A Heart attack Is a tightness in the chest and a sudden pain in the heart area. It is a paroxysmal pain that occurs behind the sternum, which is considered a symptom and not a disease. Symptoms usually start abruptly and usually last from seconds to minutes.
When there is insufficient supply of oxygenated blood in the heart muscle or the heart demands more oxygen from increased work or intense physical activity, an imbalance occurs and a heart attack can occur. The reason for this is primarily a hardening of the arteries (atherosclerosis).
It is estimated that approximately 9.8 million Americans suffer annually from this condition, and that 500,000 new cases occur every year.
Types of heart attack
There are three types of infarct or angina pectoris: stable, unstable and variant (Prinzmetal).
Stable
It lasts a few minutes and is triggered by physical or emotional stress. Sometimes even for a very cold or very large meal. Pain can radiate to the neck, jaw, teeth, shoulders and arms. After resting a little normally the pain fades.
Unstable
It does not disappear with rest, what is more, it can happen even if you are calm or at rest. This attack is stronger and lasts longer. The risk of heart attacks in patients with unstable angina pectoris is 20 percent, so an emergency doctor should be called immediately.
Angina prinzmetal the variant
He's a rare guy. Pain occurs at rest as well as during sleep. Spasm occurs in the coronary artery, so doctors talk about coronary vasospasm.
Causes and factors that influence
Coronary heart disease is the most common cause of reduced blood flow to the heart. This disease is the accumulation of fat deposits inside the coronary arteries, which causes it to narrow and restrict the amount of blood that flows into the heart muscle.
Certain risk factors make it more likely to develop coronary heart disease and have a heart attack. Some of these risk factors can be controlled.
Risk factors that can be controlled
The main risk factors that can be controlled are:
- Smoke
- High blood pressure
- High blood cholesterol
- An unhealthy diet (high in trans fat, saturated fat, cholesterol and sodium)
- Overweight and obesity
- Lack of physical activity in the daily routine
- High blood sugar due to insulin resistance or diabetes
Some of these risk factors, such as hypertension, obesity, and blood sugar, tend to occur together, which is known as metabolic syndrome. Generally, a person with metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes.
Risk factors that can not be controlled
Risk factors that can not be controlled include:
- Family background : If the parent or sibling was diagnosed with this heart disease before age 55 the risk increases. Also if the mother or sister was diagnosed before the age of 65 with heart disease.
- Age : The risk of heart disease increases for men after age 45 and for women after age 55 (or after menopause).
- Preeclampsia : This condition can develop during pregnancy. The two main signs of preeclampsia are an increase in blood pressure and excess protein in the urine. Preeclampsia is linked to an increased risk of heart disease throughout life, including coronary heart disease, heart attack, heart failure, and high blood pressure.
symptom
The symptoms manifest basically in pain, burning and a feeling of pressure or oppression behind the sternum.
The pain often radiates to other areas of the body, such as the neck, throat, jaw, teeth, arms, or upper abdomen. In addition, pain may occur between the shoulder blades.
A feeling of heaviness and numbness in the arm, shoulder, elbow or hand is often described, and especially the left part of the body is affected.
In addition, symptoms such as sudden difficulty breathing, nausea, vomiting, sweating, and choking may occur.
In women, symptoms such as fatigue, shortness of breath, and upset stomach are more common. Chest pain on the other hand is uncharacteristic.
Stroke or angina pectoris has a special feature in diabetics, because because of the diabetic neuropathy associated with diabetic neuropathy, they often do not feel any pain. Therefore, it can occur in a silent way, almost without pain, or with little pain.
Diagnosis
The diagnostic studies that can be used are:
- Chest x-ray: usually normal in angina, but certain precautions should be taken according to the patient's history.
- Graduated stress test: this is the most used test for the evaluation of patients with chest pain and can be performed alone or in combination with echocardiography or myocardial perfusion scintigraphy.
- Other tests that may be useful include: ECG (including exercise with ECG monitoring and ECG ambulatory monitoring), selective coronary angiography (a definitive diagnostic test to assess the anatomical extent and severity of CAD), among others.
Treatment
General measures include cessation of smoking, as well as treatment of risk factors (eg, hypertension, high cholesterol, diabetes mellitus, obesity, hyperlipidemia).
Other pharmacological therapies that may be considered include aspirin, clopidogrel, hormone replacement therapy, sublingual nitroglycerin, beta blockers, calcium channel blockers, angiotensin converting enzyme (ACE) inhibitors, autologous cell injections, Revascularization, among others.
Other procedures that may be considered are: intra-aortic balloon counterpulsation, improved external counterpulsation (in patients whose angina is refractory to medical therapy and not suitable candidates for percutaneous or surgical revascularization), transmyocardial (experimental) laser revascularization, among others.
References
- O'Toole (2013). Angina - causes, symptoms, treatment. Medical Library. Retrieved from: southerncross.co.nz.
- Gary H. Gibbons (2013). Risk for a Heart Attack. Department of Health and Human Services. Retrieved from: nhlbi.nih.gov.
- Jamshid Alaeddini (2016). Angina Pectoris. MedScape. Retrieved from: emedicine.medscape.com.
- Watch Seidel (2016). Angina pectoris Symptome. NetDoktor. Retrieved from: netdoktor.de.
- Heart Foundation (2013). Managing your angina. Heart Foundation of New Zealand. Retrieved from: southerncross.co.nz.