Basic Anatomy of Human’s Heart

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What Causes a Heart-Attack?

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Most heart attacks are caused by a blood clot obstructing blood flow in a coronary artery. The underlying source of an obstructive blood clot is atherosclerosis (a chronic and progressive disease

that narrows and stiffens the coronary arteries)

Narrow, stiff, and brittle coronary arteries are at risk for condition known as plaque rupture. Plaque is a mixture of fat, cholesterol, cellular waste, calcium, and other substances.

Cholesterol is a soft, fatty, and non-dissolvable substance found in the blood and cells. It is needed to form cell walls, certain hormones, and tissue, but it can be harmful in excess. Triglycerides are the chemical form of fats in foods and the body. High blood pressure results when the heart has to work too hard to pump blood through the arteries, and when the arteries resist blood flow too strongly. An overworked heart, like other muscles, eventually enlarges—but unlike muscles in your arm, which become stronger, an enlarged heart becomes weaker. High blood pressure causes arteries to harden and loss their elasticity.

Who Suffers a Heart Attack?Age, gender, genetics, and lifestyle choices all play a role in risk of atherosclerosis and a heart

attack. Some heart attack risk factors, such as age, gender, and heredity, are non-modifiable

—you cannot change them. Many risk factors, however, are modifiable. Risk factors are cumulative: the more you have, the greater your risk of a heart attack.

Nonmodifiable Risk FactorsAgeHeart attacks are most common in people over 45 years of age; the peak incidence is among people aged 50–70. People younger than 45 who may suffer a heart attack include cocaine users, those with insulin-dependent diabetes, individuals with hypercholesterolemia, and those with a family history of coronary artery disease occurring at a young age. Age also affects the outcome of a heart attack: the majority of heart attack victims who die are over 65. GenderBetween the ages of 40 and 70, men are more likely than women to have a heart attack. Among people more than 70 years old, however, the incidence is the same in men and women. The average age for a first heart attack among men is 66 years, and, among women, 70 years. Heredity and RacePeople from families with a history of coronary artery disease and heart attack have a greater likelihood of developing heart disease. People of different racial heritages also have different risk factors for the cardiovascular diseases that may contribute to the risk of heart attack. For example, severe high blood pressure is more common in African Americans than in Americans of Caucasian descent.

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Modifiable Risk Factors

Tobacco UseCigarette, pipe, and cigar smoking, as well as secondhand smoke, all damage the coronary arteries, contributing to plaque formation and heart attack risk. Smoking also increases the risk of blood clot formation. Quitting smoking can greatly reduce your risk of a heart attack and improve both lung health and overall health. Over-the-counter smoking-cessation aids such as nicotine lozenges and gum are available, as are prescription medications. Consult your doctor for advice and strategies for quitting.

High Blood PressureHypertension is a risk factor for heart attack but is generally asymptomatic—meaning that you’ll know whether you have high blood pressure only if your doctor checks it regularly. Blood pressure may be controlled by exercising, decreasing salt intake, and maintaining a normal body weight. A variety of prescription medications are available for use when lifestyle modification fails to reduce blood pressure.

Hypercholesterolemia and TriglyceridesCholesterol levels also contribute to the risk of a heart attack. Like hypertension, hypercholesterolemia is asymptomatic and requires blood tests to detect. Cholesterol can be controlled via a low-fat diet, regular exercise, and cholesterol- lowering medications known as statins.

ExerciseRegular exercise is part of any healthy lifestyle. Exercise can help control cholesterol, lower blood pressure, and prevent or reduce obesity. Cardiovascular fitness reduces the overall risk of having a heart attack, and regular exercise will also make you look and feel better.

ObesityExcess body fat—even in the absence of other risk factors—increases heart attack risk. Obesity is also associated with hypertension, diabetes mellitus, and high cholesterol.

DiabetesInsulin is a hormone, secreted by the pancreas, that enables the body to metabolize and utilize glucose, a form of sugar. Diabetes occurs when the body is incapable of producing or responding to insulin. Diabetes accelerates atherosclerosis and may adversely increase cholesterol levels.

StressHow you deal with stress can affect your risk of a heart attack. Some people cope with stress by exercising, whereas others may smoke, drink alcohol, or overeat. Stress can also increase blood pressure. Learning healthy stress management techniques can help reduce heart attack risk.

Alcohol ConsumptionExcessive alcohol consumption can increase blood pressure, cause arrhythmias (irregular heartbeats), contribute to obesity, and increase triglyceride levels. Conversely, moderate alcohol consumption may actually decrease risk.

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The Symptoms of a Heart Attack

Typical Heart Attack Symptoms

Chest pain is the hallmark symptom of a heart attack. It is often described as tightness, pressure, or squeezing across the chest that may radiate to the jaw, neck, arms, back, and upper middle region of the abdomen. Pain in the left arm is more common, but both arms may be affected.

Although chest pain is considered the prototypical sign of a heart attack, up to one-third of patients, and specific subpopulations, do not actually experience chest pain. Women, patients more than 75 years old, and those with heart failure, diabetes, and a history of stroke are the most likely not to experience chest pain.

Other heart attack symptoms include:

•Shortness of breath (dyspnea) •Nausea with or without vomiting and/or abdominal pain •Anxiety •Lightheadedness with or without loss of consciousness •Coughing •Sweating •Wheezing

Onset of Symptoms

The onset of a heart attack may be sudden, intense, and dramatic, or it may be gradual and subtle. Chest pain may be more a feeling of discomfort than actual pain. Check for other symptoms and listen to your body. If you have chest pain, discomfort, or dyspnea seek medical care.

How to React to Symptoms

In cannot be overemphasized that a heart attack is a life-threatening and time-dependent medical emergency. The longer symptoms persist—that is, the longer the thrombus is allowed to prevent the circulation of oxygenated blood—the greater the potential damage to the heart muscle, and the less likely the chances of survival. Do not ignore, dismiss, or tolerate symptoms even if they are mild. A heart attack is not like indigestion—it will not pass.The fastest to way to access lifesaving and muscle-saving treatment is to contact EMS. EMS teams can diagnosis a heart attack and sometimes begin treatment before reaching the hospital, saving time in the race to clear the obstruction. Patients who arrive at the hospital in an ambulance tend to receive faster treatment than those who transport themselves to the emergency department.

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Complication of a Heart Attck

Complications of a Heart Attack

During a heart attack, your heart is not functioning properly. Complications, such as cardiac arrest and cardiogenic shock, may result.

Cardiac ArrestDuring a heart attack, the heart is unable to beat properly, so irregular or abnormal heart rhythms (arrhythmias) may occur. Arrhythmias occurring in the ventricles (ventricular arrhythmias) may cause the ventricles to quiver rather than expand and contract. The heart may stop beating or beat too quickly, too slowly, or chaotically. As a result, there is not enough pressure to blood pump through the body. Loss of consciousness and death can both occur.

Cardiogenic ShockHeart attack patients may also go into cardiogenic shock. Shock occurs when the heart is so severely damaged that it can no longer pump blood. Blood pressure drops to dangerously low levels, indicating that the heart is barely pumping. Patients who develop cardiogenic shock may become restless, agitated, and confused. Shock patients may also fall into a coma, and there is a high risk of death.

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Heart Attack TreatmentHeart attack treatment is collectively known as reperfusion therapy. It encompasses two categories:

Pharmacologic therapy: Blood clot–dissolving drugs known as thrombolytic agents or fibrinolytic agents are administered intravenously to dissolve blood clots.

Mechanical intervention: Collectively known as percutaneous coronary intervention (PCI), mechanical intervention methods include balloon angioplasty and/or stenting. These procedures physically reopen the coronary arteries. (see the below pictures)

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How Big Is the Stent ?

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Some times after she underwent an angioplasty

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Is there any complication after angioplasty?

Serious complications are unusual following angioplasty and stenting but, nevertheless, can occur.

Less serious complications include bleeding or bruising where your vascular surgeon inserted the catheters. Sometimes, the hole created by the catheter does not completely close. This can create a false channel of blood flow. Rarely, an abnormal connection can form between an artery and a vein at the place where the catheter was inserted. These problems usually go away. However, if you have any serious symptoms, your vascular surgeon can treat you.You may have an increased risk for blood clots forming along your stent, especially in the first month after your procedure. To reduce this risk, your physician may prescribe medications that thin your blood.

As more time passes after your angioplasty and stenting, restenosis becomes more likely. Stents, especially drug-coated stents, may reduce this risk. However, in some cases, you may need a repeat angioplasty or a bypass surgery if a restenosis develops.

Serious, but unusual complications include:

•Reaction to contrast dye •A clot in the artery that your physician treated •A torn or weakened blood vessel •A large blood collection called a hematoma •Kidney problems •Damage to the lining of the artery (called dissection) •Blockages developing in arteries downstream from the treated artery from particles of the plaque breaking free (called embolization).

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