In this Health Hub article, we explore the symptoms, causes, prevention, and diagnosis of a heart attack.
A heart attack, sometimes referred to as an Acute Coronary Syndrome (ACS) or Myocardial Infarction (MI), is a life threatening event that occurs when the blood vessels that supply the heart become blocked. As a result of the blockage, the heart muscle becomes damaged making it more difficult for the heart to supply the body with the blood and oxygen it needs.
Facts & Figures
An estimated 6,000 people in Ireland suffer from a heart attack each year.
- In Ireland most heart attacks occur in people aged over 45.
- Men are 2 – 3 times more likely to have a heart attack than women.
- 10 – 15 % of people who have a heart attack may not experience any of the symptoms outlined below.
Symptoms Of A Heart Attack
Symptoms of a heart attack and their severity can vary for person to person. The symptoms to look out for include the following:
- Chest pain – this is pain which is located in the centre of the chest and is described as a sensation of pressure, tightness or squeezing.
- Pain in other areas – the pain may travel from the chest to the arms (usually the left arm, but both may be affected). Pain may also be experienced in the jaw, neck, back and abdomen.
- Shortness of breath
- Feeling anxious
- Loss of consciousness
It is important to remember that some people (elderly and women) may not experience chest pain at all and if you are unsure call 999 for an ambulance.
What Causes A Heart Attack?
The heart has its own blood supply and blood vessels knowns as coronary arteries which are responsible for bringing blood, rich in oxygen, to the heart. Most heart attacks are caused by these coronary arteries becoming blocked with deposits of cholesterol (plaques). This is referred to as Coronary Heart Disease (CHD). If one of these plaques ruptures it results in a blood clot forming at the sight of rupture. The blood clot then blocks off the supply of blood to the heart triggering a heart attack.
There are a number of risk factors that increase the possibility of a heart attack occurring. They are as follows:
- Smoking – the toxins which are present in cigarettes cause the coronary arteries to narrow and become damaged making it more difficult for blood to flow freely to the heart. If you smoke even 1 cigarette a day you are 30% more likely to have a heart attack than a non-smoker.
- Diet – foods high in saturated fat can increase your cholesterol levels which increase the risk of the coronary arteries becoming blocked leading to a heart attack.
- High Blood Pressure – having poorly controlled blood pressure causes damage to the coronary arteries.
- Diabetes – increased levels of glucose (sugar) in the blood causes damage to the coronary arteries.
- Being overweight – increases your risk of developing high blood pressure, high cholesterol and diabetes which are all key risk factors resulting in a heart attack.
- Alcohol – alcohol increases blood pressure and cholesterol levels which in turn increases the risk of a heart attack.
- Sex – men are 2 to 3 times more likely to have a heart attack than women.
- Family History – if you have a first degree relative with a history of heart disease you are twice as likely to develop a similar condition.
- Give up smoking.
- Exercise regularly.
- Change your diet – follow a low fat, high fibre diet. Reduce salt intake and avoid eating foods high in saturated fat.
Reduce alcohol consumption. Recommended daily limits are as follows: 3-4 units for men and 2-3 units for women.
There are a number of tests that doctors carry out to diagnosis a heart attack. They include:
Electrocardiography – this is a painless procedure which measures the electrical activity of your heart. It helps to confirm that a heart attack has occurred and the type of heart attack. Types of heart attacks include:
- ST segment elevation myocardial infarction (STEMI) – this is where there is complete blockage of blood supply to the heart.
- Non-ST segment elevation myocardial infarction (NSTEMI) – this is where there is partial blockage of blood supply to the heart.
- Unstable angina – this is where blood supply is restricted but the extent of the damage to the heart is less severe than in a STEMI or a NSTEMI.
- Blood tests – here the doctors are looking at the levels of particular enzymes that leak into the blood if you have had a heart attack.
- Chest X-Ray – this allows the doctors to see the size of the heart and to look at your lungs for the presence of any fluid.
- Echocardiogram – this test uses sound waves to give a video image of the heart. It helps identify if the heart has been damaged by the heart attack.
- Coronary Angiography – this is when a liquid dye is injected into the arteries which then flow into the heart. This makes the arteries visible on X-Ray revealing any blockages.
- Exercise Stress Test – this may follow a few days or weeks after your heart attack. It involves walking on a treadmill or pedaling a stationary bike while attached to an ECG.
- Cardiac computerized tomography (CT) or Magnetic Resonance Imaging (MRI) – these are scans which collect in depth images of the heart and chest.
Heart Attack Treatments
- Oral Medication
Surgical intervention – if the arteries are damaged or severely blocked, surgery may be required to removed the blockage. Stents may also be inserted to keep blocked arteries open allowing blood to flow freely.
Medicines To Treat A Heart Attack
Below are some of the more commonly prescribed medications used to treat patients post heart attack with the aim of preventing another one. While these are the most commonly prescribed medications, this is not a complete list of all medicines used to treat these patients.
Common Side Effects
- Bruising and bleeding
- Dry Cough
- Cold hands and feet
Advice From The Pharmacist
- If you are unsure if you or someone you know is suffering from a heart attack call 999 immediately. Symptoms of indigestion are often confused with those of a heart attack. If in doubt, call for help.
- If you or someone you know is experiencing symptoms of a heart attack and there are no known allergies, administer 300mg of aspirin which is available over the counter while you are waiting for the ambulance to arrive. This helps to thin the blood and restore blood flow to the heart.
- Try to reduce your preventable risk factors for a heart attack i.e. reduce weight, quit smoking, have a healthy balance diet and reduce alcohol intake.
- Take regular exercise
- If you have been prescribed an Nitrolingual spray always carry it with you. Having multiple sprays is always a good idea, you never know when and where you may need it e.g. in the car, upstairs and downstairs, in coat pocket.
- If you are concerned that you may be at risk of a heart attack speak with your doctor. There are lifestyle changes and medications that can prevent you from having a heart attack.
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Fiona is a pharmacist at Healthwave and graduated from RCSI.