According to the recent data India is witnessing nearly two million Heart Attacks per year, which means one person dies every 33 seconds because of heart attack.

The ratio of Men experiencing heart attacks living in cities are 3 times more to those who are living in villages, and for women, the risk rises significantly after the menopause.

High blood pressure, diabetes, smoking, Low-density lipoprotein cholesterol or “bad” cholesterol, changing life style is the leading factors of Heart Attack

What is Heart Attack/Myocardial Infarction?

Our heart requires regular supply of oxygen and various other nutrients, like every other muscle in our body. There are 3 coronaries in the heart; two of them are large, while the other one is a branching artery which supplies oxygen rich blood to the heart muscles.  If any of the arteries or branch gets blocked, a part of the heart starved due to insufficient supply of oxygen, and there comes up a condition known as “Cardiac ischemia.”

If cardiac ischemia lasts for a longer period of time, the heart tissues die because of insufficient supply of oxygen. The death of heart tissues lead to Myocardial Infarction (death of heart muscles) or heart attack. A person might experience chest pain or the electrical instability due to heart attack.

SIGNS AND SYMPTOMS OF Heart Attack/Myocardial Infarction:

• Discomfort or pain in the centre or on the left side of the chest. The discomfort can feel like pressure, squeezing, fullness.
•  Pain and discomfort in the upper part of the body above the belly button like in arms, neck, jaw, back, stomach.
• Shortness of breathe
• Feeling clammy and sweaty
• Feeling of nausea and vomiting
• Sudden dizziness and light-headed

TYPES OF Heart Attack/Myocadial Infarction:

• STEMI (ST Segment elevation myocardial infarction)
• NSTEMI (non ST Segment elevation myocardial infarction)
• Coronary spasm, or unstable angina

ST Segment refers to the pattern of heartbeat as it appears on an electrocardiogram. Both STEMI and NSTEMI heart attacks cause too much damage to the heart resulting in major heart attacks.

STEMI : THE CLASSIC OR MAJOR HEART ATTACK:

STEMI heart attack happens when the coronary artery gets completely blocked and a large portion of the heart muscle does not receive blood. It causes significant damage to the heart and is considered as major or serious heart attack.

NSTEMI HEART ATTACK:

In NSTEMI the coronary artery gets partially blocked. It doesn’t cause much damage to heart but still considered a serious situation.

CAS or SILENT HEART ATTACK:

The Coronary artery Spasm also known as Coronary Spasm or the silent heart attack . These kinds of heart attacks have the similar symptoms of STEMI but can be mistaken by muscle pain, indigestion, etc. Silent heart attacks generally happen when the heart arteries gets too tighten because of which the flow of the blood reduced down drastically. These heart attacks can only be diagnosed either by imaging or blood test. Silent heart attacks are not very serious as there is no permanent damage to the heart.

DIAGONSIS:

The diagnosis of heart attack can be done by performing various tests like:

• ECG (Electrocardiograph) – It monitors the electrical activity of the heart muscles.
• Cardiac Enzyme Test: In this process blood test is conducted that can detect the enzymes produced during the heart attack
• Chest X-RAY- It is done to figure out the swollen part of the heart.

TREATMENT:

Heart Attacks require immediate treatment. Both, surgery and medications are used to treat the patient suffering from heart attacks or myocardial infarction.

The types of surgeries are:

• Angioplasty: this process is used to unblock the arteries so that the proper supply of oxygen rich blood can reach to the heart. During this process, the surgeon inserts a long thin tube known as catheter through the artery to locate the location of the blockage. The surgeon then will place a small mesh tube known as stent at the blockage point, as the stent will prevent the closing of the artery again.
• Coronary artery bypass graft (CABG):  it is an open heart surgery, where the surgeon will reroute the arteries and veins so the proper flow of blood takes place around the blockage. Generally open heart bypass surgery is performed after the weeks from the heart attack so that the heart gets the time to heal, but in some cases it is performed immediately after the heart attack.

The different types of Medications are:

• Blood thinners like aspirin are used to break the blood clots and thus improve the flow of blood through restricted/narrow arteries.
• Thrombolytic are used in rare cases, as it also helps in dissolving the blood clots.
• Antiplatelet drugs, like clopidogrel, are used to prevent the formation of new clots from developing and stop the growth of existing clots.
• Nitroglycerin is used to widen the path of the blood vessels.
• Beta-Blockers are used to lower the pressure of the blood and help the heart muscles to relax. These limit the damage of the heart.
• Pain relievers are used to lower the discomfort level.

Apart from these medications there are several other ways that one can opt to reduce the chances of getting a heart attack like doing exercise on a regular basis and following a healthy lifestyle pattern. Quitting smoking will definitely lowers down the risk of heart attacks and helps in improving the condition of the heart and the lungs. Secondhand smoking should also be avoided as much as possible.

For more information Call Says Dr. Purshotam Lal, Chairman - Metro Group of Hospitals & Director Interventional Cardiology