Heart attack is a Myocardial infarction. Myocardial infarction is a sudden occlusion of a coronary artery. As a result, part of the heart muscle will no longer receive oxygen and can be irreparably damaged if action is not taken in time. Other names for a heart attack are ‘heart attack’ and ‘myocardial infarction’. Heart attacks can occur in both men and women and come in the vast majority of cases from the 35 th year of life. Heart attacks can be life-threatening, with the highest risk of death during the infarct and in the first few hours thereafter. After discharge from the hospital, 75 percent of people are still alive after five years.
Myocardial infarction symptoms
Myocardial infarction is usually accompanied by sudden, moderate to very severe chest pain. This pain can radiate to the shoulders, jaws and back.
Many people who have a heart attack already had chest pain before that. Another name for this chest pain is ‘ angina pectoris ‘. The difference between the two conditions is that the pain in a heart attack is often more severe, does not disappear in rest, does not subside after a few minutes, and does not respond to the usual medication.
Myocardial infarction can also be accompanied by nausea, vomiting, sweating and cold, pale skin. The patient may be confused, short of breath and have a fast and / or irregular heartbeat. In severe infarcts, the patient may become unconscious and / or die. However, the complaints mentioned do not have to occur. About a fifth of myocardial infarctions even occur without complaints or symptoms.
How does a heart attack occur?
Myocardial infarction is a sudden occlusion of a coronary artery. The coronary arteries supply blood to the heart. When one of these veins is blocked, part of the heart is no longer supplied with blood. This section will no longer work and will be irreparably damaged or die if no action is taken.
The occlusion of a coronary artery is almost always the result of arteriosclerosis. Over the course of many (sometimes decades) years, a thickening has developed in and on the wall of the vein. Such a thickening is called ‘atheromatous plaque’.
The origin of this depends on many factors that are not yet all known. It is clear that heredity, smoking, cholesterol and high blood pressure play an important role in this. You can read more about this under ‘General advice and precautions’.
A thickening in and on the vein wall (atheromatous plaque) can suddenly burst open, tear or bleed. These changes can cause the blood vessel that was already narrowed by the plaque to be completely occluded. Also, a clot in the bloodstream can get stuck behind the plaque and thus clog the vein.
Is it serious and what can you expect?
A heart attack is a serious condition. There is a risk of death. The sooner medical attention is available, the better. Complications can also arise after the heart attack, such as disturbances in the heart rhythm and heart failure.
A hospitalization follows with a heart attack. During the admission, examinations are performed to determine the severity and consequences of the infarct and the treatment to be initiated. Rehabilitation is often started quickly.
In the hospital, research is started immediately. A physical examination is performed and a heart film (ECG) is made. The blood levels of a number of enzymes that are released during an infarction are determined. Based on these data, an estimate can be made of the severity, the size, and the location of the infarct. Also, possible complications are visualized.
The patient remains on cardiac monitoring for the first few days in the hospital. The function of the cardiovascular system is continuously registered so that immediate action can be taken in case of complications.
Treatment starts as early as possible: when the patient enters or rather in the ambulance. Prompt treatment is important to prevent more damage. Medicines are given that thin the blood and dissolve blood clots.
It may also be necessary that doping is done immediately. A balloon is pushed into the bloodstream through the groin. At the site of the constriction, this is inflated and the vessel is opened again. Often a stent is subsequently placed. This is a metal spring. This keeps the blood vessel open. In severe situations, it may also be necessary to have heart surgery immediately. Diversions are placed around the blocked coronary arteries.
In the hospital, the patient has mobilized again as soon as possible. This means that activities are again undertaken under supervision. By moving back as quickly as possible, the risk of complications is reduced. Before discharge from the hospital, the patient exercises climbing stairs and an exercise test is performed. After the discharge, it is important that the rehabilitation continues. This is usually done on the basis of a personal exercise program drawn up in the hospital.
Most patients can go home between three and ten days after the infarct. In the first period, medicines are prescribed that reduce the risk of a new heart attack. Sometimes these drugs have to be used throughout life.
Many people can completely resume their daily activities after discharge from the hospital and a period of rehabilitation. Healthy living rules are important to reduce the risk of a new infarct (no smoking, healthy eating and sufficient exercise).
Two months after the infarct, many people can live normal lives again. In some people, healing may be less successful.
When to the doctor?
If you suspect that you or someone else has a heart attack, call a doctor as soon as possible. Prompt medical attention is very important for the course.
What can you do about it yourself?
When you have a heart attack yourself, you cannot really do anything about it at that time. If someone in your area has a heart attack, you can, if possible, provide first aid and possibly perform CPR.
However, you can reduce the chance of a heart attack as much as possible (see ‘General advice and precautions’).
General advice and precautions
There are a number of factors that can increase the chance of having a heart attack and advance the age at which it occurs. It is important to limit these risk factors as much as possible.
The main risk factors are:
- to smoke
- high blood pressure
- high cholesterol
- being overweight
- little exercise
By limiting these risk factors as much as possible, you reduce the risk of a heart attack. If you have multiple risk factors, the risk of a heart attack is extra high. The risk factors reinforce each other. The result is more than the sum of the parts, one and one, in this case, is more than two.
If your parents or siblings have had cardiovascular problems before their sixtieth birthday, you have an increased risk of these conditions. In principle, you cannot change this heredity. However, you can minimize this risk by minimizing all other risk factors. This is especially important if you are hereditary.
Smoking accelerates the abnormalities in the blood vessels, which can eventually lead to a heart attack. Also, Smoking increases the risk of a heart attack and can occur at a younger age than usual. By stopping smoking, you stop this accelerated process and thus reduce the risk of infarction. You can contact your doctor if you need advice or help to quit smoking. The doctor can also refer you to centers that specialize in smoking cessation assistance.
High blood pressure High blood
The pressure is harmful to the vessel wall and promotes the formation of plaques that play a role in the development of a heart attack. You do not generally feel or notice high blood pressure. Therefore, it can sometimes be difficult to stick to the recommended rules (such as low alcohol and low salt intake) and continue to take your medicines. However, it is highly advisable to do this.
Diabetes promotes the development of abnormalities in the blood vessels and thus the risk of a heart attack. You can limit this influence by adhering to any prescribed diet and using your medication appropriately. You can find more information about diabetes in the Seekers-zone.com information folder ‘Diabetes mellitus type 1’ and ‘Diabetes mellitus type 2’.
High cholesterol plays a role in the formation of plaques in the blood vessels that can lead to a heart attack. It is therefore wise to have your cholesterol determined regularly by your doctor and to limit the amount of (bad, saturated) fats in your diet. To determine a suitable diet for you, please contact a dietician.
overweight increases the risk of cardiovascular disease. When you are overweight, it is very wise to try to lose weight. You can determine whether you are overweight using a simple calculation (the Body Mass Index). You can find more information about overweight in the seekers-zone.com information folder ‘Overweight’.
Little physical activity
Exercise keeps your body, heart, and vessels in good condition. This reduces the chance of problems. Many people nowadays do not exercise enough and are therefore at greater risk of developing cardiovascular disease. Therefore, try to exercise sufficiently. For example, you may be more likely to walk by bike and stairs in general. Try to exercise several times a week. If you are a heart patient, you can participate in the special programs developed for this purpose in gyms and swimming pools.
Source : R. Burger (psychologist)
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