Heart Attack
Basics
A heart attack, clinically known as a myocardial infarction, occurs when an artery supplying the heart with blood carrying oxygen and nutrients suddenly becomes blocked, causing part of the heart muscle to die Figure 01.
Because your heart is a muscle, it needs oxygen to function, just like any other tissue. The special blood vessels that feed the heart are called coronary arteries. Coronary artery disease is a process of narrowing that occurs over time in these important vessels and can lead to a heart attack. The narrowing is caused by the build-up of fats and plaques in arteries, and can exist and grow without any symptoms.
When the artery becomes blocked, your heart does not receive the blood and oxygen it needs to survive. A heart attack can leave your heart much weaker and less able to pump blood around to the rest of your body, as a portion of the muscle has died and is no longer functioning as well.
Figure 01. What happens during a heart attack
Heart attacks are the most common cause of cardiovascular death. Worldwide, about 20% to 30% of patients suffering from a heart attack die from it, one-third within the first few hours.
Causes
Most heart attacks occur because the walls of an artery have a built up a fatty material called cholesterol plaque. The plaque ruptures, exposing a new, rough surface and releases a substance that causes the blood to clot. The clot forms on the plaque and blocks the artery Figure 02.
The buildup of fatty material (cholesterol plaque) in the arteries is called artherosclerosis. It is the underlying cause of most heart attacks. The plaque buildup causes the arteries to harden and narrow, which makes may reduce blood delivery to the heart during exercise or stress. This can cause momentary chest pain that comes on when the heart is stressed (a condition known as angina). The plaque eventually ruptures, and its rough surface attracts the type of blood cells that cause clotting. Once the clot forms, no more blood reaches the heart, and part of the muscle usually dies as a result.
Figure 02. Healthy artery vs. an artery with plaque buildup
High blood pressure (hypertension), as well as smoking cigarettes, pipes, or cigars, may contribute to plaque buildup.
Your heart also has to work harder when pushing against a “high-pressure” system. This increased workload makes your heart larger and more inefficient. High blood pressure also can lead to congestive heart failure, kidney damage or kidney failure, dementia, and blindness.
Occasionally, inflammatory diseases or cocaine abuse can also cause a heart attack.
Stress, anger, or physical exertion may trigger a heart attack if your arteries are clogged and you have heart disease.
Doctors do not understand why a heart attack often follows physical or emotional stress. One reason may be that during a stressful episode, your heart’s need for oxygen increases but the body is unable to increase the blood flow through the diseased heart (ischemia). Stress hormones also make arteries narrow, which may cause a break in the fatty material built up in the blood vessel. Researchers have noticed that number of heart attacks increases during earthquakes and other natural disasters.
Symptoms
Severe chest pain is the most frequent symptom of a heart attack, although it is possible to be having a heart attack and not have chest pain at all. Another common symptom is a sensation of heavy pressure on the chest Figure 03.
Signs of a heart attack can be subtle or very obvious, and they vary from person to person. Chest pain from a heart attack, if it is present, can be strong and constant and usually lasts for 30 minutes or more. Many people describe the pain as crushing, while others say it is like squeezing, or burning. The pain often radiates down the left arm, but can also spread to your neck, back, right arm, jaw or upper chest. Some people feel little pain, while others describe the sensation as similar to heartburn, or a tight feeling in the chest. If you have more than one heart attack in your lifetime, the second attack may feel different from the first, so it’s a good idea to be familiar with the possible symptoms.
Figure 03. Areas of pain with heart attack
You are likely to feel anxious, restless and nauseous, and look pale, gray, and sweaty.
You may feel faint, weak or short of breath, and have a sense of impending doom. You may even vomit.
The pain from a condition called angina (medical term for chest pain due to coronary heart disease) is similar to what you may feel during a heart attack. If you have angina, and the pain does not go away within a few minutes after resting or medication, you may be having a heart attack.
Angina is a symptom of a condition myocardial ischemia (insufficient blood supply to the heart). This occurs when the heart muscle (myocardium) doesn't get as much blood (hence as much oxygen) as it needs for a given level of work. Angina attacks may be brought on by exercise, stress, or excitement, but can even happen when you are at rest. Angina is almost always an indication that you are at risk for a heart attack sometime in the future. Attacks usually only last a few minutes, and the pain can be eased with medication called nitroglycerin. The nitroglycerin pills are placed under the tongue and work almost immediately to control the pain, as they dissolve quickly and enter the bloodstream right away. If you take your medication and rest, but the pain does not go away, it may be due to a heart attack. If pain is not relieved after three nitroglycerin pills, you should seek immediate medical attention, usually by calling 911.
Risk Factors
Being over the age of 50, being male, and having heart disease in your family all put you at greater risk for heart attack.
Older adults are more likely to suffer from coronary artery disease than younger people. Eighty percent of people who die from the disease are 65 or older. Men are at greater risk of heart attack than women. A man’s risk begins around the age of 35 or 40, although even younger men have been known to have heart attacks. Women become at risk for coronary artery disease by the time they are in their late fifties or early sixties. Once a woman has been postmenopausal for 10 years, her risk is equal to that of a man.
Estrogen is believed to protect the heart from the disease, which is why more heart attacks are seen in post-menopausal women.
After a woman stops menstruating (menopause), which usually occurs in the mid to late forties, the amount of estrogen she produces drops significantly. It is not a coincidence that more heart attacks are seen in post-menopausal women.
Children of people with coronary heart disease are more prone to the condition.
If you smoke cigarettes, cigars, and pipes, your risk of heart attack is doubled.
Smoking increases the rate fatty material builds up in the arteries. In addition, secondhand smoke can up the odds for nonsmokers who are exposed to it.
Having high blood pressure and high blood cholesterol makes you more likely to have a heart attack.
The buildup of fatty material, called plaque, can be caused by consuming too much of certain types of fats. High blood pressure (hypertension) exaggerates this process.
Having a diet that contains high levels of bad cholesterol puts you at greater risk for developing high blood pressure and coronary artery disease.
Cholesterol is a type of soft, fat-like substance (lipid) critical to good health in moderate quantities. It is a part of cell membranes, is found in all body tissues, and can be converted into various hormones. Cholesterol comes from two sources: your own liver produces it, and it is also found in food you eat (especially animal products such as meat, poultry, seafood, dairy products, and eggs).
Risk factors like smoking tobacco, not getting enough exercise, and being overweight or obese can be controlled.
Having high blood pressure, high cholesterol, and high fat levels in the blood are also risk factors that you can manage. Medications, if necessary, can be used to control cholesterol and high blood pressure, and are usually very effective, as is diet and exercise.
If you have diabetes mellitus, you are at greater risk of heart attack than nondiabetics.
Even if you maintain good control of your blood sugar levels, about 66% of those with diabetes die of a heart or blood vessel condition.
Your chances of developing coronary artery disease increase with each risk factor you have.
If you are an obese smoker with high blood pressure, high cholesterol, and a family history of heart disease, you have a greater chance of developing heart disease than someone who has only one of these conditions. The level of severity in each risk factor also increases the possibility of getting heart disease.
Increased homocysteine (a naturally occurring amino acid) levels are also a risk factor.
Homocysteine is a naturally occurring amino acid. A high blood level of homocysteine (known as hyperhomocysteinemia) is thought to be a risk factor because it can irritate your arteries, making them rigid and rough, which can lead to plaque buildup. Doctors are still looking into the connection between homocysteine and heart disease, but many believe taking folic acid and vitamins B6 and B12 may help lower your homocysteine levels and thus your risk of developing coronary heart disease.
Stress plays a part as well.
Stress hormones may make fatty material built up in the artery more likely to break, because they cause the arteries to constrict. Stress management may help you to better cope with situations that make you mad. Whether this reduces the likelihood of a heart attack is not known at present.
Diagnosis
A heart attack, clinically known as a myocardial infarction, occurs when an artery supplying the heart with blood carrying oxygen and nutrients suddenly becomes blocked, causing part of the heart muscle to die Figure 01.
Because your heart is a muscle, it needs oxygen to function, just like any other tissue. The special blood vessels that feed the heart are called coronary arteries. Coronary artery disease is a process of narrowing that occurs over time in these important vessels and can lead to a heart attack. The narrowing is caused by the build-up of fats and plaques in arteries, and can exist and grow without any symptoms.
When the artery becomes blocked, your heart does not receive the blood and oxygen it needs to survive. A heart attack can leave your heart much weaker and less able to pump blood around to the rest of your body, as a portion of the muscle has died and is no longer functioning as well.Figure 01. What happens during a heart attack
Heart attacks are the most common cause of cardiovascular death. Worldwide, about 20% to 30% of patients suffering from a heart attack die from it, one-third within the first few hours.
Most heart attacks occur because the walls of an artery have a built up a fatty material called cholesterol plaque. The plaque ruptures, exposing a new, rough surface and releases a substance that causes the blood to clot. The clot forms on the plaque and blocks the artery Figure 02.
The buildup of fatty material (cholesterol plaque) in the arteries is called artherosclerosis. It is the underlying cause of most heart attacks. The plaque buildup causes the arteries to harden and narrow, which makes may reduce blood delivery to the heart during exercise or stress. This can cause momentary chest pain that comes on when the heart is stressed (a condition known as angina). The plaque eventually ruptures, and its rough surface attracts the type of blood cells that cause clotting. Once the clot forms, no more blood reaches the heart, and part of the muscle usually dies as a result.Figure 02. Healthy artery vs. an artery with plaque buildup
High blood pressure (hypertension), as well as smoking cigarettes, pipes, or cigars, may contribute to plaque buildup.
Your heart also has to work harder when pushing against a “high-pressure” system. This increased workload makes your heart larger and more inefficient. High blood pressure also can lead to congestive heart failure, kidney damage or kidney failure, dementia, and blindness.
Occasionally, inflammatory diseases or cocaine abuse can also cause a heart attack.
Stress, anger, or physical exertion may trigger a heart attack if your arteries are clogged and you have heart disease.
Doctors do not understand why a heart attack often follows physical or emotional stress. One reason may be that during a stressful episode, your heart’s need for oxygen increases but the body is unable to increase the blood flow through the diseased heart (ischemia). Stress hormones also make arteries narrow, which may cause a break in the fatty material built up in the blood vessel. Researchers have noticed that number of heart attacks increases during earthquakes and other natural disasters.
Severe chest pain is the most frequent symptom of a heart attack, although it is possible to be having a heart attack and not have chest pain at all. Another common symptom is a sensation of heavy pressure on the chest Figure 03.
Signs of a heart attack can be subtle or very obvious, and they vary from person to person. Chest pain from a heart attack, if it is present, can be strong and constant and usually lasts for 30 minutes or more. Many people describe the pain as crushing, while others say it is like squeezing, or burning. The pain often radiates down the left arm, but can also spread to your neck, back, right arm, jaw or upper chest. Some people feel little pain, while others describe the sensation as similar to heartburn, or a tight feeling in the chest. If you have more than one heart attack in your lifetime, the second attack may feel different from the first, so it’s a good idea to be familiar with the possible symptoms.Figure 03. Areas of pain with heart attack
You are likely to feel anxious, restless and nauseous, and look pale, gray, and sweaty.
You may feel faint, weak or short of breath, and have a sense of impending doom. You may even vomit.
The pain from a condition called angina (medical term for chest pain due to coronary heart disease) is similar to what you may feel during a heart attack. If you have angina, and the pain does not go away within a few minutes after resting or medication, you may be having a heart attack.
Angina is a symptom of a condition myocardial ischemia (insufficient blood supply to the heart). This occurs when the heart muscle (myocardium) doesn't get as much blood (hence as much oxygen) as it needs for a given level of work. Angina attacks may be brought on by exercise, stress, or excitement, but can even happen when you are at rest. Angina is almost always an indication that you are at risk for a heart attack sometime in the future. Attacks usually only last a few minutes, and the pain can be eased with medication called nitroglycerin. The nitroglycerin pills are placed under the tongue and work almost immediately to control the pain, as they dissolve quickly and enter the bloodstream right away. If you take your medication and rest, but the pain does not go away, it may be due to a heart attack. If pain is not relieved after three nitroglycerin pills, you should seek immediate medical attention, usually by calling 911.
Being over the age of 50, being male, and having heart disease in your family all put you at greater risk for heart attack.
Older adults are more likely to suffer from coronary artery disease than younger people. Eighty percent of people who die from the disease are 65 or older. Men are at greater risk of heart attack than women. A man’s risk begins around the age of 35 or 40, although even younger men have been known to have heart attacks. Women become at risk for coronary artery disease by the time they are in their late fifties or early sixties. Once a woman has been postmenopausal for 10 years, her risk is equal to that of a man.
Estrogen is believed to protect the heart from the disease, which is why more heart attacks are seen in post-menopausal women.
After a woman stops menstruating (menopause), which usually occurs in the mid to late forties, the amount of estrogen she produces drops significantly. It is not a coincidence that more heart attacks are seen in post-menopausal women.
Children of people with coronary heart disease are more prone to the condition.
If you smoke cigarettes, cigars, and pipes, your risk of heart attack is doubled.
Smoking increases the rate fatty material builds up in the arteries. In addition, secondhand smoke can up the odds for nonsmokers who are exposed to it.
Having high blood pressure and high blood cholesterol makes you more likely to have a heart attack.
The buildup of fatty material, called plaque, can be caused by consuming too much of certain types of fats. High blood pressure (hypertension) exaggerates this process.
Having a diet that contains high levels of bad cholesterol puts you at greater risk for developing high blood pressure and coronary artery disease.
Cholesterol is a type of soft, fat-like substance (lipid) critical to good health in moderate quantities. It is a part of cell membranes, is found in all body tissues, and can be converted into various hormones. Cholesterol comes from two sources: your own liver produces it, and it is also found in food you eat (especially animal products such as meat, poultry, seafood, dairy products, and eggs).
Risk factors like smoking tobacco, not getting enough exercise, and being overweight or obese can be controlled.
Having high blood pressure, high cholesterol, and high fat levels in the blood are also risk factors that you can manage. Medications, if necessary, can be used to control cholesterol and high blood pressure, and are usually very effective, as is diet and exercise.
If you have diabetes mellitus, you are at greater risk of heart attack than nondiabetics.
Even if you maintain good control of your blood sugar levels, about 66% of those with diabetes die of a heart or blood vessel condition.
Your chances of developing coronary artery disease increase with each risk factor you have.
If you are an obese smoker with high blood pressure, high cholesterol, and a family history of heart disease, you have a greater chance of developing heart disease than someone who has only one of these conditions. The level of severity in each risk factor also increases the possibility of getting heart disease.
Increased homocysteine (a naturally occurring amino acid) levels are also a risk factor.
Homocysteine is a naturally occurring amino acid. A high blood level of homocysteine (known as hyperhomocysteinemia) is thought to be a risk factor because it can irritate your arteries, making them rigid and rough, which can lead to plaque buildup. Doctors are still looking into the connection between homocysteine and heart disease, but many believe taking folic acid and vitamins B6 and B12 may help lower your homocysteine levels and thus your risk of developing coronary heart disease.
Stress plays a part as well.
Stress hormones may make fatty material built up in the artery more likely to break, because they cause the arteries to constrict. Stress management may help you to better cope with situations that make you mad. Whether this reduces the likelihood of a heart attack is not known at present.
Your doctor may perform several tests to determine if you are having a heart attack.
If you are having chest pains, your doctor will perform an electrocardiogram (ECG). This test keeps track of the electrical activity in your heartbeat, and will alert your doctor of specific changes that occur only when you experience a heart attack. You health professional may also do a blood test that measures certain cardiac enzymes (released by dying heart cells) that are detectable a few hours after a heart attack occurs. The levels of these enzymes (known as cardiac markers) can help your doctor determine if a heart attack is present (if the ECG did not already do this). Your doctor may order other tests, such as an ultrasound to examine the heart (echocardiogram) or nuclear imaging, if the results of an ECG and other tests do not clearly show whether or not you are having a heart attack. If you have had a heart attack, you may have low blood pressure or an increased heart rate, so your doctor will also listen to your heart and lungs to check for any complications.
Forming good habits early in life is the best way to prevent a heart attack. Control your weight and adopt healthy eating habits.
Plaque buildup usually begins in the late teens, meaning all adults have a certain amount of it. It takes a long time for the buildup to develop, which means you have many years to form the kinds of healthy lifestyle habits that will prevent the buildup from becoming heavy.
Avoid red meat, fried foods, high-fat dairy products and high-fat processed foods. Avoid the skin of chicken, and eat eggs only occasionally, as they are both high in cholesterol. Learn to substitute other types of snacks on the run, such as low-fat yogurt and fruit, for greasy fast food. The earlier you adopt good habits, the easier it will be to reach for something healthy when you need a quick bite, as opposed to stopping for a hotdog or a hamburger at lunch when you are in a hurry.
The diet and exercise habits that you form over the long term will have the greatest effect on lowering your risk for heart attack. Your health care professional can help to provide you with a sensible eating and exercise plan
Changing your diet to include more fruits, vegetables, and fish, developing an exercise program, and quitting smoking can decrease your risk of a heart attack.
Try to eat two to three servings of fruit and three to five servings of vegetables a day. Eating fish twice a week is also recommended. Losing even 10 to 20 pounds can help cut heart risks if you are overweight. Regular, vigorous exercise can help prevent coronary artery disease, but even moderate routines are helpful and can lower cholesterol, blood pressure, weight and blood sugar levels. If you are a smoker, you can dramatically and quickly lower your risk of suffering from a heart attack by stopping today.
While drinking moderate amounts of alcohol (one drink per day for women and two for men) may lower your coronary heart disease risk, doctors do not recommend that you start drinking or increase the amount of alcohol you normally consume.
Studies have shown that people who drink moderate amounts of alcohol have a lower risk of heart disease than nondrinkers; however, too much alcohol can increase blood pressure and cause other problems.
Have your blood pressure and cholesterol levels checked.
An easy blood pressure check can alert you to potential problems, and your doctor can order a simple blood test to check your cholesterol levels. If your blood pressure or cholesterol levels are high, you and your doctor can decide on a plan to bring the numbers down to within normal range. Your doctor will want to see blood pressure readings below 135/85 mm Hg. Your levels of “good” cholesterol (HDL) and your levels of “bad” cholesterol (LDL) are important to consider, in addition to your total cholesterol level, which doctors recommend to be less than 200 mg/DL.
Prevention and Screening
Forming good habits early in life is the best way to prevent a heart attack. Control your weight and adopt healthy eating habits.
Plaque buildup usually begins in the late teens, meaning all adults have a certain amount of it. It takes a long time for the buildup to develop, which means you have many years to form the kinds of healthy lifestyle habits that will prevent the buildup from becoming heavy.
Avoid red meat, fried foods, high-fat dairy products and high-fat processed foods. Avoid the skin of chicken, and eat eggs only occasionally, as they are both high in cholesterol. Learn to substitute other types of snacks on the run, such as low-fat yogurt and fruit, for greasy fast food. The earlier you adopt good habits, the easier it will be to reach for something healthy when you need a quick bite, as opposed to stopping for a hotdog or a hamburger at lunch when you are in a hurry.
The diet and exercise habits that you form over the long term will have the greatest effect on lowering your risk for heart attack. Your health care professional can help to provide you with a sensible eating and exercise plan
Changing your diet to include more fruits, vegetables, and fish, developing an exercise program, and quitting smoking can decrease your risk of a heart attack.
Try to eat two to three servings of fruit and three to five servings of vegetables a day. Eating fish twice a week is also recommended. Losing even 10 to 20 pounds can help cut heart risks if you are overweight. Regular, vigorous exercise can help prevent coronary artery disease, but even moderate routines are helpful and can lower cholesterol, blood pressure, weight and blood sugar levels. If you are a smoker, you can dramatically and quickly lower your risk of suffering from a heart attack by stopping today.
While drinking moderate amounts of alcohol (one drink per day for women and two for men) may lower your coronary heart disease risk, doctors do not recommend that you start drinking or increase the amount of alcohol you normally consume.
Studies have shown that people who drink moderate amounts of alcohol have a lower risk of heart disease than nondrinkers; however, too much alcohol can increase blood pressure and cause other problems.
Have your blood pressure and cholesterol levels checked.
An easy blood pressure check can alert you to potential problems, and your doctor can order a simple blood test to check your cholesterol levels. If your blood pressure or cholesterol levels are high, you and your doctor can decide on a plan to bring the numbers down to within normal range. Your doctor will want to see blood pressure readings below 135/85 mm Hg. Your levels of “good” cholesterol (HDL) and your levels of “bad” cholesterol (LDL) are important to consider, in addition to your total cholesterol level, which doctors recommend to be less than 200 mg/DL.
Treatment
Heart attacks are life threatening. If you are experiencing chest pain or other symptoms of a heart attack, call for emergency medical services, which is 911 in most communities.
Sit down and wait for emergency medical caregivers to arrive; do not try to drive yourself to the hospital. Emergency medical services can begin treating you immediately. Because the most damage occurs during the first two hours of a heart attack, a delay in calling for help may result in a poorer prognosis or even death.
Don’t try to diagnose yourself.
Many conditions can cause symptoms similar to a heart attack. Only 10% to 20% of chest-pain patients admitted to emergency rooms are actually having a heart attack, so an evaluation and testing should be performed promptly after your arrival at the emergency room. Treatment is aimed at decreasing the amount of permanent tissue damage by returning an adequate blood supply to your heart muscle. The artery must be opened by drug therapy or an invasive procedure as quickly as possible. Early treatment can decrease your long-term chances of dying by about 50%.
Chew aspirin at home before the paramedics arrive, unless you have had serious trouble with stomach bleeding. It can decrease additional clot formation and may lower your risk of death from the heart attack.
After surviving a heart attack, you should modify your diet to include more fruits, vegetables, and whole grains, and fewer saturated fats and cholesterol. Developing an exercise regimen in addition is sure to help the extra pounds disappear.
Your health care professional can help you get started on an exercise program and a proper diet. If you have been eating high-fat foods for years and are not used to getting regular exercise, it may take you a while to adapt to the changes. However, it is very important that stick to a plan.
If you are a smoker, you should stop smoking immediately. Smoking doubles your chances for having a heart attack.
Understand what foods are heart-healthy and why. If faced with the choice between red meat (high in saturated fat) and shellfish (high in cholesterol), learn how to make the right decision.
There are two main types of cholesterol. The “good” cholesterol (HDL) helps to carry away the buildup of “bad” cholesterol (LDL) that collects in the arteries and forms plaque. Your body regulates the amount of cholesterol in the bloodstream on its own, but diet does contribute to blood cholesterol levels. The type of fat a food contains determines what kind of effect it will have on raising your blood cholesterol. Foods high in saturated fat, like red meat, palm kernel oils, butter, and other high fat dairy products are the worst for you in terms of raising cholesterol. High cholesterol foods like eggs and shellfish should be avoided or eaten in moderation. Monounsaturated fats, like olive oil, are a better choice because they do not increase your bad cholesterol levels. “Good” cholesterol levels are raised by an exercise program and by quitting smoking.
A cardiac rehabilitation program will help you learn about lifestyle changes that can decrease your chance of a second heart attack.
The program instructors will monitor you while you gradually increase physical activity. Your doctor can recommend one for you.
Your doctor is the best source of information on the drug treatment choices available to you.
An angioplasty is a moderately invasive procedure that may be done if you have had a heart attack, but only under certain circumstances.
Angioplasty is considered an alternative option to clot-dissolving drugs. This is usually done within 12 hours by a skilled doctor (an interventional cardiologist) who performs at least 75 of these procedures a year, and at a medical center where more than 200 angioplasties are performed each year. A specially trained doctor inserts a flexible tube (catheter) in an artery in the groin, threads the device through the arteries to the heart, and inflates a balloon at the clogged area. After opening the blockage, the doctor may insert a stent, a device designed to hold the artery open.
Should you continue to experience chest pain, or if you have large areas of heart tissue that have not received enough oxygen, you may be in need of bypass surgery Figure 04.
Bypass surgery is a highly invasive procedure where the chest is opened and the doctors work directly on the heart muscle. It is usually done on patients whose blockages are not treatable by angioplasty, or because multiple vessels are seriously diseased. During a bypass procedure, a surgeon will attach a section of artery or vein in front of the diseased and narrowed artery to carry blood around the blockage, thereby creating an alternate route for the blood flow. The doctor will need to borrow these arteries or veins from another part of your body, usually the leg. Or, an artery known as the internal mammary artery (IMA) may be detached from the chest wall and the open end attached to the coronary artery below the blocked area. Either way, blood can then use this new path to once again flow freely to the heart muscle.
You can have just one artery bypassed, or several, depending on how many are blocked. The operation is usually not done during a heart attack, but before a heart attack occurs or within the weeks or months following one, in order to prevent another. The surgery usually lasts between three and six hours, during which time your heart may be stopped and chilled so that its oxygen requirement is very low. A heart/lung machine will pump and oxygenate your blood for you.
Figure 04. How bypass surgery works (animation and audio)
Although bypass surgery is a major operation, most patients report that, overall, they feel much better once they have healed because they no longer have chest pain.
Exercise will be easier to do, and you will probably not get out of breath as quickly. However, the recovery time is substantial, spanning a period of four to six weeks, possibly more depending on your general health.
Always check with your doctor before taking any type of herbal remedy. Those that contain ephedra may trigger angina or a heart attack and can occasionally lead to death.
Complications of a heart attack can be life-threatening, but you will be watched very carefully for any warning signs of trouble both in the hospital and once you have left.
Almost all heart attack patients are at risk for developing an irregular heart rhythm (arrhythmia). An electronic device called a defibrillator, used to restore the heart’s normal rhythm by applying an electric shock to it, may be used if the abnormal heartbeat becomes life-threatening.
Congestive heart failure (CHF) may occur when a large area of tissue has died and the heart muscle is not able to pump adequately. Because the heart is not able to pump adequately, fluid can build up in the lungs and other tissues. Symptoms of CHF include shortness of breath and an increased heart rate. Medication for congestive heart failure may be required.
Your prognosis varies depending on the level of permanent damage to the heart muscle and other factors.
Factors such as how well the left side of the heart is functioning or pumping, whether or not there are areas of the heart still not receiving enough oxygen, how stable the electrical system that controls the heart rhythm is, and the progression of plaque buildup in the arteries will all be factors to your prognosis. A poorer prognosis is more likely if you experience problems with irregular heart rhythms and/or if your heart has lost much of its ability to pump blood (pump failure).
Careful monitoring in a coronary or intensive care unit is crucial, especially during the first 24 hours after your heart attack.
You will rest in bed for the first 12 to 24 hours, since activity makes the heart work harder and can increase the amount of damage already done. You can typically get up to a chair or sit on the edge of the bed within the first 24 hours, and should be walking a few times daily within four to five days.
Several days after a heart attack, you will usually have some type of stress testing. During stress testing, you will exercise or receive drugs that mimic the effect of exercise on the heart. This allows your doctor to evaluate how well your heart functions when additional demands are placed on it.
Testing will depend on your condition and the length of time since your heart attack. These tests help your doctor to determine the extent of the damage to your heart, how well your heart is functioning, if you experience chest pain with increased activity, and how much you may be capable of doing.
A health care professional will start you on a special diet while you are in the hospital, and will recommend that you change your eating and exercise habits once you have returned home.
Doctors will usually start you on a clear liquid diet when your pain is under control and the risk of vomiting subsides. Once you are able to tolerate liquids, you will advance to a heart-healthy diet. The cardiac diet gets half its calories from complex carbohydrates, contains less than 30% of daily calories from fats, is low in saturated fats, includes food with plenty of potassium, magnesium, and fiber (such as fruits, vegetables and whole grains), and includes very little salt.
After you are discharged from the hospital, you are likely to be prescribed a number of medications designed to aid in your recovery, and to help prevent a second heart attack.
You will probably receive drugs that help control high blood pressure and cholesterol levels in addition to other heart medications.