Dr Swapnil Mate Cardiologist

Symptoms Of A Heart Attack : Warning Signs

The types of echocardiography include :-

The signs and symptoms of a heart attack include :

Chest pain(angina) - described as a sensation of heartburn, tightness, pressure, or squeezing. Even though chest pain may also arise due to non-cardiac causes, if that pain travels to the left arm, right arm, jaw, neck, then there might be a possibility of a heart attack. Chest pain is the first and the most common symptom of a heart attack
Shortness of breath - As the heart rate changes, the breathing pattern will also change simultaneously. If the heart is not pumping blood efficiently, this causes shortness of breath. Therefore, shortness of breath mainly arises due to low oxygen in the blood.
Sweating
Fatigues, dizziness
Nausea or vomiting
Cardiogenic shock due to defects in the ventricles of the heart
Heart palpitations(irregular beatings of the heart)
Sudden death due to ventricular fibrillation(irregular electrical activity of the heart)
In some cases where the patient has gone through open-heart surgery or transplantation or if the patient has some inherited illness like diabetes, then a silent infarction may occur. This does not arise with any warning signs. This condition can be identified by doing an electrocardiogram or a blood enzyme test.

Risk Factors Of A Heart Attack

There are two types of risk factors, those that cannot be controlled and those which can be controlled

Major risk factors that cannot be controlled are :

Genetics - genes control every part of the circulatory system. If the parent has had an episode of heart attack, then the child is most likely to run the risk of having a heart attack in the future, since the child shares the DNA of its mother.
Increasing age - since during the period of late adulthood, the body's genetic programming reduces, the heart's capacity to pump blood throughout the circulatory system also reduces. So the person is most likely to have a heart attack.

Major risk factors that can be controlled are :

Smoking - actively smoking or increased exposure to smoke increases the risk of having a heart attack because smoking makes the blood sticky, and it is most likely to clot, which can obstruct the blood flow to the heart. It also lowers good cholesterol in the body.
High blood pressure - High blood pressure or hypertension makes the coronary arteries less elastic, which reduces blood flow to the heart. This makes the heart work harder, causing stiffening of the heart muscle and death of the cells present in the cardiac muscle.
Cholesterol - The total number of cholesterol in the blood also affects the heart. There are two types of cholesterol, High-density lipoprotein, and low-density lipoprotein. The high-density lipoprotein is good for the heart since it helps in removing cholesterol deposits from the coronary arteries and transports them to the liver, which then removes them from the body. The low-density lipoprotein transports cholesterol from the liver to other tissues and cells, which use this as energy. Low-density lipoprotein, along with triglycerides, gets deposited in the arterial wall, obstructing the blood flow to the heart. This can cause a heart attack. Cholesterol levels can be controlled by following a strict diet that does not contain saturated fats.
Obesity -Obese individuals require more blood so that they can carry oxygen and nutrients to the tissues to function efficiently. This puts pressure on the heart to work harder, which stiffens the heart muscle, reducing blood flow and causing a heart attack.
Diabetes -When your body does not respond to insulin or does not produce much insulin, glucose remains in the bloodstream. This causes an increase in the blood sugar level. An increase in blood sugar damages the walls of coronary arteries due to fatty deposits in the walls. This causes a heart attack.
Lack of physical exercise - Lack of physical activity increases blood cholesterol, blood pressure, and blood sugar levels, all contributing to a heart attack.
Stress - A person can react to stress in ways that can contribute to a heart attack, for example, smoking, alcohol consumption. Overeating, etc.
Sleep - Not getting the required amount of sleep can lead to a possible episode of a heart attack because while sleeping, your blood pressure reduces, maintaining its optimum level. If a person does not get enough sleep or does not sleep at all, it puts pressure on the heart to work harder. This stiffens the heart muscle, causing damage to the tissues of the muscle.

How Does A Heart Attack Take Place?

The coronary arteries, originating from the aortic valve, are responsible for transporting oxygen-rich blood to the heart. If the individual leads a poor lifestyle, then calcium, proteins, triglycerides, and low-density lipoprotein gets deposited in the walls of the coronary arteries. When these deposits harden, they crack(rupture). When platelets arrive at the area, they form blood clots around the area. If a blood clot blocks the coronary arteries, the heart works harder for oxygen. This stiffens the cardiac muscle, causing the death of the cardiac muscle tissues, leading to a heart attack. Heart attack ruptures the entire pumping system of the heart, which includes blood vessels, arteries, capillaries, and veins.

Prevention And Treatments

Primary Angioplasty - this is the treatment given to patients who have suffered from myocardial infarction or heart attack. This procedure involves widening the coronary artery walls where cholesterol deposits are present. The narrowed areas of the artery walls are widened by using a long, flexible tube (catheter) and placing it in between the plaque deposits. The catheter is inserted into the main blood vessel of the lower arm and passed carefully into the aorta (the artery that provides blood to the heart muscles from its blood supply). A balloon is placed at the tip of the tube in such a way that when it is blown, it forces the narrowed areas of the artery to wide open. This clears the passage of the coronary artery walls, allowing blood to flow to the heart.
Valvuloplasty - This treatment is given to infants who are suffering from heart disease. It is done by placing a catheter through the blood vessel into the heart. The balloon is placed at the tip of the catheter. When it is blown, it forces the valve to open. The balloon valvuloplasty is done in mitral, aortic, or pulmonary valves.
Coronary Thrombectomy - This treatment involves removing a blood clot(thrombus) from the blood vessel. The formation of blood clots can take place when a person has a heart attack. When the plague deposits in the heart or brain, the clotting process starts, which obstructs the blood flow to the heart muscle. Since the heart muscle is not getting the oxygenated blood, the heart muscle stops functioning or dies.
Alcohol septal ablation - This procedure involves injecting alcohol(ethanol) into the part where the heart muscle has thickened. It kills the cells of the muscle and shrinks the diseased tissue and restores blood flow to the heart muscle.
Atherectomy - This treatment provides an alternative to coronary angioplasty where it cuts the plague from the wall of the coronary arteries, instead of pushing it into the wall.
Heart valve replacement - the valve is replaced either surgically in case of surgical aortic valve replacement or transcatheter aortic valve replacement where a catheter is used to replace the valve.
Cardiac Imaging - Techniques of cardiac imaging like echocardiography, a device called a transducer is placed on the top of the chest and ultrasonic waves are sent to the heart to bounce off and show the live image of the heart, using a monitor. Intravascular ultrasound uses a catheter instead of a transducer to capture the images of coronary arteries. This helps the specialists to see whether the blood flow is obstructed or not. Coronary angiography also uses a catheter, but before inserting it in the body through wrists or legs, it injects a dye into the bloodstream to create X-ray images of the coronary arteries.
Lifestyle Changes - To prevent a second episode of heart attack, certain changes in the lifestyle must be done like having a balanced diet which contained all nutrients vital to the body, engaging in regular physical activity regularly, trying to quit smoking and alcohol consumption, getting a minimum amount of 7 hours of sleep daily, and so on. Taking medications like statins, aspirins, beta-blockers should be taken to reduce blood pressure, prevent clotting of blood, and keep cholesterol at the optimum level.

The cardiology team of Dr. Swapnil Mate's Cardiology clinic provide services and recommend safe treatment procedures, especially to those who arrive at the emergency ward. They also provide post-operational care to those that have gone through an episode of heart attack in the past. Consult Dr. Swapnil Mate for any further queries.