The Key To Surviving A Heart Attack.
The key to surviving a heart attack is to recognize that you might be having one, then getting medical help as rapidly as possible.
An acute heart attack (also called a myocardial infarction, or MI),is caused by the sudden blockage of a coronary artery, which causes at least some of the heart muscle supplied by that artery to die. Because many of the short-term and long-term consequences of an MI are determined by how much heart muscle is damaged, once the artery becomes blocked (that is, once an MI begins), it is critical to receive medical care immediately.
What this means, of course, is that if you are having a heart attack, trying to ride it out at home for a while - hoping the symptoms will turn out to be indigestion or a muscle strain - can produce a delay that may cause devastating and permanent consequences.
Anyone who has coronary artery disease (CAD), or who (by virtue of their cardiac risk factors) might have CAD, should know what symptoms to look for.
What Heart Attack Symptoms Should Tip You Off?
The classic symptom of an MI is an intense, sometimes squeezing, pressure or pain in or around the chest, often radiating to the jaw or left arm, and sometimes accompanied by profuse sweating, or a nearly overwhelming sense of fear or impending doom.
Unfortunately, you can't count on having this classic pattern. Sometimes the discomfort may be relatively mild, and may be felt in the back, abdomen, shoulders, or either or both arms. Unexplained sudden shortness of breath, nausea and vomiting, or merely a feeling of heartburn, may be the only symptoms. These "atypical" symptoms may not make you think of a heart problem, and may keep you from seeking medical help. Women appear to experience "atypical" symptoms more often than men.
This is why anyone with one or more risk factors for CAD needs to pay close attention to any sudden, unusual or unexplained symptoms involving the upper half of the body. This warning would apply, for instance, to any middle-aged or older person who is overweight, relatively sedentary, a smoker, or who has diabetes, high cholesterol, high blood pressure, or a family history of heart disease. For such people (and there are a lot of us), any unexplained symptoms that even might be due to a heart problem should be regarded very seriously.
What Should You Do If You Think You Might Be Having A Heart Attack?
If you experience any symptoms suggestive of heart attack, especially if you know you have risk factors for CAD, you should get medical help as soon as possible. Generally, the safest thing to do is to call 911 and have the paramedics come to you. Once you are in the care of paramedics, your risk of dying from a cardiac arrest is greatly diminished.
If you live in an area where paramedics are not readily available, then have someone drive you to a hospital. But whatever you do, get help right away, because if you are having a heart attack, every minute is vitally important. And while you're waiting for the paramedics, or while being driven to the hospital, take an aspirin.
What Should Happen At the Hospital?
When you arrive at the hospital, the medical personnel should take your symptoms very seriously. This is not one of those times when you should expect to sit around in the emergency department for two hours, waiting for a sullen, gum-snapping clerk to take your insurance information. Instead, you should expect to be immediately placed into a treatment room, and several individuals should simultaneously hook you up to a cardiac monitor, start an I.V., give you some oxygen, get an electrocardiogram (ECG), draw some blood to test, and begin asking you questions about your symptoms and examining your heart.
To make sure you elicit the correct response from medical personnel, you've got to say the magic words as soon as you arrive. The magic words are, "I think I'm having a heart attack."
Don't tell them you're here because your shoulder hurts, or you think you have heartburn, or that you have any of the other alternate possibilities you've imagined (and hoped) for yourself. Your attitude should not be, "It's probably nothing, so I won't make a big deal. Let them figure out if it's my heart." If that's your approach, you'll get the sullen, gum-snapping treatment, precious minutes (or even hours) will be wasted, and you'll pay a heavy price.
Once you have recognized the symptoms of a possible heart attack, gotten yourself to a hospital, and alerted the medical personnel that you may have a heart problem, you've done your job.
The next step is up to the doctors. And it's important for you to know, in general terms, what the doctors ought to be doing for you when are having an acute heart attack. You can read more about that here:
Friday, December 4, 2009
How to Survive a Heart Attack
There are two good reasons you should know the basic information about how to survive a heart attack. First, odds are very high that either you or someone you love will suffer from a heart attack during your lifetime. And second, whether you (or your loved one) survive that heart attack may depend on what you and your doctors do about it during the first few hours -- and over the long term.
What Is a Heart Attack?
A heart attack, also called a myocardial infarction (MI), is the most severe form of acute coronary syndrome (ACS). MIs, like all forms of ACS, are usually triggered by the rupture of a plaque within a coronary artery. This plaque rupture causes a blood clot to form, leading to blockage of the artery. The portion of the heart muscle being supplied by the blocked artery then begins to die. It's the death of heart muscle that defines an MI.
What Are the Consequences of a Heart Attack?
To a large degree, the outcome of an MI depends on how much of your heart muscle dies, which, in turn, is related to which of your coronary artery is blocked, and where in the artery the blockage occurs. (A blockage near the origin of an artery will affect more heart muscle than a blockage farther down the artery.)
If the heart muscle damage is severe, it is possible to develop acute heart failure during the MI itself, which is a very dangerous condition. If the amount of heart muscle damage is less severe but still significant, you can develop heart failure later on. So, taking steps to prevent heart failure after an MI, or aggressively treating heart failure should it develop, is an extremely important aspect to treating an MI.
An MI can also produce dangerous heart arrhythmias. During the acute MI itself, electrical instability occurs that may cause ventricular tachycardia (VT) and ventricular fibrillation (VF). Later, the scar tissue that results from the healing process can cause a permanent electrical instability. So, unfortunately, cardiac arrest and sudden death are risks both during an acute MI and after full recovery from an MI.
Why Are the First Few Hours of a Heart Attack Critical?
For anyone having an MI, getting rapid medical attention is absolutely critical for two reasons:
•Most of the cardiac arrests seen with acute MIs occur within the first few hours. If the cardiac arrest happens after you have come under medical care, there is an excellent chance it can be successfully treated; otherwise the odds of surviving a cardiac arrest are very low.
•Both the short-term and the long-term consequences of an MI are largely determined by how much of your heart muscle dies. With rapid and aggressive medical treatment, the blocked artery can usually be opened quickly, thus preserving most of the heart muscle that is at risk of dying. If treatment is given within three or four hours, much of the permanent muscle damage can be avoided. But if treatment is delayed beyond five or six hours, the amount of heart muscle that can be saved drops off significantly. After about 12 hours, the damage is usually irreversible.
Getting rapid and appropriate medical care requires that two things happen. First, it requires that you know the signs of a heart attack, and seek medical help the moment you think you might be having one. Second, it requires that the medical personnel who are caring for you do the right things, and do them quickly. The following articles will help you do what you need to do, and to get the care you need to get.
What Is a Heart Attack?
A heart attack, also called a myocardial infarction (MI), is the most severe form of acute coronary syndrome (ACS). MIs, like all forms of ACS, are usually triggered by the rupture of a plaque within a coronary artery. This plaque rupture causes a blood clot to form, leading to blockage of the artery. The portion of the heart muscle being supplied by the blocked artery then begins to die. It's the death of heart muscle that defines an MI.
What Are the Consequences of a Heart Attack?
To a large degree, the outcome of an MI depends on how much of your heart muscle dies, which, in turn, is related to which of your coronary artery is blocked, and where in the artery the blockage occurs. (A blockage near the origin of an artery will affect more heart muscle than a blockage farther down the artery.)
If the heart muscle damage is severe, it is possible to develop acute heart failure during the MI itself, which is a very dangerous condition. If the amount of heart muscle damage is less severe but still significant, you can develop heart failure later on. So, taking steps to prevent heart failure after an MI, or aggressively treating heart failure should it develop, is an extremely important aspect to treating an MI.
An MI can also produce dangerous heart arrhythmias. During the acute MI itself, electrical instability occurs that may cause ventricular tachycardia (VT) and ventricular fibrillation (VF). Later, the scar tissue that results from the healing process can cause a permanent electrical instability. So, unfortunately, cardiac arrest and sudden death are risks both during an acute MI and after full recovery from an MI.
Why Are the First Few Hours of a Heart Attack Critical?
For anyone having an MI, getting rapid medical attention is absolutely critical for two reasons:
•Most of the cardiac arrests seen with acute MIs occur within the first few hours. If the cardiac arrest happens after you have come under medical care, there is an excellent chance it can be successfully treated; otherwise the odds of surviving a cardiac arrest are very low.
•Both the short-term and the long-term consequences of an MI are largely determined by how much of your heart muscle dies. With rapid and aggressive medical treatment, the blocked artery can usually be opened quickly, thus preserving most of the heart muscle that is at risk of dying. If treatment is given within three or four hours, much of the permanent muscle damage can be avoided. But if treatment is delayed beyond five or six hours, the amount of heart muscle that can be saved drops off significantly. After about 12 hours, the damage is usually irreversible.
Getting rapid and appropriate medical care requires that two things happen. First, it requires that you know the signs of a heart attack, and seek medical help the moment you think you might be having one. Second, it requires that the medical personnel who are caring for you do the right things, and do them quickly. The following articles will help you do what you need to do, and to get the care you need to get.
Chest Pain - How should chest pain be evaluated?
If the chest pain is acute in onset: When you arrive in the emergency room with chest pain, doctors can usually get to the root of your problem quite rapidly by 1) taking a directed medical history, 2) performing a physical examination, 3) getting an ECG and cardiac enzymes. If the diagnosis is still in doubt, further testing will be needed, depending on which conditions are being considered.
The first order of business is to rule out a potentially life-threatening cardiac problem – heart attack usually being the main concern (aortic dissection - a tearing of the wall of the aorta - is also life-threatening, but far less common). Rapidly diagnosing heart attack is especially important since immediate treatment can significantly limit the heart damage that occurs, and can prolong overall survival. Almost as important is the diagnosis of unstable angina, since rapid and aggressive treatment of this condition is also necessary to prolong survival.
Once a life-threatening problem is ruled out, most emergency room doctors will make a presumptive diagnosis (i.e., “This is probably what’s causing your pain,”) and refer you to your own physician for follow-up evaluation and treatment.
If the chest pain is a more chronic, recurrent, or non-acute problem: Angina due to coronary artery disease is the chief concern here. Often, stress testing with thallium will be needed to rule out this diagnosis, and not infrequently a cardiac catheterization will also be necessary. The importance of diagnosing angina is not to relieve your pain, but instead to deal with the long-term implications of angina. Namely, the coronary artery disorder that causes angina is a progressive disease process that gets worse over time, and – if untreated – often leads to heart attacks, disability, and death. It is vitally important to make the diagnosis so that treatment can be optimized not only to relieve the pain, but also to slow or halt the progression of the underlying coronary artery disease.
When something other than “routine” coronary artery disease is causing your chest pain a diagnosis also needs to be made before the pain can be adequately treated. Depending on which problems might be suspected by your doctor, you may need x-rays, endoscopy of your GI tract, or pulmonary (lung) function tests.
When is chest pain an emergency?
As we have seen, the term “chest pain” encompasses many different kinds of symptoms and many different kinds of medical disorders. Some of these disorders are quite benign and trivial, but some are dangerous and life-threatening. So when you have chest pain, how do you know when to treat it as an emergency?
There are no hard and fast rules here. Sometimes even minor chest symptoms can turn out to be due to coronary artery disease (evidenced by the fact that up to 30% of heart attacks are accompanied by symptoms so trivial that the patient does not notice them). And you should tell your doctor about any chest pain you experience. But here are some general guidelines that are useful for deciding whether you need to go to the emergency room.
Chest pain is relatively likely to represent a dangerous cardiac disorder - and should be treated as an emergency - if any of the following are true:•You are 40 years old or older, and have one or more risk factors for coronary artery disease (family history, smoking, obesity, sedentary lifestyle, elevated cholesterol, diabetes).
•You are any age and have a very strong family history of early heart disease.
•The pain can best be described by the terms tightness, squeezing, heaviness, or crushing.
•The pain is accompanied by weakness, nausea, shortness of breath, sweating, dizziness or fainting.
•The pain “radiates” to the shoulders, arms, or jaw.
•The pain is more severe than any you have had before.
•The pain is accompanied by the uncontrollable feeling that something is horribly wrong (this is often called by doctors, “a sense of impending doom”).
•The pain gets continually worse over the first 15 or 20 minutes.
•The pain is new – you have never experienced anything like it before.
On the other hand, chest pain is relatively unlikely to represent a dangerous cardiac disorder if either of the following are true:
•The pain changes with changes in body position.
•The pain is momentary or fleeting.
•You have had similar pains in the past, and a cardiac disorder was ruled out.
The first order of business is to rule out a potentially life-threatening cardiac problem – heart attack usually being the main concern (aortic dissection - a tearing of the wall of the aorta - is also life-threatening, but far less common). Rapidly diagnosing heart attack is especially important since immediate treatment can significantly limit the heart damage that occurs, and can prolong overall survival. Almost as important is the diagnosis of unstable angina, since rapid and aggressive treatment of this condition is also necessary to prolong survival.
Once a life-threatening problem is ruled out, most emergency room doctors will make a presumptive diagnosis (i.e., “This is probably what’s causing your pain,”) and refer you to your own physician for follow-up evaluation and treatment.
If the chest pain is a more chronic, recurrent, or non-acute problem: Angina due to coronary artery disease is the chief concern here. Often, stress testing with thallium will be needed to rule out this diagnosis, and not infrequently a cardiac catheterization will also be necessary. The importance of diagnosing angina is not to relieve your pain, but instead to deal with the long-term implications of angina. Namely, the coronary artery disorder that causes angina is a progressive disease process that gets worse over time, and – if untreated – often leads to heart attacks, disability, and death. It is vitally important to make the diagnosis so that treatment can be optimized not only to relieve the pain, but also to slow or halt the progression of the underlying coronary artery disease.
When something other than “routine” coronary artery disease is causing your chest pain a diagnosis also needs to be made before the pain can be adequately treated. Depending on which problems might be suspected by your doctor, you may need x-rays, endoscopy of your GI tract, or pulmonary (lung) function tests.
When is chest pain an emergency?
As we have seen, the term “chest pain” encompasses many different kinds of symptoms and many different kinds of medical disorders. Some of these disorders are quite benign and trivial, but some are dangerous and life-threatening. So when you have chest pain, how do you know when to treat it as an emergency?
There are no hard and fast rules here. Sometimes even minor chest symptoms can turn out to be due to coronary artery disease (evidenced by the fact that up to 30% of heart attacks are accompanied by symptoms so trivial that the patient does not notice them). And you should tell your doctor about any chest pain you experience. But here are some general guidelines that are useful for deciding whether you need to go to the emergency room.
Chest pain is relatively likely to represent a dangerous cardiac disorder - and should be treated as an emergency - if any of the following are true:•You are 40 years old or older, and have one or more risk factors for coronary artery disease (family history, smoking, obesity, sedentary lifestyle, elevated cholesterol, diabetes).
•You are any age and have a very strong family history of early heart disease.
•The pain can best be described by the terms tightness, squeezing, heaviness, or crushing.
•The pain is accompanied by weakness, nausea, shortness of breath, sweating, dizziness or fainting.
•The pain “radiates” to the shoulders, arms, or jaw.
•The pain is more severe than any you have had before.
•The pain is accompanied by the uncontrollable feeling that something is horribly wrong (this is often called by doctors, “a sense of impending doom”).
•The pain gets continually worse over the first 15 or 20 minutes.
•The pain is new – you have never experienced anything like it before.
On the other hand, chest pain is relatively unlikely to represent a dangerous cardiac disorder if either of the following are true:
•The pain changes with changes in body position.
•The pain is momentary or fleeting.
•You have had similar pains in the past, and a cardiac disorder was ruled out.
Key Symptoms of Heart Disease
Because there are many possible conditions that follow under the umbrella of heart disease, the related symptoms are numerous. But here are some key symptoms to be aware of:
1. Chest Pain or Chest Discomfort
Few symptoms are more alarming than chest pain. In the minds of many people, chest pain equals heart pain. And while many other conditions can cause chest pain, cardiac disease is so common - and so dangerous - that the symptom of chest pain should never be dismissed out of hand as being insignificant.
"Chest pain" is an imprecise term. It is often used to describe any pain, pressure, squeezing, choking, numbness or any other discomfort in the chest, neck, or upper abdomen, and is often associated with pain in the jaw, head, or arms. It can last from less than a second to days or weeks, can occur frequently or rarely, and can occur sporadically or predictably. This description of chest pain is obviously very vague, and as you might expect, many medical conditions aside from heart disease can produce symptoms like this.
2. Heart Palpitations
Palpitations, an unusual awareness of the heartbeat, is an extremely common symptom. Most people who complain of palpitations describe them either as "skips" in the heartbeat (that is, a pause, often followed by a particularly strong beat,) or as periods of rapid and/or irregular heartbeats.
Most people with palpitations have some type of cardiac arrhythmia -- abnormal heart rhythms. There are many types of arrhythmias, and almost all can cause palpitations, but the most common causes of palpitations are premature atrial complexes (PACs), premature ventricular complexes (PVCs), episodes of atrial fibrillation, and episodes of supraventricular tachycardia (SVT).
Unfortunately, on occasion, palpitations can signal a more dangerous heart arrhythmia, such as ventricular tachycardia.
3. Lightheadedness or Dizziness
Episodes of lightheadedness or dizziness can have many causes, including anemia (low blood count) and other blood disorders, dehydration, viral illnesses, prolonged bed rest, diabetes, thyroid disease, gastrointestinal disturbances, liver disease, kidney disease, vascular disease, neurological disorders, dysautonomias, vasovagal episodes, heart failure and cardiac arrhythmias. Because so many different conditions can produce these symptoms, anybody experiencing episodes of lightheadedness or dizziness ought to have a thorough and complete examination by a physician. And since disorders of so many organ systems can cause these symptoms, a good general internist or family doctor may be the best place to start.
4. Syncope (Fainting/Loss of Consciousness)
Syncope is a sudden and temporary loss of consciousness, or fainting. It is a common symptom - most people pass out at least once in their lives - and often does not indicate a serious medical problem. However, sometimes syncope indicates a dangerous or even life-threatening condition, so when syncope occurs it is important to figure out the cause.
The causes of syncope can be grouped into four major categories: neurologic, metabolic, vasomotor and cardiac. Of these, only cardiac syncope commonly leads to sudden death.
5. Fatigue, Lethargy or Daytime Sleepiness
Fatigue, lethargy or somnolence (daytime sleepiness) are very common symptoms. Fatigue or lethargy can be thought of as an inability to continue functioning at one's normal levels. Somnolence implies, in addition, that one either craves sleep - or worse, finds oneself suddenly asleep, a condition known as narcolepsy - during the daytime.
While fatigue and lethargy can be symptoms of heart disease (particularly, of heart failure), these common and non-specific symptoms can also be due to disorders of virtually any other organ system in the body. Similar to lightheadedness and dizziness, individuals with fatigue and lethargy need a good general medical evaluation in order to begin pinning down a specific cause.
Somnolence is often caused by nocturnal sleep disorders such as sleep apnea, restless leg syndrome or insomnia. All these sleep disturbances, however, are more common in patients with heart disease.
6. Shortness of Breath
Shortness of breath is most often a symptom of cardiac or pulmonary (lung) disorders. Heart failure and coronary artery disease frequently produce shortness of breath. Patients with heart failure commonly experience shortness of breath with exertion, or when lying flat on their backs. They also can suddenly wake up at night gasping for breath, a condition known as paroxysmal nocturnal dyspnea. Other cardiac conditions such as valvular heart disease or pericardial disease can produce this symptom, as can cardiac arrhythmias.
Numerous lung conditions can produce shortness of breath including asthma, emphysema, bronchitis, pneumonia, or pleural effusion (a fluid accumulation between the lung and chest wall).
Shortness of breath is almost always a sign of a significant medical problem, and should always be evaluated by a doctor.
1. Chest Pain or Chest Discomfort
Few symptoms are more alarming than chest pain. In the minds of many people, chest pain equals heart pain. And while many other conditions can cause chest pain, cardiac disease is so common - and so dangerous - that the symptom of chest pain should never be dismissed out of hand as being insignificant.
"Chest pain" is an imprecise term. It is often used to describe any pain, pressure, squeezing, choking, numbness or any other discomfort in the chest, neck, or upper abdomen, and is often associated with pain in the jaw, head, or arms. It can last from less than a second to days or weeks, can occur frequently or rarely, and can occur sporadically or predictably. This description of chest pain is obviously very vague, and as you might expect, many medical conditions aside from heart disease can produce symptoms like this.
2. Heart Palpitations
Palpitations, an unusual awareness of the heartbeat, is an extremely common symptom. Most people who complain of palpitations describe them either as "skips" in the heartbeat (that is, a pause, often followed by a particularly strong beat,) or as periods of rapid and/or irregular heartbeats.
Most people with palpitations have some type of cardiac arrhythmia -- abnormal heart rhythms. There are many types of arrhythmias, and almost all can cause palpitations, but the most common causes of palpitations are premature atrial complexes (PACs), premature ventricular complexes (PVCs), episodes of atrial fibrillation, and episodes of supraventricular tachycardia (SVT).
Unfortunately, on occasion, palpitations can signal a more dangerous heart arrhythmia, such as ventricular tachycardia.
3. Lightheadedness or Dizziness
Episodes of lightheadedness or dizziness can have many causes, including anemia (low blood count) and other blood disorders, dehydration, viral illnesses, prolonged bed rest, diabetes, thyroid disease, gastrointestinal disturbances, liver disease, kidney disease, vascular disease, neurological disorders, dysautonomias, vasovagal episodes, heart failure and cardiac arrhythmias. Because so many different conditions can produce these symptoms, anybody experiencing episodes of lightheadedness or dizziness ought to have a thorough and complete examination by a physician. And since disorders of so many organ systems can cause these symptoms, a good general internist or family doctor may be the best place to start.
4. Syncope (Fainting/Loss of Consciousness)
Syncope is a sudden and temporary loss of consciousness, or fainting. It is a common symptom - most people pass out at least once in their lives - and often does not indicate a serious medical problem. However, sometimes syncope indicates a dangerous or even life-threatening condition, so when syncope occurs it is important to figure out the cause.
The causes of syncope can be grouped into four major categories: neurologic, metabolic, vasomotor and cardiac. Of these, only cardiac syncope commonly leads to sudden death.
5. Fatigue, Lethargy or Daytime Sleepiness
Fatigue, lethargy or somnolence (daytime sleepiness) are very common symptoms. Fatigue or lethargy can be thought of as an inability to continue functioning at one's normal levels. Somnolence implies, in addition, that one either craves sleep - or worse, finds oneself suddenly asleep, a condition known as narcolepsy - during the daytime.
While fatigue and lethargy can be symptoms of heart disease (particularly, of heart failure), these common and non-specific symptoms can also be due to disorders of virtually any other organ system in the body. Similar to lightheadedness and dizziness, individuals with fatigue and lethargy need a good general medical evaluation in order to begin pinning down a specific cause.
Somnolence is often caused by nocturnal sleep disorders such as sleep apnea, restless leg syndrome or insomnia. All these sleep disturbances, however, are more common in patients with heart disease.
6. Shortness of Breath
Shortness of breath is most often a symptom of cardiac or pulmonary (lung) disorders. Heart failure and coronary artery disease frequently produce shortness of breath. Patients with heart failure commonly experience shortness of breath with exertion, or when lying flat on their backs. They also can suddenly wake up at night gasping for breath, a condition known as paroxysmal nocturnal dyspnea. Other cardiac conditions such as valvular heart disease or pericardial disease can produce this symptom, as can cardiac arrhythmias.
Numerous lung conditions can produce shortness of breath including asthma, emphysema, bronchitis, pneumonia, or pleural effusion (a fluid accumulation between the lung and chest wall).
Shortness of breath is almost always a sign of a significant medical problem, and should always be evaluated by a doctor.
Monday, November 30, 2009
What Is a Heart Attack?
A heart attack occurs when blood flow to a section of heart muscle becomes blocked. If the flow of blood isn’t restored quickly, the section of heart muscle becomes damaged from lack of oxygen and begins to die.
Heart attack is a leading killer of both men and women in the United States. But fortunately, today there are excellent treatments for heart attack that can save lives and prevent disabilities. Treatment is most effective when started within 1 hour of the beginning of symptoms. If you think you or someone you’re with is having a heart attack, call 9–1–1 right away.
Overview
Heart attacks occur most often as a result of a condition called coronary artery disease (CAD). In CAD, a fatty material called plaque (plak) builds up over many years on the inside walls of the coronary arteries (the arteries that supply blood and oxygen to your heart). Eventually, an area of plaque can rupture, causing a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block the flow of oxygen-rich blood to the part of the heart muscle fed by the artery.
Heart With Muscle Damage and a Blocked Artery
Figure A is an overview of a heart and coronary artery showing damage (dead heart muscle) caused by a heart attack. Figure B is a cross-section of the coronary artery with plaque buildup and a blood clot.
During a heart attack, if the blockage in the coronary artery isn’t treated quickly, the heart muscle will begin to die and be replaced by scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems.
Severe problems linked to heart attack can include heart failure and life-threatening arrhythmias (irregular heartbeats). Heart failure is a condition in which the heart can’t pump enough blood throughout the body. Ventricular fibrillation is a serious arrhythmia that can cause death if not treated quickly.
Get Help Quickly
Acting fast at the first sign of heart attack symptoms can save your life and limit damage to your heart. Treatment is most effective when started within 1 hour of the beginning of symptoms.
The most common heart attack signs and symptoms are:
Chest discomfort or pain—uncomfortable pressure, squeezing, fullness, or pain in the center of the chest that can be mild or strong. This discomfort or pain lasts more than a few minutes or goes away and comes back.
Upper body discomfort in one or both arms, the back, neck, jaw, or stomach.
Shortness of breath may occur with or before chest discomfort.
Other signs include nausea (feeling sick to your stomach), vomiting, lightheadedness or fainting, or breaking out in a cold sweat.
If you think you or someone you know may be having a heart attack:
Call 9–1–1 within a few minutes—5 at the most—of the start of symptoms.
If your symptoms stop completely in less than 5 minutes, still call your doctor.
Only take an ambulance to the hospital. Going in a private car can delay treatment.
Take a nitroglycerin pill if your doctor has prescribed this type of medicine.
Outlook
Each year, about 1.1 million people in the United States have heart attacks, and almost half of them die. CAD, which often results in a heart attack, is the leading killer of both men and women in the United States.
Many more people could recover from heart attacks if they got help faster. Of the people who die from heart attacks, about half die within an hour of the first symptoms and before they reach the hospital.
Heart attack is a leading killer of both men and women in the United States. But fortunately, today there are excellent treatments for heart attack that can save lives and prevent disabilities. Treatment is most effective when started within 1 hour of the beginning of symptoms. If you think you or someone you’re with is having a heart attack, call 9–1–1 right away.
Overview
Heart attacks occur most often as a result of a condition called coronary artery disease (CAD). In CAD, a fatty material called plaque (plak) builds up over many years on the inside walls of the coronary arteries (the arteries that supply blood and oxygen to your heart). Eventually, an area of plaque can rupture, causing a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block the flow of oxygen-rich blood to the part of the heart muscle fed by the artery.
Heart With Muscle Damage and a Blocked Artery
Figure A is an overview of a heart and coronary artery showing damage (dead heart muscle) caused by a heart attack. Figure B is a cross-section of the coronary artery with plaque buildup and a blood clot.
During a heart attack, if the blockage in the coronary artery isn’t treated quickly, the heart muscle will begin to die and be replaced by scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems.
Severe problems linked to heart attack can include heart failure and life-threatening arrhythmias (irregular heartbeats). Heart failure is a condition in which the heart can’t pump enough blood throughout the body. Ventricular fibrillation is a serious arrhythmia that can cause death if not treated quickly.
Get Help Quickly
Acting fast at the first sign of heart attack symptoms can save your life and limit damage to your heart. Treatment is most effective when started within 1 hour of the beginning of symptoms.
The most common heart attack signs and symptoms are:
Chest discomfort or pain—uncomfortable pressure, squeezing, fullness, or pain in the center of the chest that can be mild or strong. This discomfort or pain lasts more than a few minutes or goes away and comes back.
Upper body discomfort in one or both arms, the back, neck, jaw, or stomach.
Shortness of breath may occur with or before chest discomfort.
Other signs include nausea (feeling sick to your stomach), vomiting, lightheadedness or fainting, or breaking out in a cold sweat.
If you think you or someone you know may be having a heart attack:
Call 9–1–1 within a few minutes—5 at the most—of the start of symptoms.
If your symptoms stop completely in less than 5 minutes, still call your doctor.
Only take an ambulance to the hospital. Going in a private car can delay treatment.
Take a nitroglycerin pill if your doctor has prescribed this type of medicine.
Outlook
Each year, about 1.1 million people in the United States have heart attacks, and almost half of them die. CAD, which often results in a heart attack, is the leading killer of both men and women in the United States.
Many more people could recover from heart attacks if they got help faster. Of the people who die from heart attacks, about half die within an hour of the first symptoms and before they reach the hospital.
Friday, November 20, 2009
Coronary Artery Bypass Surgery
Also called: Bypass surgery, CABG, Coronary artery bypass graft
If you have coronary artery disease (CAD), the arteries that supply blood and oxygen to the heart muscle become hardened and narrowed. If lifestyle changes and medicines don't help, your doctor may recommend coronary artery bypass surgery.
The surgery uses a piece of a vein from the leg or artery from the chest or wrist. The surgeon attaches this to the coronary artery above and below the narrowed area or blockage. This allows blood to bypass the blockage. Some people need more than one bypass.
You may need bypass surgery for various reasons. Another procedure for CAD, angioplasty, may not have widened the artery enough. In some cases, the angioplasty tube can't reach the blockage.
A bypass also can close again. This happens in more than 10 percent of bypass surgeries, usually after 10 or more years.
If you have coronary artery disease (CAD), the arteries that supply blood and oxygen to the heart muscle become hardened and narrowed. If lifestyle changes and medicines don't help, your doctor may recommend coronary artery bypass surgery.
The surgery uses a piece of a vein from the leg or artery from the chest or wrist. The surgeon attaches this to the coronary artery above and below the narrowed area or blockage. This allows blood to bypass the blockage. Some people need more than one bypass.
You may need bypass surgery for various reasons. Another procedure for CAD, angioplasty, may not have widened the artery enough. In some cases, the angioplasty tube can't reach the blockage.
A bypass also can close again. This happens in more than 10 percent of bypass surgeries, usually after 10 or more years.
Heart Surgery
Also called: Cardiac surgery
Each day, thousands of people in the world have heart surgery. There are many different types of heart surgery. Surgeries may be used to
.Repair or replace the valves that control blood flow through the heart's chambers
.Bypass or widen blocked or narrowed arteries to the heart
.Repair aneurysms, or bulges in the aorta, which can be deadly if they burst
.Implant devices to regulate heart rhythms
.Destroy small amounts of tissue that disturb electrical flow through the heart
.Make channels in the heart muscle to allow blood from a heart chamber directly into the heart muscle
.Boost the heart's pumping power with muscles taken from the back or abdomen
.Replace the damaged heart with a heart from a donor
Each day, thousands of people in the world have heart surgery. There are many different types of heart surgery. Surgeries may be used to
.Repair or replace the valves that control blood flow through the heart's chambers
.Bypass or widen blocked or narrowed arteries to the heart
.Repair aneurysms, or bulges in the aorta, which can be deadly if they burst
.Implant devices to regulate heart rhythms
.Destroy small amounts of tissue that disturb electrical flow through the heart
.Make channels in the heart muscle to allow blood from a heart chamber directly into the heart muscle
.Boost the heart's pumping power with muscles taken from the back or abdomen
.Replace the damaged heart with a heart from a donor
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