what is the cause of a heart attack
Coronary Heart Disease
A heart attack happens if the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart can't get oxygen. Most heart attacks occur as a result of coronary heart disease (CHD).
CHD is a condition in which a waxy substance called plaque builds up inside of the coronary arteries. These arteries supply oxygen-rich blood to your heart.
When plaque builds up in the arteries, the condition is called atherosclerosis. The buildup of plaque occurs over many years.
Eventually, an area of plaque can rupture (break open) inside of an artery. This causes a blood clot to form on the plaque's surface. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery.
If the blockage isn't treated quickly, the portion of heart muscle fed by the artery begins to die. Healthy heart tissue is replaced with scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems.
Coronary Heart Disease
A heart attack happens if the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart can't get oxygen. Most heart attacks occur as a result of coronary heart disease (CHD).
CHD is a condition in which a waxy substance called plaque builds up inside of the coronary arteries. These arteries supply oxygen-rich blood to your heart.
When plaque builds up in the arteries, the condition is called atherosclerosis. The buildup of plaque occurs over many years.
Eventually, an area of plaque can rupture (break open) inside of an artery. This causes a blood clot to form on the plaque's surface. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery.
If the blockage isn't treated quickly, the portion of heart muscle fed by the artery begins to die. Healthy heart tissue is replaced with scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems.
A less common cause of heart attack is a severe spasm (tightening) of a coronary artery. The spasm cuts off blood flow through the artery. Spasms can occur in coronary arteries that aren't affected by atherosclerosis.
What causes a coronary artery to spasm isn't always clear. A spasm may be related to:
Taking certain drugs, such as cocaine
Emotional stress or pain
Exposure to extreme cold
Cigarette smoking
The animation below shows how plaque buildup or a coronary artery spasm can lead to a heart attack. Click the "start" button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames.
What causes a coronary artery to spasm isn't always clear. A spasm may be related to:
Taking certain drugs, such as cocaine
Emotional stress or pain
Exposure to extreme cold
Cigarette smoking
The animation below shows how plaque buildup or a coronary artery spasm can lead to a heart attack. Click the "start" button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames.
Heart Attack Causes
Most heart attacks are the end result of coronary heart disease, a condition that clogs coronary arteries with fatty, calcified plaques. As blood flow is gradually impeded, the body may compensate by growing a network of collateral arteries to circumvent blockages; the presence of collateral vessels may greatly reduce the amount of heart muscle damaged by a heart attack. In the early 1980s, researchers confirmed that the precipitating cause of nearly all heart attacks is not the obstructive plaque itself, but the sudden formation of a blood clot on top of plaque that cuts off blood flow in an already narrowed vessel.
While the step-by-step process leading to heart attack is not fully understood, major risk factors are well-established. Some can be controlled. Of these, the main ones are high blood pressure, high cholesterol, obesity, smoking, and a sedentary lifestyle. Stress is also believed to raise the risk, and exertion and excitement can act as triggers for an attack.
Men over the age of 50 with a family history of heart disease are predisposed to heart attack. High levels of estrogen are thought to protect premenopausal women fairly well from heart attack, but the risk increases significantly after menopause.
Heart Attack Diagnosis
A cardiologist, a heart specialist, relies on various tests and scans to diagnose a heart attack and to identify sites of blockage in the arteries and tissue damage. Test recordings of electrical activity within the heart, supported by blood tests, provide data for an initial assessment of the patient's condition. Images of the heart and coronary arteries supplied by angiograms and radioisotope scans locate specific areas of damage and blockage. Ultrasound tests called echocardiograms evaluate the heart's function. With such data, the doctor can pursue proper treatment and anticipate potential complications
Heart Attack Treatment
A heart attack is a medical emergency that must be quickly addressed by conventional medicine. Alternative medicine cannot compete with standard drug and surgical therapy during the emergency and follow-up phases of heart attack treatment. However, alternative medicine may make valuable contributions to heart attack prevention and recovery.
Conventional Medicine for a Heart Attack
Heart attack victims are usually hospitalized in special coronary care units (CCU) for at least 36 hours. Standard drug therapy includes a painkiller such as morphine, vasodilators such as nitroglycerine to expand blood vessels, beta-adrenergic blocker drugs to calm the heart, and aspirin to reduce clotting activity. In some cases, clot-dissolving drugs like tPA or tenectaplase (TNKase) are also given. These drugs are most effective if given within a few hours of the beginning of a heart attack. Emergency angioplasty, and possibly surgery, might be performed to remove a clot, reopen a clogged artery, or bypass blocked arteries.
Once past the critical phase of a heart attack, patients continue to receive beta blockers to slow the heart, nitrates to increase heart blood flow, and blood thinners such as heparin, clopidogrel, Brilinta, Effient, or aspirin to prevent further blood clotting.
Most heart attacks are the end result of coronary heart disease, a condition that clogs coronary arteries with fatty, calcified plaques. As blood flow is gradually impeded, the body may compensate by growing a network of collateral arteries to circumvent blockages; the presence of collateral vessels may greatly reduce the amount of heart muscle damaged by a heart attack. In the early 1980s, researchers confirmed that the precipitating cause of nearly all heart attacks is not the obstructive plaque itself, but the sudden formation of a blood clot on top of plaque that cuts off blood flow in an already narrowed vessel.
While the step-by-step process leading to heart attack is not fully understood, major risk factors are well-established. Some can be controlled. Of these, the main ones are high blood pressure, high cholesterol, obesity, smoking, and a sedentary lifestyle. Stress is also believed to raise the risk, and exertion and excitement can act as triggers for an attack.
Men over the age of 50 with a family history of heart disease are predisposed to heart attack. High levels of estrogen are thought to protect premenopausal women fairly well from heart attack, but the risk increases significantly after menopause.
Heart Attack Diagnosis
A cardiologist, a heart specialist, relies on various tests and scans to diagnose a heart attack and to identify sites of blockage in the arteries and tissue damage. Test recordings of electrical activity within the heart, supported by blood tests, provide data for an initial assessment of the patient's condition. Images of the heart and coronary arteries supplied by angiograms and radioisotope scans locate specific areas of damage and blockage. Ultrasound tests called echocardiograms evaluate the heart's function. With such data, the doctor can pursue proper treatment and anticipate potential complications
Heart Attack Treatment
A heart attack is a medical emergency that must be quickly addressed by conventional medicine. Alternative medicine cannot compete with standard drug and surgical therapy during the emergency and follow-up phases of heart attack treatment. However, alternative medicine may make valuable contributions to heart attack prevention and recovery.
Conventional Medicine for a Heart Attack
Heart attack victims are usually hospitalized in special coronary care units (CCU) for at least 36 hours. Standard drug therapy includes a painkiller such as morphine, vasodilators such as nitroglycerine to expand blood vessels, beta-adrenergic blocker drugs to calm the heart, and aspirin to reduce clotting activity. In some cases, clot-dissolving drugs like tPA or tenectaplase (TNKase) are also given. These drugs are most effective if given within a few hours of the beginning of a heart attack. Emergency angioplasty, and possibly surgery, might be performed to remove a clot, reopen a clogged artery, or bypass blocked arteries.
Once past the critical phase of a heart attack, patients continue to receive beta blockers to slow the heart, nitrates to increase heart blood flow, and blood thinners such as heparin, clopidogrel, Brilinta, Effient, or aspirin to prevent further blood clotting.
While hospitalized, heart attack patients are hooked to electrocardiogram machines for constant monitoring, in case heart rhythm abnormalities develop. If the heart starts beating too fast or too slow, various medications may be given. Some patients may be fitted with pacemakers. If a patient experiences a dangerous arrhythmia known as ventricular fibrillation, an electric shock to the chest is given. Patients who show signs of congestive heart failure are given a variety of medications to decrease strain on the heart and to encourage the heart to beat more forcefully.
People recovering from a heart attack are urged to get back on their feet as quickly as possible, which reduces the chances of blood clots forming in the deep veins of the legs; the clots could travel through the circulatory system and lodge in the lung, creating a blockage. Gentle exercise is recommended, but nothing that requires significant exertion. Long-term recovery from heart attack requires psychological and lifestyle adjustments: Habits that need to go include smoking, heavy drinking, and eating high-fat foods.
As a preventive measure, most heart attack survivors take a daily aspirin tablet to thin the blood. Other drugs may also be prescribed, depending on the patient.
Some patients require invasive procedures to improve blood flow to the heart over the long term. The two most common procedures are angioplasty -- a catheter technique that widens clogged arteries by breaking up plaques -- and coronary bypass surgery, which diverts blood flow around clogged arteries.
Lifestyle After a Heart Attack
Regular aerobic exercise greatly enhances efforts to prevent or recover from a heart attack. If you already have a heart condition, schedule a stress test before beginning an exercise program in order to determine how much exertion is safe. Heart attack survivors are advised to exercise with other people rather than alone during the first months of recovery. Many community health and recreation centers offer physician-supervised cardiovascular rehabilitation programs.
Mind/Body Medicine After a Heart Attack
Reducing stress may be one of the risk factors that you can control to help prevent a heart attack and aid recovery. Many techniques promote relaxation -- among them, meditation, biofeedback, and yoga. Relaxation has also been shown to provide relief from pain, which may be encountered during the recovery period.
State of mind is another important consideration in heart attack recovery. People with a positive attitude about recovery tend to do much better. You may find that a particular mind/body technique helps you to focus on positive thoughts. You may also find, as many others have, that sharing thoughts and emotions with a support group is extremely beneficial.
Nutrition and Diet After a Heart Attack
The basic goals of a heart-healthy diet are to keep salt, sugar, and saturated fat to a minimum to control cholesterol, blood pressure, and weight. Eating magnesium-rich foods such as nuts, beans, bran, fish, and dark green vegetables may help prevent a heart attack. Magnesium protects the heart directly and indirectly, by stabilizing heart rate, reducing coronary artery spasm, and combating such conditions as atherosclerosis and high blood pressure.
Nutrition and Diet After a Heart Attack continued...
Much evidence suggests that unstable chemical compounds known as free radicals make the body more vulnerable to heart attack by striking the heart and coronary arteries and promoting atherosclerosis. Free radicals can be neutralized by antioxidants like vitamins A, C, and E. Fruits, vegetables, and grains supply many of the antioxidant vitamins.
Omega-3 fatty acids have also received a lot of attention for being heart healthy by lessening inflammation in the body. Omega-3s can be found in olive oil, canola oil, walnuts, and flax seed. However, omega-3 fatty acids are probably best known for being in certain types of fish like salmon, tuna, herring, and mackerel. A landmark 2006 study showed that a modest intake of fish can reduce the risk of dying from a heart attack by a whopping 36%.
Eating root vegetables such as carrots may also help prevent heart attack. These vegetables lower cholesterol over the long term and reduce blood-clotting activity.
At-Home Remedies After a Heart Attack
Remember: Having a heart attack does not make you an invalid. You can best heal your heart by remaining active.
Do not take birth-control pills if you have had a heart attack; they are linked to increased blood-clotting activity.
Consider getting a pet. Pet owners recover more quickly from heart attacks -- probably because of reduced stress levels -- and tend to live longer than people without pets. Just be sure to choose a pet that fits your lifestyle.
Heart Attack Prevention
Stay in touch with friends and family. Research shows that people with poor social support are more vulnerable to heart disease. Also, seek ways to control feelings of anger and hostility; these emotions may add to heart attack risk.
Assess your heart attack risk profile and make appropriate changes to diet and lifestyle early.
Talk with your doctor about taking an aspirin daily. Studies have shown that this regimen significantly reduces the risk of a heart attack.
Call Your Doctor About a Heart Attack if:
You or someone you are with has signs of a heart attack. Seek emergency help without delay.
Your angina (chest pain) no longer responds to medication; this may indicate that a heart attack is under way.
Your angina attacks become more frequent, prolonged, and severe; as angina worsens, the risk of heart attack increases.
You are taking aspirin to prevent heart attack and your stool appears black and tarry. This may indicate gastrointestinal bleeding and could be a sign that aspirin has thinned your blood too much, a problem that can and should be corrected.
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