Heart Attack (Myocardial Infarction)
The classic heart attack symptoms are sudden chest pain and tightness, and shortness of breath. It is important to keep in mind that symptoms can vary. In particular, in women the symptoms can vary and can begin weeks before the actual heart attack. Women commonly report shortness of breath, nausea, fatigue, and body ache.
A more complete list of heart attack symptoms includes:
- Pressure and tightness in the chest
- Shortness of breath
- Upper body pain (e.g. arm, shoulder, jaw)
- Cold sweats
- Feeling lightheaded or dizzy
- Difficulty sleeping
- Nausea or discomfort in the abdomen
- Feelings like acid indigestion
The initial tests to diagnose a heart attack are performed in the emergency room. Once a positive diagnosis is made, follow-up tests allow further evaluation of the heart.
- Electrocardiogram. An electrocardiogram (EKG) is a noninvasive test that measures the electrical activity of the heart. Abnormalities in the resulting data reveal a past or ongoing heart attack.
- Blood tests. Elevated levels of specific cardiac enzymes known as troponins may be indicative of muscle damage from a heart attack.
- Imaging. The size, detailed anatomy, and condition of the heart are visualized using techniques such as chest X-ray, computed tomography (CT) scan. and cardiac magnetic resonance imaging (MRI). An echocardiogram also produces an image of the heart by recording and processing sound waves that bounce back from the heart.
- Stress test. Following a heart attack, this test evaluates the heart rate and rhythm under stress either in the form of exercise (treadmill or stationary bicycle) or induced with medication.
- Angiography. This procedure uses X-ray imaging to visualize the flow of a contrast dye that is injected into the arteries, and detects blockages.
The following lifestyle and medical interventions are used to treat a heart attack:
- Lifestyle changes. Individuals who suffer a heart attack can improve their cardiovascular health and prevent future heart attacks by exercising regularly; maintaining a healthy weight ; and sticking to a nutritious diet of foods that are rich in fruits and vegetables, but low in cholesterol, fat, and salt. Avoiding tobacco and limiting stress also helps maintain healthy arteries.
- Medication. Aspirin and drugs like it minimize damage to the heart by preventing clot formation. Similarly, thrombolytic drugs dissolve existing clots, while blood thinners make the blood less sticky, hence less likely to clot. Beta blockers and angiotensin-converting enzyme (ACE) inhibitors reduce burden on the heart by lowering blood pressure. Excessive chest pain is treated with pain relievers and nitroglycerine. Statin drugs that lower cholesterol can also enhance outcomes following a heart attack.
- Surgery. Surgical procedures that treat the cause of a heart attack include angioplasty and coronary bypass surgery. During an angioplasty. an existing plaque is compressed outward by inflating a balloon at the site. Then, a mesh tube (stent) is installed to prevent future plaque buildup at that site. Coronary artery bypass grafting restores blood flow to the heart by redirecting an existing upstream vein passed the blocked site.
Individuals with a high risk of having a heart attack may be advised to take aspirin and other blood-thinning medications. Blood pressure and cholesterol lowering drugs may also be prescribed to help prevent plaque formation. At-home measures for maintaining healthy cardiovascular health include regular exercise, a healthy body weight, and a diet low in cholesterol, fat and salt. At-risk individuals should also avoid smoking, limit alcohol, and eliminate high-stress activities.
- “About Heart Attacks”. American Heart Association. Jun 2014. Retrieved Jun 24, 2014. http://www.heart.org/HEARTORG/Conditions/HeartAttack/AboutHeartAttacks/About-Heart-Attacks_UCM_002038_Article.jsp.
- "Heart attack ". Mayo Clinic. Mayo Foundation for Medical Education and Research. May 2014. Retrieved Jun 24, 2014. http://www.mayoclinic.org/diseases-conditions/heart-attack/basics/definition/con-20019520.
- “What is a Heart Attack”. National Heart, Lung, and Blood Institute. NIH. Dec 2013. Retrieved Jun 24, 2014 https://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/diagnosis.html.
- “Heart Disease Facts”. Centers for Disease Control. Feb 2014. Retrieved Jun 24, 2014. http://www.nlm.nih.gov/medlineplus/ency/article/007089.htm.
- Heidt, T, Sager, H.B. Courties, G. Dutta, P. Iwamoto, Y. Zaltsman, A. von Zur Muhlen, C. Bode, C. Fricchione, G.L. Denninger, J. Lin, C.P. Vinegoni, C. Libby, P. Swirski, F.K. Weissleder, R. Nahrendorf, M. “Chronic variable stress activates hematopoietic stem cells.” Nat Med. Published online 22 June 2014.
By Tina Shahian, PhD
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