By Eduardo Gonzales MD
How fatal is a heart attack? What can we do when we or somebody we know is having one? —email@example.com
Heart attack or myocardial infarction (MI) remains a major killer worldwide. It is the number one killer in the US, accounting for one in seven deaths. It is likewise a notorious killer in the Philippines where diseases of the heart and cardiovascular system are currently the leading causes of mortality. Despite the grim numbers, however, thanks to advances in medicine in the last 30 years, at present, more than two out of three of people who develop a heart attack can survive it, as long as they are attended to properly.
Odds are therefore high that you or a family member will suffer from a heart attack during your lifetime. But your chances of surviving the heart attack are very good, provided you or your family member know you are having one and you know what to do.
Anatomy of a heart attack
A heart attack occurs when a coronary artery (i.e., a blood vessel that supplies the heart muscles with oxygenated blood) that had been narrowed because of coronary artery disease gets completely clogged by a blood clot. This deprives many heart muscle cells of oxygen. Unless the clot is removed immediately, the muscle cells will die, the heart will be unable to pump enough blood to all parts of the body, and heart failure ensues. The outcome of a heart attack depends on how big the clogged artery is and how soon the blood clot is removed
How do you know you’re having a heart attack?
The most common manifestation of a heart attack is a squeezing or pressing pain in the middle of the chest that lasts for more than a few minutes. The pain may spread to the left arm or jaw, back, right arm or over the abdomen. About a third of people who suffer an attack do not experience chest pain. Instead, pain is felt over the other areas stated above. Sometimes there may be no pain at all.
Aside from pain, other symptoms of a heart attack include profuse sweating, anxiousness, shortness of breath, pounding of the heart, nausea and vomiting, a sense of impending doom, and loss of consciousness.
The symptoms of a heart attack can appear suddenly and may be so severe that they cannot be mistaken for anything else. Often, however, they are initially mild then slowly progress in severity. Many people mistakenly dismiss such mild symptoms, attributing them to benign conditions such as heartburn, overexertion, stress, or overeating. They should not, especially if the symptoms come on suddenly, or if they worsen over a period of hours or days.
Incidentally, most people who develop a heart attack experience intermittent chest pains for days, months, or years before the attack. But in about a fifth of cases, the heart attack itself is the first and only presentation of a diseased heart. Also, one in five heart attacks is “silent” and will have few, if any, symptoms. Fortunately, most silent heart attacks are mild.
What to do in case of a heart attack
Life-saving drugs that can quickly dissolve a blood clot in the heart and preserve the heart muscles are now available. But they have to be administered immediately (preferably within an hour after the onset of the heart attack) and in a hospital setting. As an alternative to clot-dissolving drugs, angioplasty can be performed. This is a procedure in which a catheter with an inflatable segment is pushed through to the blocked artery, and inflated to break up the clot. During the procedure, a mesh tube (stent) is also inserted into the artery to keep it patent. In the Philippines however, very few hospitals have the capability to perform angioplasties.
A heart attack is a medical emergency where time is of the essence. Half of the deaths due to the condition occur within three to four hours after the symptoms appear and most of these occur simply because people don’t immediately go to the hospital, waiting instead to see if the symptoms persist.
When you suspect somebody (or you) is having a heart attack, stop the person from further performing any physical activity, not even walking. If aspirin is available, make him/her chew then swallow one tablet. Then, carry the person gently and bring him/ her immediately to a hospital.
Note: Email inquiries on health matters to: firstname.lastname@example.org