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.

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.

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

Healthy Heart Diet

If you want to have a healthy heart, you have to learn how to eat a healthy heart diet. All of the food you eat effects the health of your heart. Learn which foods are heart smart and try to include them as a regular part of your diet.

Consult your doctor for an eating plan that best suits your dietary needs. If you are of average health, you can probably follow the Food Pyramid eating plan.

No matter which eating plan you follow, the following guidelines are recommended:

•Total fat intake should be less than 30 percent of total calories daily.
•Saturated fatty acid intake should be less than 10 percent of total calories daily.
•Polyunsaturated fatty acid intake should be no more that 10 percent of total calories daily.
•Monounsaturated fatty acids make up the rest of total fat intake, about 10 to 15 percent of total calories daily.
•Cholesterol intake should be no more than 300 milligrams per day.
•Sodium intake should be no more than 3000 milligrams per day.
•Beware of chemicals in your food like caffeine, MSG, and other food additives.
Don't forget that you can enjoy the taste of eating right. Healthy heart foods can be delicious! For more information, consult our Heart Smart Hints.

Heart Attacks

A heart attack is sudden. The causes of the heart attack are not. Years of unhealthy heart habits suddenly, unexpectedly, catch up with you. Anywhere. Anytime. A diseased heart is like a ticking timebomb. The heart attack is its explosion.

Technically, a heart attack occurs when the supply of nutrient-rich blood to the heart muscle is reduced or stopped. If the blood supply is shut down for a long time, muscle cells die from a lack of oxygen. If enough cells die, the victim will also die. Often, only a small part of the heart muscle is deprived of oxygen so the victim can recover.

Why does the blood supply reduce or stop? There are many possibilities. One of the most common is arteriosclerosis, an arterial disease. If blood is unable to flow through the blood vessels, it cannot nourish the body and heart.

Is there a way to predict a heart attack? Angina pectoris, or chest pain, is a warning sign of a possible heart attack. Any chest pain should be taken seriously and investigated.

Heart attacks are frightening for both the victim and for the victim's companions. Be a Heart Saver by learning the best ways to help a heart attack victim.

Heart Health Tips

If you're not convinced about the need to develop an exercise program for your life, you can at least try following some of these tips in your everyday routine. Take advantage of any opportunity for exercise. Try some today.

•Take the stairs instead of an elevator or escalator at school or the mall. Just start with one flight. Soon, you'll be ready for two.
•Park your car at the far end of the parking lot. The short walk to and from the store or school helps your heart.
•If you ride a bus or subway, get off a stop before your destination. Walk the rest of the way.
•If you can, spend a few minutes of your lunch break taking a stroll around the campus grounds. It should help you stay awake after lunch.
•Think of housework as an extra chance to exercise. Vacuuming briskly can be a real workout.
•Mowing the lawn, pulling weeds, and raking leaves are chores that can be done yourself as a chance to exercise.
•If you have a dog, think of the dog as an exercise machine with fur. A brisk walk with the dog is good for both of your hearts. Make it a part of your daily routine.
•If you have a family, schedule an after-dinner walk. Make it quality time.

Stent Procedure

What is a stent and how is one used?

A stent is a wire metal mesh tube used to prop open an artery during angioplasty. The stent is collapsed to a small diameter and put over a balloon catheter. It's then moved into the area of the blockage. When the balloon is inflated, the stent expands, locks in place and forms a scaffold. This holds the artery open. The stent stays in the artery permanently, holds it open, improves blood flow to the heart muscle and relieves symptoms (usually chest pain). Within a few weeks of the time the stent was placed, the inside lining of the artery (the endothelium) grows over the metal surface of the stent.

When are stents used?

Stents are used depending on certain features of the artery blockage. This includes the size of the artery and where the blockage is. Stenting is a fairly common procedure; in fact, over 70 percent of coronary angioplasty procedures also include stenting.

What are the advantages of using a stent?

In certain patients, stents reduce the renarrowing that occurs after balloon angioplasty or other procedures that use catheters. Stents also help restore normal blood flow and keep an artery open if it's been torn or injured by the balloon catheter.

Can stented arteries reclose?

Yes. Reclosure (restenosis) is also a problem with the stent procedure. In recent years doctors have used new types of stents called drug-eluting stents. These are coated with drugs that are slowly released and help keep the blood vessel from reclosing. Stents that are not coated with drugs are called bare metal stents. As detailed below, it is very important that patients with either type of stent take their anti-clotting medicines as directed.

What precautions should be taken after a stent procedure?

Patients who've had a stent procedure must take one or more blood-thinning agents. Examples are aspirin and clopidogrel. These medications help reduce the risk of a blood clot developing in the stent and blocking the artery. Some recent studies have suggested that blood clots may develop later on (more than a year after stent placement) in the drug-eluting stents. Therefore it is really important to stay on your medications as long as your cardiologist recommends. Aspirin is usually recommended for life, and clopidogrel is generally used for one to 12 months (depending on the type of stent) after the procedure. Clopidogrel can cause side effects, so blood tests will be done periodically. If you are taking this medication, it is important that you don't stop taking it for any reason without consulting your cardiologist who has been treating your coronary artery disease..

For the next four weeks a magnetic resonance imaging (MRI) scan should not be done without a cardiologist's approval. But metal detectors don't affect the stent.

What is Heart?

The human heart provides a continuous blood circulation through the cardiac cycle and is one of the most vital organs in the human body. It is divided into four chambers: the two upper chambers are called the left and right atria and two lower chambers are called the right and left ventricles. Normally the right ventricle pumps the same blood amount into the lungs with each bit that the left ventricle pumps out. Physicians commonly refer to the right atrium and right ventricle together as the right heart and to the left atrium and ventricle as the left heart.[1]

The electric energy that stimulates the heart occurs in the sinoatrial node, which produces a definite potential and then discharges, sending an impulse across the atria. The Purkinje fibers transmit the electric charge to the myocardium while the cells of the atrial walls transmit it from cell to cell, making the atrial syncytium.

The human heart and its disorders (cardiopathies) are studied primarily by cardiology.

[edit] StructureThe human heart is equipped with four types of valves, which prevent the blood flowback between strokes: mitral valve, aortic valve, pulmonic valve and tricuspid valve. The mitral and tricuspid valves are classified as the atrioventricular (AV) valves. This is because they are found between the atria and ventricles.

The interventricular septum separates the left atrium and ventricle from the right atrium and ventricle, dividing the heart into two functionally separate and anatomically distinct units.