Heart Attacks Explained

1.  What is a heart attack?

A heart attack is a frightening experience. If you have experienced a heart attack, or are close with someone who has, are probably still reeling from the experience. But tens of thousands of people survive heart attacks and go on to lead productive, enjoyable lives. Some of the frequently asked questions below can help you better understand what has happened, and how your heart can heal. Knowledge is power. Arming yourself with this information can help you can live a healthier, longer life. Let us look at some of the facts:

Your heart muscle needs oxygen to survive. A heart attack occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely. This happens because coronary arteries that supply the heart muscle with blood flow can become narrowed from a buildup of fat, cholesterol and other substances that together are called plaque. 

This slow process is known as atherosclerosis and is discussed below. When plaque within a heart artery breaks, a blood clot forms around the plaque. This blood clot can block the blood flow through the artery to the heart muscle.

Ischemia results when the heart muscle is starved for oxygen and nutrients. When damage or death of part of the heart muscle occurs as a result of ischemia, it’s called a heart attack, or myocardial infarction (MI).

2.  What causes a heart attack?

The vast majority of heart attacks occur because of a blockage in one of the blood vessels that supply your heart. This most often happens because of plaque, a sticky substance that can build up on the insides of your arteries (similar to how pouring grease down your kitchen sink can clog your home plumbing). That buildup is called atherosclerosis. Sometimes, plaque deposits inside the coronary (heart) arteries can break open or rupture, and a blood clot can get stuck where the rupture happened. If the clot blocks the artery, this can deprive the heart muscle of blood and cause a heart attack.

Heart attacks are possible without a blockage, but this is rare and only accounts for about 5% of all heart attacks. This kind of heart attack can occur for the following reasons:

• Spasm of the artery: Your blood vessels have a muscle lining that allows them to become wider or narrower as needed. Those muscles can sometimes twitch or spasm, cutting off blood flow to heart muscle.
• Rare medical conditions: An example of this would be any disease that causes unusual narrowing of blood vessels.
• Trauma: This includes tears or ruptures in the coronary arteries.
• Obstruction that came from elsewhere in the body: A blood clot or air bubble (embolism) that gets trapped in a coronary artery.
• Electrolyte imbalances: Having too much or too little of key minerals like potassium in your blood can cause a heart attack.
• Eating disorders: Over time, an eating disorder can cause damage to your heart and ultimately result in a heart attack.

3.  What are the symptoms of a heart attack?

Some heart attacks strike suddenly. But many people have warning signs and symptoms hours, days or weeks in advance. Chest pain or pressure (angina) that keeps happening and doesn’t go away with rest may be an early warning sign. 

The major symptoms of a heart attack are

• Chest pain or discomfort. Most heart attacks involve discomfort in the center or left side of the chest that lasts for more than a few minutes or that goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain.
• Feeling weak, light-headed, or faint. You may also break out into a cold sweat.
• Pain or discomfort in the jaw, neck, or back.
• Pain or discomfort in one or both arms or shoulders. 
• Shortness of breath. This often comes along with chest discomfort, but shortness of breath also can happen before chest discomfort.

Other symptoms of a heart attack could include unusual or unexplained tiredness and nausea or vomiting. 

Higher levels of estrogen can reduce the risk of a heart attack. As a result, women have a greater risk of a heart attack after menopause than before menopause. However, women who have a heart attack are more at risk of underdiagnosis and undertreatment.

Although some women have no symptoms, others may have:

• Nausea
• Vomiting
• Extreme fatigue
• Shortness of breath
• Pain in the upper back or jaw
• Dizziness or lightheadedness

4.  How is a heart attack diagnosed

Our specialist team of cardiologists typically diagnose a heart attack after they perform a physical exam and review your medical history. They will likely conduct an electrocardiogram (ECG) to check your heart’s electrical activity.

An echocardiogram, which uses sound waves to create an image of the heart’s chambers and valves, can reveal how blood is flowing through the heart and what parts of the heart, if any, have been damaged.

They may also order a cardiac catheterization. This is a probe inserted into the blood vessels through a flexible tube called a catheter. It allows your doctor to view areas in and around your heart where plaque may have built up. They can also inject dye into your arteries, order an X-ray to see how the blood flows, and view any blockages.

Another step could include taking a sample of your blood or perform other tests to see if there’s evidence of heart muscle damage. 

A commonly used blood test checks for levels of troponin T, a protein found in the heart muscle. Elevated levels of troponin T in the bloodstream is associated with a heart attack.

5.  Heart attack complications

Heart attacks can result in various complications. When a heart attack occurs, it can disrupt your heart’s normal rhythm, potentially stopping it altogether. These abnormal rhythms are known as arrhythmias.

When your heart stops getting a supply of blood during a heart attack, some of the heart tissue can die. This can weaken your heart and cause serious complications such as heart failure.

Heart attacks can also affect your heart valves and cause leaks. 

The long-term effects on your heart will be determined by how much time it takes to receive medical treatment and how much of your heart has been damaged from the heart attack. 

6.  Recovery

A heart attack can damage your heart muscles and impact their function. This can include changing your heart’s rhythm and reducing its ability to pump blood effectively to all the organs and tissues in your body.

Following a heart attack, it’s important to work with your healthcare team to design a recovery plan. This plan may include the following lifestyle changes:

• participating in light or moderate exercise, according to what your doctor approves
• eating a nutrient-dense, balanced diet low in saturated and trans fats
• losing weight if you’re carrying extra weight
• quitting smoking if you smoke
• monitoring your blood sugar levels closely if you have diabetes
• taking steps to keep your blood pressure and cholesterol within a healthy range
• avoiding strenuous activities, especially shortly after the heart attack
• undergoing cardiac rehabilitation

No one understands the heart better than the team at German Heart Centre!  Should you have any concerns or questions about the topic of heart health, we are just a phone call away. Get in touch to book your next consultation!

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information on the topic.