All you should know about Heart Attack?

Dr Sandeep Gore, Head of Emergency Medicine, Fortis Hospital, Mulund, shares how the risk of Heart attack can be identified and reduced.

'Huge advance' in fighting world's biggest killer
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In recent times, Heart Attack has become a significant cause of death and disabilities in India. It is responsible for more than 35% of deaths in individuals of the age of 35 years and above. It is a life-threatening medical emergency which occurs due to sudden blockage of blood supply to the Heart muscles. The blockage occurs due to a blood clot(s) in blood vessels supplying the oxygenated blood to the Heart. If not treated promptly, it can permanently damage the heart muscles and may lead to death by Cardiac Arrest.

Symptoms of a heart attack

  • Chest pain spreading to the left arm, shoulders, back, neck, and jaw
  • Profuse sweating
  • Difficulty in breathing 
  • Blackouts

What should one do?

If one experiences heart attack symptoms, then he/she must seek medical help. Meanwhile, he/she must avoid physical exertion. Always remember, every chest pain is a cardiac pain unless proven otherwise.

DIAGNOSIS: 

The medical professionals, through tests like Electrocardiogram, Cardiac Enzymes, chest X-ray, and Echocardiography, can diagnose the ailment. Sometimes, a series of ECGs and Cardiac Enzymes are needed to rule out the cardiac cause.

TREATMENT: 

Initially, the patient gets stabilised in the Emergency Department where he receives Analgesics (morphine), blood thinners (Anti-platelets and Anti-coagulant drugs), Nitrates and Statins. The primary angioplasty is considered as standard treatment in Heart Attacks (Acute Myocardial Infarction), it should be carried out within 90 minutes of the arrival of the patient in the Emergency Department. In Primary Angioplasty, the blood flow supplying oxygenated blood to the heart is restored by removing the blood clot, and a stent is placed to keep the vessel open. At the centres where Primary Angioplasty is not available or not possible, due to other reasons, then Thrombolysis (dissolving the blood clot by giving medicines) should be offered to patients as early as possible. If Thrombolysis is opted, then it should take place within 30 mins of the arrival of the patient to the Emergency Dept.

PREVENTION:

Prevention is always better than the cure. To prevent Heart Attack, one must be aware of the modifiable risk factors which lead to Heart Attack. Making lifestyle changes can risk modifiable risk factors.

  • Being overweight and obese
  • Smoking
  • High cholesterol
  • Hypertension
  • Diabetes Mellitus
  • Stress
  • Sedentary lifestyle

If one has around five risk factors, then chances of suffering a Heart Attack are 30% in the next ten years. It is equivalent to the risk of recurrence of Heart Attack in a patient who already had one. Therefore, the reduction in risk factors is of paramount importance.

PREVENTIVE STEPS:

  • Quit smoking, it kills and is lethal. Amount of cigarettes smoked is directly proportional to the risk of Heart Attack and death due to Heart Attack. One must quit smoking; counseling and sometimes Nicotine Replacement Therapies are needed.
  • Consume Healthy diet: One should avoid junk food, fast food, and red meat. Diet, rich in vegetables and fruits, can prevent Heart Attack. One should opt high-fiber diet; carbohydrates with low Glycaemic Index can be preferred. Monounsaturated fatty acids and Omega-3 fatty acids should be included.
  • Maintain the normal body weight: Nowadays, Obesity and being overweight is surpassing smoking as leading modifiable risk factor. There is the linear relationship between being overweight and obese with morbidity and mortality associated with heart attack. One must bring down Body Mass Index to less than 25 by diet and exercise.
  • Do regular physical activities: Studies have demonstrated that if one does regular aerobic exercise or moderate to intense physical activity for 150 minutes per week will have significantly fewer chances to have the heart attack than the one who doesn’t do. Even modest aerobic exercise like the brisk walk for 25 minutes per day reduces the significant risk of heart attack.
  • Control the blood cholesterol level: One must undergo Lipid Profile testing in the early twenties. If blood Lipid levels are high then one must control it by exercise, proper diet and if required by medicines (statins).
  • Maintaining the blood pressure within normal range: One must maintain Blood Pressure below 130/80mm Hg to reduce this risk factor. Blood pressure can be controlled by doing regular aerobic exercise, by avoiding excessive consumption of salt and by avoiding stressful situations. The patient who doesn’t respond to lifestyle modification need medicines to control Hypertension.
  • Diabetes control: Diabetes carries a high risk of heart attack. Diet and exercise should be tried initially to control blood sugar within the normal range in diabetic patients. If it did not work out then one must go for drug or Insulin Therapy. The HbA1C level should be in normal range in diabetic patients to prevent the heart attack.