Do you sometimes feel a little pain or tightness in your chest? Many of us think, "This must be gastritis." But not all chest pain is gastritis. It can be the beginning of a more serious, life-threatening heart attack, or what we call a heart attack. If recognized in time, it can save a life. So let's talk about this precisely and simply today.
Simply put, what is a heart attack?
A heart attack, medically known as a ``Myocardial Infarction'', is a very dangerous condition that occurs when the heart muscle does not receive the required amount of blood. Imagine that a pipe that brings water to our house is clogged with dirt. Then the water does not come out of the tap, right? That's how it is, when one or more of the blood vessels (arteries) that carry blood to the heart are blocked, blood does not flow to a part of the heart.
When blood flow is lost, the heart muscle that is deprived of blood begins to die. If blood flow is not restored quickly, this can cause permanent damage to the heart or even death.
A heart attack is a life-threatening emergency. If you think you or someone you are with is having a heart attack, call 1990 without delay. In such a situation, time is of the essence. Even a few minutes of delay can cause permanent damage to the heart.
What really happens when a heart attack occurs?
When you have a heart attack, the blood flow to a part of your heart either stops completely or is greatly reduced. This causes the heart muscle to become damaged or die. When a part of the heart dies without blood, it can no longer pump blood. This can disrupt the pumping action of the entire heart. This can reduce or stop the flow of blood to the entire body. This can be fatal if not treated quickly.
What could be the symptoms of this?
There can be many symptoms of a heart attack. Some are very common, some are a little less common. But it is very important to know these symptoms well.
The main symptoms that most people experience are:
| Symptom | How it feels |
|---|---|
| Chest pain (Angina) | The chest may feel tight, squeezed, or heavy. Some people may experience unbearable, throbbing pain. This pain may start in the chest and spread to the left arm (sometimes both arms), shoulder, neck, jaw, back, or abdomen. |
| Difficulty breathing | It becomes difficult to breathe, and you may feel like you are suffocating. |
| Other features | Nausea, stomach upset, sweating, rapid heartbeat (palpitations), a feeling of anxiety or "something bad is going to happen", dizziness or loss of consciousness. |
The most important thing is that many people mistake this chest pain for "gastritis" or "a heart attack." But in reality, they could be having a heart attack at that time.
Are there differences in symptoms between men and women?
Yes, this is a very important point. The symptoms that women experience when they have a heart attack can be different than those of men.
- Women are less likely to experience severe chest pain than men. Instead, they may experience symptoms such as shortness of breath, extreme fatigue, insomnia, nausea, and vomiting . They may also experience pain in the back, shoulders, neck, arms, or abdomen.
- Men are generally more likely to experience the "classic" chest pain we all know.
Therefore, it is very important for women in particular to be aware of these different symptoms.
What are the causes of a heart attack?
Most heart attacks are caused by a blockage in a blood vessel that supplies blood to the heart. The main cause of this is cholesterol deposits (Plaque) . Just as when you pour oil down the kitchen sink, the oil gets stuck inside the pipes, cholesterol and other things get stuck inside our blood vessels and form a layer. We call this `(Atherosclerosis).` When these cholesterol deposits increase and the blood vessels narrow, we call that condition `(Coronary Artery Disease)`.
Sometimes, the surface of these cholesterol deposits ruptures. A blood clot can form at the site of the rupture and become lodged. If this clot completely blocks the blood vessel, it can cut off blood flow to the heart muscle, causing a heart attack.
In addition to this main cause, heart attacks can also occur for other reasons very rarely (about 5% of all heart attacks).
- Coronary artery spasm.
- Rare medical conditions that cause abnormal narrowing of blood vessels.
- Damage to the blood vessels of the heart due to an accident.
- Embolism is when something like a blood clot that has formed elsewhere in the body travels and gets stuck in a blood vessel in the heart.
- Eating disorders can cause long-term damage to the heart.
Who is most at risk?
There are several risk factors that can affect the risk of having a heart attack. Some of them we cannot change, but some we can control.
| Type of risk factor | Description |
|---|---|
| Things we cannot change |
|
| Things we can change |
|
How do doctors tell if you're having a heart attack?
A heart attack is usually diagnosed in a hospital's emergency room (ETU). When you go to the ETU with your symptoms, a doctor will examine you. They will check your pulse rate, blood pressure, listen to your heart and lungs, and ask about any symptoms you have been experiencing.
Then, several tests are performed to confirm this situation.
- Blood Tests: This is the most reliable way to diagnose a heart attack. When the heart muscle is damaged, a chemical called ``Cardiac Troponin`` is released into the blood from those cells. This is measured with a blood test.
- ECG (Electrocardiogram): This is the first test you will be given when you go to the ETU. It looks at the electrical signals of your heart to determine if there is any damage to your heart or if there is an irregular heartbeat.
- Echocardiogram: This is like an ultrasound scan. It takes pictures of the inside and outside of your heart to see how well it is pumping and whether the valves are working properly.
- Coronary Angiogram: This test uses a special dye and X-rays to take pictures of the blood vessels in the heart. This can help determine if any blood vessels are blocked.
How is it treated?
The main goal of treating a heart attack is to restore blood flow to the damaged heart muscle as quickly as possible. This can be achieved using a variety of methods, from medications to surgery.
Immediate treatment
- Oxygen: Oxygen is given to those who are having difficulty breathing through a nasal tube or mouth mask.
- Types of medicines:
- Anticoagulants: Blood thinners like aspirin.
- Nitroglycerin: This reduces chest pain and dilates blood vessels, making it easier for blood to flow.
- Painkillers: Medicines such as morphine are given to reduce chest pain.
- Thrombolytics: These are given within the first 12 hours of a heart attack.
- Beta-blockers: These control the heart rate, giving the heart a rest and helping it recover.
- Statins: These control cholesterol, stabilize cholesterol deposits in the blood vessels, and prevent another heart attack.
Specific treatments
- Percutaneous Coronary Intervention (PCI) / Angioplasty: This is the most common treatment. Simply put, a thin tube (catheter) is inserted through the leg or arm into a blood vessel in the heart, and a balloon-like device is inflated to open the blocked area. A stent , a mesh-like device, is then placed in the area to keep the vessel from closing again.How quickly this is done has a huge impact on the patient's life.
- Coronary Artery Bypass Surgery (CABG): This is commonly called bypass surgery . This surgery is done when the blood vessels in the heart are severely blocked in many places. This involves taking a piece of a blood vessel from another part of the body (usually the chest, arm, or leg) and creating a new path for blood to flow around the blocked area.
How long does it take to recover after treatment?
The time it takes for you to feel better after treatment depends on the severity of the heart attack, when treatment started, and any other medical conditions you had.
The average hospital stay is as follows:
- If treated with medication alone: About 6 days.
- If PCI/Stent treatment was performed: About 4 days.
- If you had bypass surgery (CABG): This is a major surgery and recovery will take time. You may need to stay for 8 to 12 days.
It can take anywhere from two weeks to three months to fully recover from the hospital and return to work and normal activities. Your doctor will give you specific instructions on this.
What should you do to survive a heart attack and prevent it from happening again?
There are many things we can do to prevent a heart attack. If you have already had one, it is essential to do these things to prevent another one.
- Get proper medical advice: Visit your family doctor (PCP) for a check-up at least once a year. Check things like blood pressure, sugar levels, and cholesterol levels.
- Quit smoking completely: Cigarettes, cigars, and e-cigarettes (vaping) should all be stopped.
- Exercise regularly: Get at least 30 minutes of moderate-intensity exercise, at least 5 days a week. Even a brisk walk is good.
- Adopt a healthy diet: Reduce foods high in oil, salt, sugar, fast food, and packaged foods as much as possible. Include more vegetables, fruits, herbs, and lean meats and fish in your diet.
- Maintain a healthy weight: It is very important to maintain a healthy weight for your height.
- Control other diseases: If you have diabetes, high blood pressure, or cholesterol, take the medications prescribed by your doctor exactly and on time.
- Reduce stress: Relax your mind with things like yoga and meditation.
If you have had a heart attack, your doctor may refer you to a cardiac rehabilitation program . This will provide you with medical supervision and guidance on exercise, diet, and lifestyle changes.
Why do you say 1990 instead of going to the hospital alone?
If you have symptoms of a heart attack, calling 1990 and getting an ambulance can be a life-saving measure, rather than finding a vehicle and driving yourself to the hospital. There are several reasons for this:
1. Treatment can begin in the ambulance: The trained medical staff on the ambulance can begin basic tests (like an ECG) and treatments (oxygen, aspirin) you need on the way to the hospital. This saves valuable time.
2. You will receive immediate attention at the hospital: When you arrive by ambulance, you will be notified in advance that you are an emergency patient, so you will receive immediate attention and treatment at the ETU.
3. If you lose consciousness on the way: A heart attack can cause your heart to beat irregularly or stop, causing you to lose consciousness. This can be a serious accident if you are driving a vehicle. If this happens in an ambulance, they can treat you immediately and save you.
Remember, "Every second you save is a piece of meat in your heart." That means you're getting a better chance in life.
Take-Home Message
- A heart attack is a medical emergency. If you have symptoms, don't delay.
- Symptoms are not always severe chest pain. They can also include shortness of breath, nausea, back pain, and extreme fatigue. Women should be especially aware of this.
- If you suspect that you or someone else is having a heart attack, do not try to go to the hospital alone, but call 1990 immediately.
- You can greatly reduce your risk of having a heart attack by quitting smoking, eating a healthy diet, exercising, and maintaining a healthy weight.
- If you have any questions about your heart health, talk openly with your doctor.
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