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  Heart attack

When the supply of oxygen to an area of heart muscle is blocked then a heart attack occurs. This is also called myocardial infarction. Most heart attacks are caused by a blockage in the arteries. This blockage leads to irregular heartbeat that causes a severe decrease in the pumping function of the heart and may bring about sudden death. This blockage has to be treated within a few hours. These blockages are usually caused by the build-up of fatty deposits called plaque inside the artery walls (atherosclerosis).

Heart attack
Heart attack

Causes: Cholesterol is a blood fat needed by the body in moderate amounts but when the cholesterol level is high, this can lead to atherosclerosis and coronary artery disease (CAD).Heart attacks are mostly caused by a blood clot that blocks the coronary artery. It gets stuck in a narrow part of an artery to the heart. These clots are more likely to form where atherosclerosis has made an artery narrower. As a result of the supply of blood is restricted or is blocked to a part of the heart and that area does not receive oxygen. If the blockage continues long enough, cells in the affected area die. This is called Coronary Artery Disease (CAD).So; it is important to get your cholesterol level tested from time to time that includes triglycerides, HDL, LDL and total cholesterol. Another cause of heart attacks is a severe spasm (tightening) of the coronary artery that cuts off blood flow to the heart. These spasms can occur in persons with or without CAD.

Other causes of heart attacks are:
• Smoking
• Diabetes
• High cholesterol level
• High blood pressure
• Family history of heart attack
• Atherosclerosis (hardening of the arteries)
• Lack of exercise
• Obesity
• Male sex
• Taking certain drugs, such as cocaine
• Emotional stress
• Exposure to cold

You may be having a heart attack if you:
• Feel tightness or pain in the chest accompanied by sweating, nausea or vomiting.
• Pain extending from your chest into the jaw, left arm or left shoulder.
• Breathlessness for more than a couple of seconds

Incase you experience any of these symptoms; do not ignore the pain or discomfort. Call for help immediately even if you have the slightest doubt that it could be related to your heart. The sooner you get medical help the better the chances of preventing further damage to your heart.

Prevention: Learn everything that you need to know about heart attacks from reliable sources and involve your doctor if you have any queries. It always helps to know and keep information. There are some habits you need to give up and some you need to cultivate. Quit smoking: As smoking can also lead to heart attacks it is best to quit. Get help from your doctor and family.
Control weight: Obesity is another main cause of heart attacks as generally those who are over weight have a high cholesterol level. So lose weight and keep your cholesterol level under control.
Healthy diet: Eat healthy food. Avoid high saturated fat and sodium to control the cholesterol level and blood pressure. Involve a dietician if need be but do not ignore the fact that healthy food leads to healthy body. Blood sugar: If you have diabetes control your blood sugar as it could lead to a heart attack.

Exercise: Follow a regular exercise regime. It may be a bit difficult in the beginning but once you start you will like it. It is the best way to stay fit and healthy. Try to work up to at least 30 minutes of aerobic exercise (that raises your heart rate) at least 4 times a week. Control your blood pressure if you have hypertension.

Nowadays, emergency services are available 24/7.The patient will be asked to take nitro-glycerine tablets or patches, in case these are available, particularly if they had prior heart attacks or angina. Even ambulances are well equipped with well oxygen first aid. If breathing and pulse are present then oxygen is provided and the patient is calmed. Electrocardiogram is initiated if available.

Secondary prevention The patient will have to be on medications post the attack to prevent secondary cardiovascular events such as further myocardial infarctions or cerebrovascular accident (CVA). Medicines such as aspirin and/or clopidogrel are given to reduce the risk of thrombus formation. High risk patients with left ventricular dysfunction (LVD) and/or continuing cardiac ischaemia, β-Blocker therapy such as bisoprolol or metoprolol are given. Statin therapy has shown good results in reducing mortality and morbidity. Patients with a history of diabetes, hypertension or left ventricular dysfunction, ACE inhibitor therapy are given 24-48 hours, post the attack. It helps decrease ventricular remodelling and reduces mortality.Epelerone is also shown to reduce the risk of cardiovascular death when used in conjunction with other standard therapies as mentioned.

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