What is a Heart Attack?


Early intervention is very important in a heart attack that starts with sudden pain and tightness in your chest . Early intervention can both reduce the risk of life and ensure that the heart muscle can be saved unharmed.Positive changes to be made in factors that can lead to heart diseases such as diabetes, overweight, malnutrition and inactivity can delay the onset of the disease.
With the sudden rupture of the plaques in the heart vessel and the formation of a clot on it, the heart vessel may suddenly become clogged, resulting in the heart muscle being deprived of oxygen. Without oxygen, the heart muscle cells begin to die after a while. This process is called heart attack = myocardial infarction.

Heart Attack Risk Factors


Treatment of a heart attack is most effective within the first hours after the event begins. Therefore, as soon as you suspect a heart attack, you should apply to a health institution as soon as possible. With rapid diagnosis and treatment, it is possible to overcome the crisis unscathed. In this respect, it is important to recognize the signs ofheart attack .There are 2 important risk factors that increase the risk of heart attack : The first one is called "unchangeable risks" . Genetic factors, age, being male, fall into this first group. Men and those with a family history of early heart attack are at greater risk for a heart attack. The risks increase with age.The second risk factors are called "modifiable risks" . Reducing these risk factors depends on the individual's efforts.

Modifiable Risks in a Heart Attack 
  • smoking,

  • high blood pressure (hypertension),

  • diabetes disease,

  • having high blood fats

  • High body weight (obesity).

But someone with all of these risk factors is at the highest risk of heart attack. For these reasons, it is very important to know the risk of having a heart attack in advance.

The risk of heart attack is higher in some individuals in the society. For this reason, it can be life-saving to identify high-risk individuals by subjecting all individuals to risk analysis and to implement risk-reducing measures.



Symptoms

What are the symptoms of a heart attack?


Chest Pain

Most heart attacks cause pain in the middle of the rib cage. The complaint usually lasts a few minutes and may be of a temporary character. It can be felt as pressure, squeezing, heaviness, pain. Indigestion may occur, which can be confused with stomach discomfort such as burning in the chest.


Pain in the Upper Trunk

A heart attack can also occur with pain in one or both arms, back, shoulders, neck, jaw and upper stomach.


Shortness of breath

Shortness of breath may be the only symptom of a heart attack or may develop before or after the pain. It can develop at rest or with minimal movements.

Other Symptoms of a Heart Attack


  • Sudden cold sweat

  • Sudden unexplained fatigue attacks (especially in women),

  • nausea and vomiting,

  • sudden dizziness,

  • Increase or prolongation of existing complaints.

Contrary to what is commonly known, heart attacks do not always occur as sudden and severe chest pain. Some people can have a silent heart attack (especially diabetics) without any obvious symptoms.

Knowing the symptoms of a heart attack allows an individual who encounters such a situation to reach medical care without wasting time. Because early intervention is very important in a heart attack. Early intervention can both reduce the risk of life and ensure that the heart muscle can be saved unharmed.


Diagnostic Methods

Heart Attack Diagnostic Methods


The diagnosis of heart attack can be made by the doctor. The two most important information for this diagnosis is provided by the patient's complaints and evaluation of the ECG . If the ECG (electrocardiography) findings are typically consistent with a heart attack and the patient's complaints are consistent with the heart attack, the diagnosis is made and treatment is started immediately.In some cases, ECG findings may not be obvious. In this case, some enzymes that rise in the blood as a result of damage to the heart muscle are measured. Although these blood tests are helpful in making the diagnosis, they have the disadvantage that they only increase after a certain period of time. For this reason, specialists may request echocardiography or angiography examinations.

Treatment Methods

Heart Attack Treatment Methods

Early diagnosis and treatment of a heart attack reduces the damage to the heart. Before a definitive heart attack is diagnosed, various treatments are applied even if only in doubt. These applications are as follows:

Anti-Blood Coagulation Drugs

Nitroglycerin to reduce chest pain and improve blood flow

Oxygen Therapy

After the diagnosis of heart attack is confirmed, physicians will start treatment quickly to unclog the heart vessels. There are two treatment methods that can be applied for this purpose;

Clot Dissolving Drugs (Thrombolytic Therapy)

The second is percutaneous coronary intervention (coronary angiography and angioplasty).


Thrombolytic therapy

It is the method of administering anticoagulant drugs through the vein to dissolve the clot that has formed in the vein. This drug therapy is effective within the first 6 hours after a heart attack and should be administered as soon as the diagnosis is made.
Since the drugs have serious bleeding side effects, they are preferred in the limited group of patients living in areas where coronary angiography is not available.

Percutaneous Coronary Interventions

It is a non-surgical method to open clogged or narrowed vessels. It is a method in which clogged vessels are opened by advancing a thin, plastic tube (catheter) with a balloon at the end through the arm or inguinal vein and inflating the balloon when the stenosis level is reached, and sticking the plaque and clot in the vessel to the vessel wall.

At the end of this intervention, the blood flow in the blood vessel is provided. During the procedure, cage-like structures called “stents” are placed that keep the stenosis open for years.

Other treatments for a heart attack are medications and the establishment of a healthy lifestyle. Medications: After a heart attack, your doctor may want you to use one or more of the following medications continuously.

ACE Inhibitors

ACE inhibitors are drugs that lower blood pressure and reduce the pressure on the heart muscle. It also has additional benefits, such as preventing the weakening of the heart muscle after an attack.

Blood thinners

They are drugs that prevent unwanted clot formation by combining coagulation cells. In addition, they should be used for at least 1 year after the stent, as they prevent the stent from becoming clogged with clots.

Beta Blockers

Beta blockers reduce your heart's workload. In addition, it is used to prevent chest pain and prevent a new heart attack. It is also used in the treatment of rhythm disorder.

Cholesterol Lowering Drugs (Statins)

Statins lower or control your blood cholesterol. By lowering your blood cholesterol level, you can prevent a new heart attack or stroke.
Additional rhythm-regulating drugs that control the heart rhythm, antidepressants or diuretics to reduce your anxiety level may also be given. You should use your medications as recommended by your doctor and you should not stop treatment unless your doctor tells you to.

Other Treatments

Coronary artery bypass graft operation can also be performed to treat a heart attack. During coronary bypass, it is aimed to bring blood to the blocked area through your doctor to open your blocked vessel.

Lifestyle change: At least as important as medications and stenting procedures, people who have had a heart attack adopt a healthy lifestyle. For this purpose, it is recommended to quit smoking, exercise regularly, eat healthy, maintain ideal weight, and manage stress. These lifestyle changes are vital in preventing a recurrence of a heart attack.

Emergency Treatment is Vital

After the diagnosis of heart attack is made, urgent treatment should be started. This treatment has two purposes; To prevent loss of life due to a heart attack and to prevent damage to the heart muscle.

Fatal heart rhythm disorders are the leading cause of death from heart attacks. These are more common in the first hours of a heart attack. For this reason, the patient diagnosed with a heart attack is hospitalized in the coronary intensive care unit. Here, the heart functions are constantly monitored by machines and a possible irregularity can be intervened immediately.

Another important goal in the treatment of heart attack is to prevent the heart muscle from being damaged by opening the blocked vessel. If vasodilating treatment can be applied within the first hour of a heart attack, damage to the heart muscle is largely prevented. For this reason, the first 60 minutes of treatment is called the "golden hour".

If the artery remains blocked for a longer time, the heart muscle is irreversibly damaged and heart failure may develop in the long term, even if the patient survives the heart attack. This is a very negative factor for long-term survival and quality of life.

Post-Hospital Care is Crucial

Care and treatment after a heart attack is very important. A second crisis always carries a much greater risk. For this reason, a detailed risk assessment is performed before the patient is discharged. All of the factors leading to a heart attack are being reviewed and an attempt to eliminate them is planned.

This care should include lifestyle changes, rehabilitation, dietary counseling and medication. At this stage, the patient should not cut off his close contact with his doctor, should not disrupt the education process and should be a part of his treatment.

If the factors that cause the heart attack are not adequately combated, the probability of recurrence of the heart attack is high. It is of great importance to quit smoking, do regular and controlled exercises, reach the ideal weight with the appropriate diet, treat high blood pressure, diabetes and high blood fats.

In addition, compliance with the drug treatments given and not interrupting them positively affect long-term survival and quality of life.