The American Heart Association says that for many people suffering from a heart attack for the first time is when they realize they have heart disease. (Read about “Coronary Heart Disease”) The warning signs are having a heart attack vary. Here are some of the most common:

* Uncomfortable chest pain or heavy feeling in the chest that lasts more than a few minutes.
* Pain that runs along the shoulders, neck, jaw or arms.
* Chest pain accompanied by dizziness, sweating, nausea or shortness of breath.

Not all of these symptoms are present in all cases. The American Academy of Family Physicians says the symptoms may come and go, some of the people who have a heart attack may not experience any symptoms.

In addition, the Food and Drug Administration of the United States (FDA English) tells us that women are more likely to have the so called silent kills. That’s because women unlike men, have different notices of heart attack. Women tend to have more nausea and pain in the stomach. Also, you may experience heartburn that can be taken as indigestion. In women, like men, symptoms come and go. Either way, it is extremely important to get medical help if you suspect a heart attack. The American Heart Association (AHA English) tells us that drugs and surgery to undo clots are more efficient when used in the early stages of a heart attack. However, studies show that many victims of heart attacks wait several hours – up to ten hours or more – before seeking help.

The why of a heart attack

A heart attack results when blood supply to the heart is restricted or reduced. This limits the amount of oxygen to the heart, resulting in enormous damage to the heart muscle. The amount of blood the heart can be reduced as a result of atherosclerosis, in which fatty deposits build up in artery walls until a blockage occurs. Although heart attacks can strike without warning, an attack can be followed by continuous chest pain called angina pectoris. (Read about “Angina”) Although the symptoms of angina are similar to those of a heart attack, the National Heart, Lung and Blood Institute (NHLBI acronym in English) indicates that angina is presented more physical effort, a heart attack can occur at any time, even during rest. Although angina pectoris is not the same as a heart attack, it does indicate the presence of coronary artery disease and should not be ignored.

Seek help early

A heart attack is a medical emergency. Time is critical. If someone experiences symptoms that may indicate a heart attack, call 911 or your local emergency number and tell the staff was that doctor when symptoms began and the severity of them. According to the AHA, the ambulance would be best for you, as the staff of the same emergency treatment can begin immediately on arrival, but if you suspect a heart attack and the ambulance service is not available, you can ask someone to drive (someone suspected of having a heart attack too, should not drive) to the emergency room nearest you.

After calling 911, the AHA recommends aspirin as soon as possible, unless there is reason to do otherwise (eg if you are allergic to medication, or have any condition that would prohibit taking aspirin). According to the AHA, studies show that taking aspirin when symptoms begin or increase, greatly improves the chance of surviving a heart attack. Moreover, remember that taking aspirin during a stroke is not recommended because if the stroke is caused by a break instead of a blood clot, aspirin matters worse. (Read about “Stroke”)

The key is to remember that a heart attack is more harmful during the first two hours. The sooner you get help, the better chance of survival.
Treatments and options

One of the most important reasons not to go to the hospital later is that special procedures can limit the damage done to the heart if they are started as soon as possible. For example, a defibrillator helps get the heart into normal rhythm. Moreover, what is called reperfusion therapy, can be carried out. That will increase the flow of blood to the heart.

According to the NHLBI and the American Medical Association, there are several treatment options that can be used to improve blood flow.

* Drugs – Breaking clot or thrombolytic agents can be injected to dissolve clots and open arteries. NHLBI says that drugs to dissolve clots need to be injected within a few hours after the onset of a heart attack. Even more so, remember that there are dangers of the drug to dissolve clots, including stroke and brain bleeding. So what kind of drug used and the decision to use depends on the situation and the patient.
* Coronary angioplasty or balloon angioplasty or balloon – In this procedure, a soft tube or catheter is carried by a narrow artery to a vein of the heart. The catheter has a small ball or globe in the lace of which is inflated and deflated to open and stretch the artery (a laser can be used instead of or in addition to the balloon). This is done to improve the flow of blood. The balloon and catheter are removed.
* Stents – Stents are often inserted during angioplasty to help keep the artery open. A stent may also be used without surgery. Basically, a stent is a tube made of wire that is permanently integrated into the artery to prevent it from closing up again. Even with a stent, the artery can reclose again requiring angioplasty or bypass surgery. The NHLBI says this is very common for people with diabetes or angina pectoris. (Read about “Diabetes”) The new closure is called in-stent restenosis. The AHA says the use of stents coated with medication that helps prevent the vein to close and helps reduce the risk. Brachytherapy can be used, according to the FDA. It is a procedure in which radioactive material is applied to the body. After the initial opening of the stenosis block covered with a balloon catheter (PTCA), a brachytherapy device is temporarily placed on one side of in-stent restenosis. The FDA says the radiation treatment helps control the overreaction of healing in the affected and also decreases the possibility of a recurrence of the blockage.
* Bypass surgery – In this procedure, a piece of vein is taken from the leg or a piece of artery is removed from the chest or wrist and then settles to the heart artery above and below the narrowed area. Here’s how to create a tube passage around the obstruction. The NHLBI says bypass surgery may be the procedure of choice for some patients and is also appropriate when angioplasty has not been successful or when a lock can not be achieved with angioplasty. Sometimes it takes more than a bypass. The bypass also can close again. This can happen in 10 percent of bypass surgeries, and usually occurs after ten years or more.

Success in all these treatments depends on how quickly treatment begins after a heart attack.

Following or in conjunction with treatment, the patient will undergo a cardiac rehabilitation period, committing to exercise and changing your lifestyle. Successful rehabilitation depends on how big the damage, and the patient’s ability to make changes and follow the instructions of the doctor.

In addition to the physical, the doctor may also recommend continued treatment with the drug. Recent guidelines of the AHA and the American College of Cardiology suggest that continued treatment with medications, including ACE inhibitors and beta-blockers has been shown to reduce the risk of death in patients who have survived a heart attack. These groups also stress the importance of quitting smoking and avoiding secondhand smoke. (Read about “Quit Smoking”) The eating foods with omega-3 fatty acids, the use of new antiplatelet agents for patients who can not take aspirin to reduce the risk of blood clots are also among the recommended groups.

Other ways to reduce the risk of major heart problems includes taking any medication that is prescribed by your doctor if you have high blood pressure or high cholesterol. (Read about “Cholesterol” “Hypertension: high blood pressure”) Also, if you have diabetes, it is very important to follow all doctor’s instructions for maintaining the blood sugar to normal.

Coronary heart disease, also called ischemic heart disease, are diseases of the heart caused by atherosclerosis (atherosclerosis). This causes oxygen deficiency (ischemia) in the heart muscle. Coronary heart disease are divided into acute (heart attack or myocardial infarction) and chronic (angina pectoris) forms.

The ICD has additional categories, mostly asymptomatic diagnoses. The classifications according to the ICD-9 and ICD-10 are quite diverse. Thus, part of the ICD-10 category of “certain current complications following acute myocardial infarction ‘(code I23) in ICD-9 classified under” no well-defined diseases and complications of heart disease “(code 429), and thus not subject to the coronary heart disease.

Heart attack: sudden closure of a total coronary

A heart attack or stroke occurs when a blood clot suddenly quit a coronary artery. By getting close to the corresponding portion of the heart muscle no longer oxygen and dies. The closure of the coronary artery is accompanied by a sudden, severe and prolonged pain in the chest, often radiating (to the neck, arms, jaws or mouth). Nausea and sweating also occur often. These symptoms may also become less pronounced. The pain does not respond sufficiently at rest and medication. The heart develops at the site of an infarct scar tissue that eventually is. That part of the heart muscle is no longer. Following the loss of myocardial infarction occurs in heart muscle. The severity of a heart attack depends on the size of the damage to the heart. For major damage to the heart muscle is insufficient and heart failure occurs (see: What is heart failure?). Also, narrowing of the coronary arteries leading to a lack of oxygen, which angina pectoris may occur. A heart attack is a dangerous condition with severe arrhythmias (and sometimes death) could be compromised.

Angina pectoris: a temporary shortage in blood supply

Angina pectoris, literally, “chest pain” is caused by a temporary deficiency in the blood supply of the heart. This is almost always one (or more) in a narrowing of the coronary arteries, allowing a part of the heart muscle gets enough oxygen. Most likely, this lack of oxygen on exertion, so if the heart must work harder and the heart muscle needs more oxygen than the narrowed blood vessel can rely. Unlike a heart attack the symptoms of angina pectoris shortly after the effort has ended. Angina pectoris gives a typical oppressive, crushing pain behind the breastbone. If angina occurs at rest (not on exertion), then it is called angina pectoris at rest. The distinction between angina pectoris at rest and a heart attack can be difficult.

Angina pectoris can be divided into stable and unstable angina pectoris. Between two types of angina pectoris are differences in the occurrence of complaints in the pathophysiology and probably also in the forecast.

* In stable angina pectoris there is a stable pattern of complaints with little change in the duration and intensity of the symptoms. The symptoms usually occur at times provocative (eg effort, transition between cold and heat). Pathophysiological view, there is a narrowing of atherosclerotic coronary arteries.
* There is as unstable angina pectoris complaints recently arisen in a period of six weeks have increased in duration and / or severity. The pattern of complaints is similar to that of stable angina pectoris but without provocative moments. The complications created by the appearance of a clot in the coronary artery at the site of an atherosclerotic plaque or lesion.

The ECG provides important information about location and severity

The electrocardiogram (ECG) provides important information about the location and severity of the vascular closure in patients with acute myocardial infarction. Patients with acute myocardial infarction on the basis of the ECG into two categories:

* Myocardial infarction with ST-elevation: there is a final clot at the origin of a coronary. These patients are relatively young and the infarction is often their first clinical manifestation of coronary heart disease.
* Myocardial infarction without ST elevation: the vascular closure is not complete or more peripheral than a heart attack with ST-elevation. These patients usually been known that coronary heart disease.

In stable angina pectoris the ECG usually provides limited information. There are only visible abnormalities on the ECG when there are complaints, so when angina occurs. For this reason, find patients with (suspected) angina pectoris study site where the heart is responsible, as in a walking or cycling test. Then one may be found occurring oxygen deficiency.

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