Dr Irfan Yaqoob

A heart attack, or myocardial infarction, occurs when blood flow to the heart is blocked. Heart attacks are caused by blockages in coronary arteries, the blood vessels that carry oxygen-rich blood to the heart.
A heart attack is a medical emergency. Blocked or reduced blood flow to the heart damages the heart muscle. If blood flow is not restored quickly, the heart muscle will begin to die.
Blood flow to the heart can become completely cut-off or severely reduced when a blood clot gets lodged in any artery that has been previously narrowed by a build-up of plaque.
Plaque is a combination of fat, cholesterol, and other substances that can build up in the inner lining of artery walls. This build-up is known as atherosclerosis, or “hardening of the arteries.” A build-up of plaque in the arteries leading to the heart is known as coronary artery disease (CAD) and is a major risk factor for heart attacks.

Difference Between Heart Attack and Cardiac Arrest
The term “heart attack” is often incorrectly used to describe cardiac arrest — when the heart suddenly stops beating. Cardiac arrest is caused by an electrical disturbance (ventricular tachycardia or ventricular fibrillation). It is often fatal if steps aren’t taken immediately to restore and stabilise the heart rhythm and pumping function.
While a heart attack can lead to cardiac arrest, the heart doesn’t always stop beating during a heart attack.
The Degree of Blockage of a Coronary Artery determines the type of heart attack. Heart attacks are divided into types based on severity:

STEMI Heart Attack
This is the deadliest type of heart attack. It happens when a coronary artery is suddenly and completely blocked. STEMI is short for ST segment elevation myocardial infarction. This refers to changes that can be seen on an electrocardiogram (ECG or EKG).
Sometimes called a massive heart attack or a “widowmaker” heart attack, a STEMI heart attack causes significantly reduced blood flow to the heart. As a result, areas of the heart muscle quickly begin to die.

NSTEMI Heart Attack
This type of heart attack happens when blood flow through a coronary artery is severely restricted but not entirely blocked. NSTEMI stands for non-ST segment elevation myocardial infarction.
Sometimes called a mini heart attack or a mild heart attack, an NSTEMI heart attack usually causes less damage to the heart than a STEMI heart attack.

Silent Heart Attack
Some people have a heart attack with mild symptoms or even none at all, known as a silent heart attack. Although they don’t involve severe symptoms, silent heart attacks are far from harmless. They can cause permanent damage to the heart muscle.

Heart Attack Complications
Certain complications may arise after a heart attack, depending on the location and extent of damage to the heart. Common heart attack complications include:

Arrhythmia
Arrhythmias happen when the electrical signals that control heartbeats become abnormal or disorganised. An arrhythmia may cause heart palpitations or irregular heartbeat.

Sudden Cardiac Arrest
An electrical disturbance can cause the heart to stop beating altogether. This condition can be fatal without immediate treatment.

Heart Failure
Damage to the heart from a heart attack or coronary heart disease can lead to problems with the pumping function of the heart.

Valve Problems
A heart attack may damage one of the four valves that keep blood flowing in the correct direction through the heart. Valve problems can lead to an abnormal heart murmur when a doctor listens to the heart, as well as fatigue, dizziness, shortness of breath, and swelling in ankles and feet.

Depression
A heart attack can be a scary, stressful, life-changing event. As many as one-third of people who survive a heart attack develop depression following the incident.

Heart Attack Symptoms
Symptoms of a heart attack can vary greatly across people and situations. They’re likely to be more severe in a major heart attack, in which a blood clot completely blocks an artery.
Sudden chest pain is the most common heart attack symptom, but not all people experience it. Some people have only mild symptoms that come on gradually. Other common symptoms include upper body discomfort, shortness of breath, light-headedness, nausea, and fatigue.
A heart attack is a medical emergency. If you experience symptoms that you believe may indicate a heart attack immediately call medical services or visit emergency services of the nearby hospital.

Heart Attack Causes and Risk Factors
You’re more likely to have a heart attack if you’re older, male, have a family history of heart disease, or belong to certain racial or ethnic groups. You can lower your heart attack risk by not smoking, staying active, and keeping your weight, blood pressure, and cholesterol under control.

Heart Attack Diagnosis and Treatment
Once you arrive at a hospital after experiencing heart attack symptoms, doctors will confirm a heart attack through a combination of heart monitoring, blood tests, and imaging tests.
You may be started right away on an intravenous (IV) “clot-busting” drug, which will help dissolve the blood clot that caused your heart attack.
More commonly, you will have a catheter procedure to open up a blocked artery by inflating a tiny balloon in the area of the blockage and leaving a mesh tube (called a stent) to keep it open.
In certain cases, you may require bypass surgery, in which doctors use blood vessels from other areas of your body to let blood flow around blocked arteries to your heart.

Heart Attacks in Men and Women
While heart attack symptoms vary widely across the board, there are some general differences between what men and women typically experience.
Men are more likely to experience chest pain, a cold sweat, nausea, dizziness, or shortness of breath.
Women are more likely to experience pressure in their chest, shortness of breath, or pain in their arms, back, neck, jaw, or stomach without chest discomfort.

Heart Attack Prevention
You can help prevent a heart attack by managing certain risk factors and making healthy lifestyle choices. It’s important to keep tabs on your blood pressure, cholesterol and triglyceride levels, and body weight, and to take action when any of these reaches an unhealthy level.

Life after a Heart Attack
A heart attack is often a devastating event that severely disrupts your life. Still, many people find ways to live a full, enjoyable life in the aftermath.
Some people experience their heart attack as a wake-up call that they need to make certain lifestyle changes, or else they might not be around much longer.
Eating habits may need to be changed after a heart attack, along with lifestyle factors like stress and physical activity.
Recovering from a heart attack can be physically and emotionally taxing, with some people experiencing depression stemming from their limitations.
It’s important to reach out for the help you need to deal with any challenges during your recovery.

Sexual life after a heart attack
A heart attack can take a toll on your romantic relationships and sex life, but that doesn’t mean you should give up on sex life afterward. It may take some recovery time before you can resume sexual activity, and you may need to make certain modifications to your sexual practices.
Impaired sexual function is common after a heart attack, yet many people are reluctant to discuss this problem with their doctor. You may improve your sexual function by improving your overall fitness and endurance.
Many doctors tout the benefits of sex and intimacy among heart attack survivors, such as stress reduction, emotional well-being, and lower blood pressure.

The writer is an interventional cardiologist at Max superspeciality hospital Dehradun. [email protected]

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