There must not be a more dreadful term than a “Heart Attack” for anyone who thinks about illness. It is a term that we keep hearing so often from our childhood, that whenever we hear about a death, the first question that strikes the mind is, “was it a heart attack’?
What actually is a heart attack? Well, the term ‘Attack’ has almost all the meanings hidden within. An attack symbolizes something sudden and that is what the heart faces. A sudden problem which causes the heart to malfunction and at times even makes it come to a standstill. So let us understand what exactly this problem is.
Just as any city or town is connected by roadways which bring to it many resources, the heart also has blood vessels which bring to it the vital requirements which help it to live and function normally. These vessels are called the Coronary arteries. There are 3 main highways through which specific areas of the heart are irrigated. These are the Right Coronary Artery, the Left Coronary artery and the Circumflex branch. Just like when there is a major accident on one of the highways, the traffic comes to a standstill, similarly, when there is a sudden ‘accident’ in one of the coronaries, there is sudden stoppage or slowing down of the flow of the vital requirements to that part of the heart which is being supplied by the vessel. This ‘accident’, usually a blood clot or a ‘thrombus’, whichdevelops inside the artery and blocks the flow. There are many reasons why this clot suddenly appears. Modern medicine has identified many such risk factors which contribute to the formation of this clot and we shall discuss about them as well. However, what happens when such a block appears is the actual sequence of a heart attack episode. The moment the vital requirements stop reaching or are slowed down in reaching the supplied area of the heart, the the area cries for help. These cries are what we sense as the symptoms of a heart attack. A severe chest pain is the most prominent symptom. The location of this pain can be any place which is connected to the heart. Usually, it is the center of the chest or upper part of the abdomen. Many a times a severe unexplainable back ache also could be the sign that the heart is suffering. This pain can also spread. Usually to the left arm or the lower jaw. There have been instances where a cardiac pain was mistaken to be a tooth ache due to the radiation of this cardiac pain to the jaw. As the heart signals a state of emergency, the entire disaster control mechanism of the body is activated. This can be seen in form of a sympathetic overdrive like sweating, sudden increase in blood pressure and a feeling of impending doom.
When such an acute emergency occurs, it is important to restore the flow on the highway supplying the heart as soon as possible. More the delay more will be damage of that part of the heart which is deprived of the vital requirements. Just like in the event of an Earthquake, faster the relief reaches the affected; more the number of lives are saved, early medical care in a developing heart attack can change the entire outcome of the event in the affected patient.
Although the body has its own mechanism to clear this traffic jam, it is as slow as it would be to send a few policemen at the site of the roadblock. What actually needed is a rapid action force which can prevent a lot of damage by acting at the right place and the right time. Modern medicine provides many such solutions which have changed the lives of the affected patients. We shall talk about them in detail in one of the forthcoming sections.
Important to realize is the need of the urgency to seek medical care. It is in fact better to over suspect than to under suspectespecially if the number of risk factors are many. So what are these risk factors?
Genetics is what loads the gun and it is the environment which pulls the trigger. If there is family history of a heart attack in a male first degree relative before the age of 45 or a female before the age of 55, there is a high likelihood that the family is genetically predisposed to a heart attack. Smoking is the worst thing that one can to the self. If smoking doesn’t kill you, either a heart attack or cancer will; and so it is the most important modifiable risk factor of a heart attack. Stress is another big player in the risks for a heart attack. Stress is not always an unwanted guest. However, when this guest becomes a permanent member of the mind, it erodes all the wellness and stands as a sole and an important cause for a coronary accident. Apart from these, Diabetes sedentary lifestyles, fast food habits uncontrolled blood pressure, are the bystanders which are waiting to be culprits in such coronary accidents
A heart attack is diagnosed with 3 important tools. One of them is the presence of the classic symptoms as described above. The second and most important one is the ECG (Electro Cardio Gram). The ECG almost confirms a developing or already developed coronary accident and the further management of the patient is dependent on this ECG. Hence, in case of the above symptoms it makes sense to go to a health care facility as soon as possible to get an ECG done. Help can also be called at home through emergency medical services, which are equipped with the tools and resources to diagnose a heart attack. Earlier the diagnosis, faster is the line of action decided and better is the outcome for the patient. In situations where the ECG is a bit non conclusive, having an old ECG taken during good health could be really helpful. This helps the medical personnel to compare the ECGs during good health and the current state. This can effectively aid the diagnosis. At times it does happen that the ECGs are a bit confusing. In these circumstances certain blood tests could indicate the ongoing injury to the heart. These blood tests are the third pillar in diagnosis of the heart attack and are called the cardiac enzymes. Usually CK-MB and Troponin T or I measurements are done to find out if the heart muscle is suffering.
In conclusion,
· It is important to recognize the symptoms of a heart attack (see animation) especially in those with more risk factors.
· Any pain in the region between the chin and the navel in an adult which lasts for more than 10 minutes and cannot be explained otherwise, should be considered as a cardiac pain unless proved otherwise.
· Reaching a health care facility as soon as possible where an ECG could be done immediately becomes the most important step that decides the fate of your patient.
Once it is diagnosed, it is the time to know how we can clear this block as soon as possible. We shall discuss this in one of the other sections.
For now, be informed, be empowered! You could save a life!