A heart attack occurs when the flow of blood to the heart is blocked. The blockage is most often a build-up of fat, cholesterol and other substances which form a plaque in the arteries that feed the heart (coronary arteries). A heart attack, also called a myocardial infarction, can be fatal, but treatment has improved dramatically over the years.
Coronary Heart Disease (CHD) is one of the major causes of mortality and morbidity in the general population of both developing and developed countries. In Jammu and Kashmir, the population is undergoing lifestyle changes but the unusual stress and strain of the last 15 years of the disturbed situation in the region apparently has contributed to increase in the prevalence of CHD. An epidemiological study was conducted to assess the prevalence of CHD in both rural and urban areas of the valley. This study was carried out in the rural and urban areas of the twin districts of Anantnag and Srinagar by random sampling. The total population of the study area comprised 44,305 persons out of which the target population was 13,893. The study was carried out on 3128 (23%) subjects (2284 males and 844 females) aged 40 years and above. In rural areas the study was conducted in a cluster of 3 villages in each district on 1552 persons (1088 males and 464 females) and in urban areas it was carried out in 3 mohallas (closed locality) in each district on 1576 persons (1196 males and 380 females).
The overall prevalence of CHD in the population studied by all diagnostic measures was 7.54%. The overall rural prevalence was 6.70% and urban prevalence was 8.37%. Prevalence of CHD was higher in males, 7.88%, and slightly lower in females, 6.63%.
According to the available figures, as many as 29,545 patients visited the Outpatient Department (OPD) in the Sher-i-Kashmir Institute of Medical Sciences (SKIMS) Soura from January 1st to October 31st, 2020, to treat their heart diseases. Among these, 1454 patients were admitted in the Cardiology department’s Inpatient Department (IPD) for surgeries and other interventions.
At the Super Speciality Hospital, Shireen Bagh Srinagar, as many as 9960 patients visited Cardiology OPD and 1509 others were admitted in the same hospital for specialised treatment in the first 10 months (January 1st to October 31st) of 2020.
SYMPTOMS
? Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back.
? Nausea, indigestion, heartburn or abdominal pain.
? Shortness of breath.
? Cold sweat.
? Fatigue.
? Lightheadedness or sudden dizziness.
Not all people who have heart attacks have the same symptoms or have the same severity of symptoms. Some people have mild pain, others have severe pain. Some people have no symptoms. The earliest warning might be recurrent chest pain or pressure (angina) that’s triggered by activity and relieved by rest. Angina is caused by a temporary decrease in blood flow to the heart. During a heart attack, the blood supply that normally nourishes the heart with oxygen is cut off and the heart muscle begins to die.
CAUSES
There are a few cardiac conditions that can cause heart attacks. One of the most common causes is plaque build-up in the arteries (atherosclerosis) that prevents blood from getting to the heart muscle.
Heart attacks can also be caused by blood clots or a torn blood vessel. Less commonly, a heart attack is caused by a blood vessel spasm.
RISK FACTORS
A number of factors can put you at risk for a heart attack. Some factors you can’t change, such as age and family history. Other factors, called modifiable risk factors, are ones you can change.
Risk factors that you can’t change include:
Age. If you’re over age 65, your risk for having a heart attack is greater.
Sex. Men are more at risk than women.
Family history. If you have a family history of heart disease, high blood pressure, obesity, or diabetes, you’re more at risk.
Modifiable risk factors:
? Smoking
? High cholesterol
? Obesity
? Lack of exercise
? Diet and alcohol consumption
? Stress
? Diagnosis
A diagnosis of a heart attack is made after performing a physical exam and reviewing medical history. Electrocardiogram (ECG) is conducted to monitor the heart’s electrical activity. A sample of your blood may be taken or perform other tests to see if there’s evidence of heart muscle damage.
TESTS AND TREATMENTS
Your doctor may order a cardiac catheterisation. This is a probe that’s inserted into your blood vessels through a soft flexible tube called a catheter. It allows your doctor to view areas where plaque may have built up. Your doctor can also inject dye into your arteries through the catheter and take an X-ray to see how the blood flows, as well as view any blockages.
Common procedures include:
Angioplasty. An angioplasty opens the blocked artery by using a balloon or by removing the plaque build-up.
Stent. A stent is a wire mesh tube that’s inserted into the artery to keep it open after angioplasty.
Heart bypass surgery. In bypass surgery, your doctor reroutes the blood around the blockage.
Heart valve surgery. In valve replacement surgery, your leaky valves are replaced to help the heart pump.
Pacemaker. A pacemaker is a device implanted beneath the skin. It’s designed to help your heart maintain a normal rhythm.
Heart transplant. A transplant is performed in severe cases where the heart attack has caused permanent tissue death to most of the heart.
PREVENTION
Fortunately, there are many things you can do to reduce your chances of getting heart disease:
? Control your blood pressure.
? Keep your cholesterol and triglyceride levels under control.
? Stay at a healthy weight.
? Eat a healthy diet.
? Get regular exercise.
? Limit alcohol.
? Don’t smoke.
? Manage stress.
Recovering from a heart attack can take several months, and it’s very important not to rush your rehabilitation.
During your recovery period, you’ll receive help and support from a range of healthcare professionals. These healthcare professionals will support you physically and mentally to ensure your recovery is conducted safely and appropriately.
The recovery process usually happens in stages, starting in hospital, where your condition can be closely monitored and your individual needs for the future can be assessed.
After being discharged from hospital, you can continue your recovery at home.
The 2 most important aims of the recovery process are:
? To gradually restore your physical fitness so you can resume normal activities (known as cardiac rehabilitation).
? To reduce your risk of another heart attack.

—The writer is a student of BSc Nursing at Pacific Institute of Medical Sciences, Udaipur, Rajasthan.

UMAIR SHAFIQ KHANDAY