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A person usually gets a heart attack when there is a blockage in the arteries of the heart. This is an emergency situation that can result in a fatality or death if it is not treated immediately. Not all heart attacks will have a crushing pain in the chest right in the beginning, there are a number of symptoms that can show the slow progression of this attack over a few hours. So how do you know if you are having a heart attack, and what kind of treatment will be required? This article seeks to answer all your questions.
Discomfort in the Chest: The patient will usually feel like there is some pressure and squeezing in the chest or pain or even fullness right in the centre. This pain can come and go every few minutes and it should not be ignored.
Pain and Discomfort in other Parts of the Body: There may be some amount of pain and discomfort in other parts of the body including the arms, the jawline, back, neck, stomach and even the teeth. This pain can also travel down to the abdomen above umbilicus. In case there is persistent pain along with the chest discomfort, then a doctor must be contacted immediately.
Other Symptoms: When you feel breathless without any reason or medical cause, and also when you experience symptoms like anxiety, indigestion, vomiting, nausea, light headedness, dizzy spells and fatigue, you may be suffering from a heart attack.
Immediate Treatment: Once you begin to experience these symptoms along with chest discomfort and chest pain, it is imperative to call the emergency unit of the nearest hospital or get in touch with a cardiologist. Until then, you will need to lie down and chew aspirin if you are not allergic to the same. This is usually more efficient that swallowing.
Diagnosis of heart attack: Heart attack is diagnosed if patient has 2 criteria out of following 3-
Pain or discomfort thought to be due to heart disease
ECG suggestive of heart attack
Elevated levels of cardiac enzymes (CK-MB and Troponin) in blood test (these levels start rising after 6 to 12 hours of heart attack)
Once you reach doctor an ECG should be done immediately along with blood pressure and pulse. If ECG shows heart attack then immediate action needs to be taken. Remember a normal first ECG does not rule out a heart attack. So a series of ECGs may be ordered by the doctor and at proper time blood test of cardiac enzymes may be done. Ruling out a heart attack may need an observation and testing up to 6 – 12 hours as cardiac enzyme test shows results only after that period.
Blockage in heart is a common term used for narrowing of coronary arteries. Coronary arteries are vessels, which supply blood and thus oxygen and food to continuously working heart muscles. Heart muscles, which are not tired working from the birth till death, however, cannot sustain long without blood supply.
A reduction in blood supply gives rise to ischemia of heart muscles commonly manifested as chest discomfort or angina. A sudden complete shutdown of blood supply leads to heart attack leading to permanent damage to heart (if blood flow not reestablished promptly).
But what causes these arteries to block? Deposition of LDL cholesterol (low density cholesterol) in inner surface of coronary arteries is the primary reason of these blockages. LDL a normal component of blood (upto certain limit) starts depositing in arteries as early as 10 years of age!
Deposition of billions of LDL molecules over several years on inner surface of arteries gives rise to visible narrowings in these arteries. Flow ahead of these narrowings is reduced in proportion to the narrowing. At a level of 70 % narrowing the flow is reduced to give ischemia (and angina) during exercise. Gradually increasing degree of narrowing reduces the exercise needed for ischemia and angina; a narrowing of more than 90 % can give symptoms at rest. A sudden clot formation at any of these stages can block the flow suddenly giving a heart attack.
If LDL is a normal component of blood, why it is deposited in the arteries at first place?
LDL above a certain limit in blood starts depositing in the arteries. Diabetes, Hypertension, smoking, less exercise and genetics makes it more sticky thus making narrowing faster. This is why these risk elements need to be properly attended for prevention from heart disease. For treatment medicines are important for stopping the progression of narrowings; angioplasty is a method of fast resolution of blockage; and bypass surgery is the method of creating a whole new blood supply for the affected part of the heart.