HEART ATTACK!!!!!!!

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What is a heart attack? What is unstable angina, and why is it a concern? A heart attack (also called myocardial infarction, or MI) occurs when one or more of the coronary arteries are blocked. The coronary arteries supply oxygen-rich blood to the heart. A blockage usually occurs when plaque inside a coronary artery breaks open and a blood clot forms around it. See an illustration of how plaque causes a heart attack. The plaque and blood clot obstruct blood flow to the heart muscle cells, depriving them of oxygen and other nutrients. Without blood supply, the heart muscle cells die. If a large area of the heart is damaged by a heart attack, it can cause sudden death. A heart attack requires immediate treatment to restore blood flow. Angina is a type of chest pain that occurs when there is not enough blood flow to the heart muscle, often the result of narrowing of the coronary arteries. Stable angina occurs predictably with a specific amount of exertion or activity. Unstable angina may occur as: * A change in the usual pattern of stable angina. * Chest pain that occurs at rest or with less and less exertion, chest pain that may be more severe and last longer, or chest pain that doesn't respond as well to nitroglycerin. * The onset of angina in a person who previously did not have it. Because unstable angina can progress to a heart attack, it requires immediate medical attention. What are the symptoms of a heart attack? The most common symptom of a heart attack is severe chest pain, also described as discomfort, pressure, squeezing, or heaviness. Many people also have at least one other symptom, such as: * Pain or discomfort that radiates to the back, jaw, neck, or arms. * Discomfort in the upper abdomen, often mistaken for heartburn. * Sweating, nausea, and vomiting. * Difficulty breathing, palpitations, dizziness, and fainting. * Weakness, numbness, and anxiety. Chest pain, however, is not always present. In a recent review of 700 people treated for heart attack, 47% came to the emergency room because they had symptoms other than chest pain, including shortness of breath, dizziness, weakness or fainting, and abdominal pain. 1 Women, older adults, and people with diabetes are less likely to have chest pain during a heart attack and are more likely to have other symptoms. What should I do if I think I am having a heart attack? If you are having chest pain and your doctor has prescribed nitroglycerin, take 1 dose. After 5 minutes, if the chest pain doesn't improve or gets worse, call 911 or other emergency services. Continue to stay on the phone with the emergency operator; he or she will give you further instructions. If you think you may be having a heart attack or unstable angina (but you do not take nitroglycerin), call 911 or other emergency services immediately. Describe your symptoms, and relay that you could be having a heart attack. It is critical to get treatment as soon as possible. Your best choice is to go to the hospital in an ambulance so that paramedics can begin lifesaving treatments even before you arrive at the hospital. If you cannot reach emergency services, have someone drive you to the hospital right away. Do not drive yourself unless you have absolutely no other option. A "wait and see" approach could be fatal. Each year, about 1.2 million Americans have a heart attack. Over 40% of those heart attacks are fatal, and more than half of those deaths occur in the emergency room or before reaching the hospital. 2 After calling for help, chew a regular-strength aspirin. A recent study showed that those who took aspirin during their heart attack and for 1 month after were less likely to die from a subsequent heart attack or stroke than those who did not take aspirin. 3 Unstable angina can lead to a heart attack or even cardiac arrest (when the heart stops). If you think you are having unstable angina, take these same precautions as though you were having a heart attack. What causes a heart attack? The underlying cause of unstable angina and heart attack is decreased blood flow to the heart. In most cases, this results from plaque buildup and rupture in the coronary arteries. Some plaques are unstable and are prone to rupture or tear. When this happens, a clot forms over the ruptured area and may block blood flow in the artery. When the heart muscle does not receive enough oxygen-rich blood, the muscle is damaged, and a heart attack occurs. If the blood flow is partially blocked or blocked for a short period of time and then resolves, it may cause unstable angina. Plaque is made up of excess cholesterol, calcium, and other substances in your blood that over time build up on the inside walls of your coronary arteries. When plaque builds up on the inside of your arteries anywhere in your body, it is called atherosclerosis. When plaque builds up in the arteries of the heart, it is called coronary artery disease. Atherosclerosis is usually the result of years of high levels of "bad" (LDL) cholesterol, high blood pressure, smoking, and other risk factors. See an illustration of an artery blocked by atherosclerosis. Sudden intense exercise, sudden strong emotion, or illegal drug use, for example, can trigger a heart attack by causing a rapid rise in blood pressure, a surge in adrenaline and other hormones, and other physical reactions. However, in most cases, there is no clear reason why heart attacks occur when they do. How is a heart attack diagnosed? When you arrive at the emergency room, you will be quickly evaluated and usually have an electrocardiogram (EKG, ECG). An electrocardiogram is a graphic record of the heart's electrical activity as it contracts and relaxes. An ECG can detect signs of poor blood flow, heart muscle damage, abnormal heartbeats, and other heart problems. Several blood tests will be done, including tests to see whether cardiac enzymes (especially troponin) are elevated, a sign of heart muscle damage. Results of these tests are usually available quickly. You may have a cardiac catheterization and coronary angiogram. Using this X-ray exam, your doctor can see whether your coronary arteries are blocked and how your heart functions. How is a heart attack treated? Quick treatment for a heart attack or unstable angina is critical. If blood supply can be rapidly restored to the heart, damage to heart tissue may be prevented (in unstable angina), or more heart tissue can be saved from permanent damage. On the way to the hospital or in the emergency room, you probably will be given an aspirin (if you have not taken one already). Other medicines that prevent blood clots from forming or that break up blood clots may be given through a needle in your vein. To be effective, these must be given within a few hours of the start of your heart attack. Medicines that help decrease your heart's workload, ease your pain, and prevent life-threatening abnormal heart rhythms are often also given. You may be taken directly to the cardiac catheterization lab to see whether your coronary arteries are blocked. If so, your doctor may decide to open them with angioplasty and probably a stent. A stent is a small, coiled, wire-mesh tube that holds the artery walls open. At the same time, you will probably receive medicines that keep your blood from clotting. If needed, emergency coronary artery bypass graft surgery may be done. After these procedures, you will probably be started on medicines to prevent more clots from forming, reduce the workload on your heart, and lower your cholesterol. These medicines help prevent another heart attack and heart failure. Usually, you continue to take these and possibly other medicines for the rest of your life. Can I prevent a heart attack? Lifestyle changes such as quitting smoking, exercising regularly, and eating foods like fish, fruits, vegetables, cereals, beans, grains, and olive oil (called a Mediterranean diet) along with taking medicines to lower cholesterol and blood pressure and taking a daily aspirin can help prevent a heart attack. If you have already had a heart attack, you may be able to prevent a second one by reducing your risk factors. Your doctor will often recommend daily aspirin to help reduce your risk of another heart attack. Participating in a cardiac rehabilitation program will help you learn how to eat a balanced diet and exercise safely to reduce your risk of more heart problems. In the past, heart attack was thought to be mostly a male disease. However, a recent study—looking at 1,820 people hospitalized for heart attacks in Minnesota from 1979 to 1994—found that while heart attack rates for men had dropped by 8%, heart attacks in women had increased by 36%. Recently, health associations have increased their efforts to make women aware of their risk.