A heart attack is an everyday term meaning that the heart has stopped beating, or stopped beating effectively enough to keep your vital organs going. It’s a medical emergency that often has obvious symptoms, and it requires immediate medical attention to save someone’s life. There can be different causes, but the most common is a myocardial infarction (MI), where a blood clot suddenly blocks one of the four main blood vessels to the heart – without oxygen delivery and filtering of waste products, the heart cannot function. A heart attack may also refer to a problem with the rhythm of the heart – an arrhythmia – that prevents it beating in synchrony to pump blood around the body effectively. Again, this can lead to a medical emergency.
Someone experiencing an MI typically has crushing central chest pain and possibly pain down their left arm or into their neck. They feel as if someone is sitting on their chest, that they can’t catch their breath, and they often get a feeling of impending doom - an anxiety that something awful is happening. Nausea, dizziness and weakness are common. They look pale and sweaty, they feel clammy, they may be breathing hard or fast, and they are likely to collapse and lose consciousness. A severe arrhythmia can cause immediate collapse, and is more likely to have shortness of breath, feeling faint or dizzy or feeling hte heart beat fast or slow just beforehand.
A condition that precedes MI is coronary artery disease or myocardial ischaemia (infarction is a clot, ischaemia is damaged or dead tissue – myocardium refers to heart muscle). Arteries can get furred up, causing on/off blockages, which can give symptoms of angina. You may experience brief central chest pain, especially if exerting yourself, such as a brisk walk or lifting something heavy. This will pass by itself, and you can have treatment to help symptoms, but this should be checked out thoroughly to get the diagnosis. In arrhythmia, people may notice the heart beating very fast or slow at times, or it’s irregular or missing a heartbeat every once in a while. They can feel palpitations, short of breath or dizzy or light-headed at times, they may even have fainted. These warning signs are a clear indication to get the heart checked, especially if symptoms come on during exercise.
If you suspect you’re having a heart attack or you’re with someone with those symptoms, call 999 for an ambulance. While you wait, you could take 300mg aspirin (4 standard 75mg tablets) to help keep blood flowing. You will be taken to the nearest Emergency Department with a cardiac unit attached. The clock is running to get you diagnosed and treated within the hour. If you have collapsed and lost consciousness, the ambulance crew and medical team will give you life-saving treatment. If you are conscious, they will assess your vital signs – your blood pressure, heart rate and breathing rate – and they will listen to your heart and lungs. They will use an ECG (electrocardiogram) to assess the electrics of your heart and they will take blood samples. Both the ECG and blood samples can definitively point to a heart attack, and they may use other imaging to check where the blockage is. The hospital doctors can then give treatment to open up the damaged artery – either medicine to disperse the clot or by inserting a tube (stent) in the vessel to keep it open, in a procedure called percutaneous coronary intervention (PCI).
Certain things can put you at higher risk of an MI. Age is the biggest factor, where our arteries become less elastic as we age, and we get build-up of plaque on the inside of the arteries, a bit like limescale in a water pipe. Plaque causes less effective flow of blood as the tube is narrower, and a piece of plaque may break off to form a clot, causing a blockage. Other conditions can accelerate this process, including diabetes, high blood pressure, high cholesterol, obesity, excess alcohol and smoking. Your family history or ethnicity can cause early-age plaque build-up in the arteries. While you can’t change your genetics or age, you can take control of other risk factors, so keeping active, eating healthily and maintaining a healthy weight will help, along with stopping smoking, reducing alcohol, losing excess weight and following advice to control your diabetes or blood pressure. It’s a tough concept to come to terms with, but the reason your doctor (and probably your family members) nag you to look after yourself, is that you’re investing in your future further down the line.