shown that some races are at a higher risk for heart disease including African Americans and Mexican Americans.

Uncontrollable factors include:

The most common symptom of a heart attack is chest pain or pressure. Also known as angina, this pain may be felt only in the chest or it may be felt in the areas surrounding the chest – like your arm or neck. Angina may be as mild as a case of indigestion or as severe as a heavy weight sitting on your chest. This pain may go away and come back. Also, not everyone who has a heart attack has chest pain. In fact, women and the elderly are less likely to have chest pain. Other symptoms may include:

  •  Dizziness or light-headedness
  •  Nauseas and/or vomiting
  •  Heart palpitations
  •  Feeling short of breath
  •  Coughing
  •  Excessive sweating

How is a heart attack diagnosed?

Exempla Rocky Mountain Cardiovascular Associates identifies and diagnoses heart attack patients with some of the following diagnostic tests:

  •  EKG – this test uses electrodes to look at the heart’s electrical activity.
  •  Coronary Angiography – this test uses dye and X-rays to determine how blood is flowing through the heart.
  •  Blood tests – including a troponin blood test. This test looks for the presence of proteins, called troponin T or troponin I, which are released into the body when the heart is damaged or during a heart attack.

How is a heart attack treated?

Exempla Rocky Mountain Cardiovascular Associates offers various treatments and procedures for heart attack patients including:

  • Angioplasty : this emergency treatment should be performed within 12 hours of a heart attack. This treatment works to open up the clogged artery.
  • Stent : a stent is a small piece of tubing that is placed into the artery preventing it from closing up again.

Smoking is a major risk for several diseases including heart disease, stroke, and several cancers. Even low-tar cigarettes and light smoking can increase the risk of heart disease substantially. There are now several alternative approaches to helping people stop smoking. These include nicotine-replacement patches and gum as well as oral medication.

If you are able to stop smoking, your risk of a heart attack or stroke decreases within a few weeks. The risk goes down to that of a nonsmoker within about 2 years. In addition, a lot of patients comment that they feel healthier and have more energy after they've stopped smoking.

Hypothyroidism can increase blood cholesterol levels and that contributes to heart disease; however, if the hypothyroidism is being treated with a thyroid hormone, then the cholesterol returns to normal.

Birth control pills can cause a small increase in the risk of thrombosis and heart attack. That occurs mainly in people who have been on the pill for more than 10 years and who smoke cigarettes.

There is an increase in the risk of heart attack if a first-degree relative (parent or sibling) has had a heart attack or stroke. That is mainly seen when the relative has had a heart attack before the age of 45 if they are male, 55 if they are female. Obviously, you cannot change your family history, but a positive history should suggest the need to improve all the other risk factors like stopping smoking and decreasing cholesterol.

Heart disease is potentially reversible by attending to risk factors like cholesterol, blood pressure, and smoking. Several studies have shown, for example, that aggressive lowering of blood cholesterol with LDL levels below 100 can open up blocked coronary arteries at least partially. Perhaps I should explain that LDL cholesterol is the "bad" cholesterol component.

I would suggest a diet that is balanced among all the main food groups, with fat content making up no more than 30 percent of calories and most of that fat being unsaturated. I would not advise patients to eat a diet that is restricted in carbohydrates or fruits and vegetables, because this may adversely affect vitamin intake and blood cholesterol.

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