Heart Attack: Symptoms, Causes, Prevention & Treatment

A heart attack, medically called myocardial infarction, occurs when oxygen-rich blood flow to a portion of the heart is blocked. This lack of blood flow usually results from an obstruction in one or more of the coronary arteries. Treatment restores blood flow and prevents heart damage.

It can vary in severity and type based on the extent of the blockage and damage to the heart. The main types of myocardial infarction are as follows:

1. ST-Segment Elevation Myocardial Infarction (STEMI): It occurs when there is a long interruption of the blood supply, causing significant damage to the heart. This type of heart attack requires immediate treatment. 

2. Non-ST Segment Elevation Myocardial Infarction (NSTEMI): This is characterised by a partial blockage of blood flow. NSTEMIs are less damaging to the heart than STEMIs. However, they still require significant medical attention and intervention to prevent further deterioration.

3. Unstable Angina: Blood flow to the heart muscle is blocked, causing attack symptoms. However, tests do not detect any heart damage. 

It can range from mild to severe. Sometimes, individuals may not experience any physical manifestations. Some common myocardial infarction symptoms are as follows:

• Chest Pain: Often the most recognisable myocardial infarction symptoms, it can feel like pressure, squeezing, heaviness, or pain in the centre or left side of the chest.

• Upper Body Discomfort: Pain may also develop in one or both arms, shoulders, back, neck, jaw, or upper part of the stomach.

• Feeling Unusually Tired: Persistent fatigue without a clear cause. 

• Shortness of Breath: This can occur while resting or doing physical activity. 

• Other Symptoms: These can include excessive sweating, nausea and vomiting, sudden dizziness, etc. 

It is important to note that not everyone who has a heart attack has the same or severe symptoms.

An attack primarily occurs because of a lack of oxygen-rich blood flow to a section of the heart muscle. The key causes of this condition are as follows:

1. Coronary Artery Disease (CAD): This is the most common cause of this condition. CAD develops when one or more of the heart (coronary) arteries become blocked due to cholesterol-containing deposits (plaque). 

2. Plaque Rupture: Over time, plaque buildup in the arteries may rupture, forming a clot and blocking the flow of blood.

3. Spasm of the Coronary Artery: It is characterised by severe squeezing of a blood vessel due to smoking or other risk factors. 

4. Certain Infections: Viral infections can damage the heart muscle. This leads to inflammation in the heart, which promotes the formation of plaques. 

5. Spontaneous Coronary Artery Dissection (SCAD): A tear inside the heart artery can cause this life-threatening condition.

Certain aspects can increase an individual’s chances of getting a heart attack. However, having one or more of these factors does not guarantee the disease. Risk factors of myocardial infarction are as follows: 

Modifiable Risk Factors

Patients can control these risks to prevent the condition. They include the following: 

1. Physical Inactivity: Lack of exercise is associated with several types of heart disease, like myocardial infarction. 

2. Unhealthy Diet: A diet high in salt, sugar, and fat contributes to the development of heart disease.

3. Tobacco Use: Smoking and inhaling secondhand smoke constricts the blood vessels, causing elevated blood pressure. 

4. Stress: Emotional stress, including intense anger, can heighten the risk of experiencing a heart attack.

5. Hypertension: High blood pressure can damage the arteries that lead to the heart. 

6. High Cholesterol Levels: Increased levels of bad cholesterol (LDL) in the blood can cause plaque buildup in the arteries. 

7. Diabetes: Poorly controlled blood sugar levels increase the risk of heart attack. 

Non-Modifiable Risk Factors

These cannot be altered, making it challenging to prevent this disease. Mentioned below are these aspects: 

1. Age: Men above 45 and women over 55 are more likely to have the disease. 

2. Family History of Heart Disease: If an individual’s siblings, parents, or grandparents had heart disease or heart attacks, especially at an early age, their risk might be higher.

3. Autoimmune Conditions: Having diseases like lupus or rheumatoid arthritis can also increase the risk of heart attacks. 

How to prevent a heart attack?

Heart attacks can strike anyone, regardless of wealth or status. Recently, the news of billionaire Cyrus Poonawalla heart attack served as a stark reminder that even those with access to the best healthcare are not immune. 

One can take proactive steps to safeguard heart health and prevent life-threatening conditions by following the below measures:

• Quit smoking. 

• Eat a heart-healthy diet low in fat, salt, and cholesterol. 

• Get regular screenings for blood pressure and cholesterol monitoring. 

• Engage in moderate-intensity aerobic exercise. 

• Maintain a healthy weight. 

• Take medications as prescribed to improve heart health.

"I've seen firsthand how heart attacks are increasingly affecting younger people, often catching them off guard. Recently, I treated a patient in his early 40s who thought he was too young to be at risk, but stress, an unhealthy diet, and a lack of exercise had silently taken their toll. 

Heart attacks can happen at any age, especially when risk factors like high blood pressure, smoking, or a sedentary lifestyle are present. By recognizing these risks early and making healthier choices, you can protect your heart and prevent the unimaginable from becoming a reality."

- Dr Bikram Kesharee Mohanty
Cardiologist

Diagnosis for this condition involves several evaluations to check the overall heart health. The tests for heart attack include the following: 

1. Physical Exam: The doctor inquires about the patient’s symptoms and risk factors for heart disease. During the physical exam, they check the patient’s pulse, blood oxygen, and blood pressure. They also listen to heart and lung sounds. 

2. Electrocardiogram (ECG or EKG): This is one of the quickest and most effective tests used to diagnose a heart attack. The myocardial infarction ECG records the electrical activity of the heart and can detect abnormal heart rhythms.

3. Blood Tests: Certain enzymes are released into the blood when the heart muscle is damaged. The most common tests look for troponin, a protein found in the heart muscle. 

4. Echocardiogram: This ultrasound test creates pictures of the heart in motion, showing areas of the heart that may not be pumping effectively.

5. Coronary Angiography: It uses dye and special X-rays to view the insides of the coronary arteries. This can help locate the blockages that caused the heart attack. 

6. MRI or CT Scan: These imaging tests can be used to diagnose heart problems and determine the severity of damage. 

7. Nuclear Scan: This shows areas of the heart that may not be getting enough blood or areas of damaged heart muscle.

How to prepare for a doctor consultation? 

It is an emergency which does not leave time for preparation. However, if an individual visits a doctor after experiencing an attack or if they are at risk of one, they should take certain preparatory measures. The following steps ensure that the visit is as effective as possible: 

• Compile a detailed personal and family medical history. 

• Write down all current medications, including over-the-counter drugs, prescription medications, supplements, and vitamins.

• Be prepared to discuss the current diet and exercise routine. 

Questions to Ask the Doctor 

When consulting a doctor about heart health or after experiencing an attack, it is crucial to ask informed questions. This helps patients better understand what to expect in terms of treatment and recovery. Consider asking these questions:

• How do you compare cardiac arrest vs heart attack, and which did I have? 

• What was the likely cause of my heart attack or heart condition?

• How can I prevent a heart attack 2 from occurring?

• What are my treatment options? 

• What are the potential side effects of the treatment you are recommending? 

• What symptoms indicate a need to seek immediate medical attention?

Treatment for a heart attack restores blood flow to the heart and minimises heart damage. The approach is selected based on the extent of blood flow blockage. Options may include the following: 

Medications

The cardiologist doctor may prescribe medicines to treat the condition, such as: 

1. Anti-Clotting Medications: Reduces blood clotting, helping to maintain blood flow through narrowed heart arteries.

2. Nitroglycerin: Helps alleviate chest pain and widens blood vessels, allowing blood to flow more freely.

3. Thrombolytics: These drugs, also known as clot busters, help dissolve a blood clot. They are only used within the first 12 hours after the attack. 

4. Beta-Blockers: Reduces blood pressure and heart rate so that the heart can recover from injury. 

5. Statins: Lowers cholesterol levels and help stabilise the plaque in heart arteries.

6. Anti-Arrhythmia Medications: It can disrupt the normal rhythm of the heart, leading to potentially dangerous arrhythmias. These drugs correct or prevent irregular heartbeats.

Surgical Procedures

Surgery may be performed to open a blocked artery after a heart attack. These procedures include: 

1. Coronary Angioplasty and Stenting: It involves threading a catheter through a blocked artery and inflating a balloon to reopen it. A stent is often placed to keep the artery open.

2. Coronary Artery Bypass Grafting (CABG): This is an open surgery performed after a heart attack or a few days later. It involves using a healthy blood vessel from another body part to create a new path for blood flow. 

Note: The treatment approach is selected based on the patient’s condition and the doctor’s opinion. 

Heart Attack Surgery Cost

The cost of heart attack treatment in India can differ significantly depending on the surgery type, hospital facilities, and the city. The table below shows the approximate expenses of these procedures:

Note: The above pricing doesn’t include diagnosis costs like myocardial infarction ECG and consultation charges. Patients are advised to consult the professionals at HexaHealth for accurate cost details.

A heart attack causes several serious complications, some of which can be life-threatening. Understanding these is crucial for managing the condition effectively. The primary risks are as follows:

1. Heart Failure: It occurs when the heart muscle is damaged and no longer pumps blood effectively. This leads to trouble breathing, fatigue, and fluid buildup in the body. 

2. Arrhythmias: Attack can disrupt the electrical impulses that coordinate the heartbeat, resulting in abnormal heart rhythms. 

3. Myocardial Rupture: Damage from the heart attack may cause a tear in the part of the heart. 

4. Aneurysm: A bulge can form in the heart wall that has become thinned and stretched by the heart attack. It can also cause blood clots. 

5. Angina: Individuals may experience chest pain due to insufficient oxygen reaching the heart. 

When to call a doctor?

If a patient experiences heart attack symptoms like chest pain, shortness of breath, and discomfort in one or both arms, they should seek medical help immediately. Calling emergency services is often the fastest way to get lifesaving treatment. They begin treatment as soon as they arrive and are equipped to revive someone whose heart has stopped.

If someone stops breathing before help arrives, it is important to give first aid for a heart attack, which involves cardiopulmonary resuscitation (CPR): 

• Interlock fingers and place the base of hands in the centre of the person’s chest.

• Position the shoulders directly above the hands and lock the elbows. 

• Apply firm, quick compressions at a rate of 100 - 120 per minute, pressing down about 2 inches deep.

• Continue this movement until the individual begins to breathe or move. 

Patients should focus on a heart-healthy diet after having a heart attack. Following these dietary guidelines can help support heart health and alleviate the risk of future attacks: 

1. Fruits and Vegetables: Eat colourful fruits and vegetables which are rich in vitamins and minerals. Examples include apples, oranges, broccoli, and leafy greens. 

2. Whole Grains: Choose oats, brown rice, whole wheat, and quinoa for their fibre and nutrient content.

3. Healthy Fats: Include fats from sources like nuts, seeds, avocados, and olive oil. Avoid saturated and trans fats in red meat, processed foods, and full-fat dairy, as they can increase blood cholesterol.

4. Lean Proteins: Opt for sources such as fish, poultry, beans, and legumes. Fatty fish like salmon are especially beneficial due to their omega-3 fatty acids.

5. Limit Sodium: High sodium intake can increase blood pressure. Patients should reduce their intake by avoiding processed and canned foods.

A heart attack is a medical emergency that demands immediate attention. Lifestyle changes, including a heart-healthy diet, can significantly reduce the risk of future heart events. Early detection and management are important for improving outcomes.

HexaHealth can help you understand and manage heart health by providing expert advice and resources. Whether you are experiencing severe signs or mini heart attack symptoms, we guide you through prevention, treatment, and recovery. Our team ensures you receive the top-notch care tailored to your needs.

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