Many people have heard or read that more than 60,000 people die every year from various types of heart attacks. The heart attack is one of the most common reasons for hospital stays in Germany and one of the most common causes of death. When they hear the word heart attack, a large part of the population only thinks of the most well-known one, the heart attack. But what exactly is a heart attack, what causes it, and how do doctors treat it?
What is a heart attack?
Infogram on the anatomy and causes of heart and vascular diseases such as heart attacks.
According to abbreviationfinder, the death of the body’s own tissue as a result of an insufficient supply of oxygen is referred to as a heart attack. This happens due to the lack of oxygen-rich blood in the affected tissue and the supplying blood vessels.
Just as with a lack of inflow, the infarction can also be triggered by the lack of outflow of blood, since the accumulated amount of blood also prevents renewed inflow. Infarction is often only understood as a heart attack. However, occlusion of an artery in the retina or optic nerves of the eye is also possible. The outflow of blood through the veins of a tissue can also cause an infarction.
In addition, embolisms are a frequently observed cause. These are particles of different composition washed in with the blood. Such vascular occlusions can be caused by fat, oxygen (trapped air bubbles) or blood clots. Endogenous and foreign substances are possible.
Embolisms are always very problematic for the body and the affected tissue and in severe cases even have to be surgically removed to avoid further complications.
Causes
First of all, a heart attack is due to a lack of blood flow. Blood supplies our body with nutrients and oxygen. If the oxygen arrives delayed or not at all in an organ or tissue structure, tissue can die as a result. This can be the tissue of a muscle, a detoxification organ or an optic nerve.
Whenever a tissue dies completely as a result of a lack of oxygen, this is an infarction. The bones, the brain, the spinal cord or the tissues of the lungs can also suffer an infarction. The best known is the infarction of the heart muscle. The undersupply of oxygen is often preceded by vascular occlusion.
In this respect, a causal connection to vascular embolisms, thrombosis and the general occlusion of supplying arteries can be established. Heart attacks as a result of infections are also known. In most cases, however, it is disturbances in the outflow or inflow of oxygen-enriched blood that cause the infarction.
Typical or common forms
- Heart attack
- brainstem infarction
- stroke
- splenic infarction
- mesenteric infarction
- pulmonary infarction
- Eye infarction (loss of vision)
Symptoms, Ailments & Signs
Depending on the area of the body affected, a heart attack causes different symptoms. Typical of a heart attack is severe chest pain, which often radiates to the left arm, upper abdomen or lower jaw and is usually accompanied by outbreaks of sweat, nausea, dizziness and fear of death.
In women, shortness of breath, a feeling of pressure in the chest and upper abdominal pain are often the main symptoms, the characteristic chest pain is much less pronounced. Lung infarction is characterized by sudden severe pain in the rib area, which is associated with shortness of breath and breathing difficulties. Bloody sputum appears when coughing.
The doctor describes the symptoms caused by a splenic infarction as an “acute abdomen”: massive pain occurs mainly in the left upper abdomen, which intensifies when inhaling and often radiates to adjacent areas. Fever, nausea and vomiting are often present. A mesenteric infarction manifests itself in the early stages by stabbing or cramping abdominal pain, which is often accompanied by nausea, vomiting and bloody diarrhea.
After a painless phase of several hours, the symptoms intensify again, and the massive intestinal damage can lead to circulatory failure. Symptoms of paralysis, visual and speech disorders, sensory disorders, visual disorders and clouding of consciousness can be signs of a stroke, in the case of a brainstem infarction the entire body can be affected by the paralysis.
Diagnosis & History
Anyone with known heart or circulatory problems is at risk of having a heart attack. Permanent high blood pressure, problems with the sugar metabolism such as diabetes or above-average cholesterol levels are already common diagnostic indicators for the occurrence of heart attacks.
Known methods for checking organs affected by infarctions are the ECG, measuring the currents in the heart muscle and its vessels, measuring blood pressure, blood and cholesterol levels, and computed tomography if a pulmonary infarction is suspected, or measuring so-called infarction markers in the blood.
Infarction markers are substances in the blood that appear as a result of the breakdown of blood clots and are therefore a clear indication that they are present. There are also nuclear medicine procedures such as MRI or lung scintigraphy, which help to determine the blood flow and ventilation conditions in the lungs in order to provide clues for any vascular occlusions that may be present.
Complications
Basically, the complications of a heart attack depend on the type of heart attack and the organ affected. After a heart attack, for example, cardiac arrhythmias, left heart failure, tearing of the papillary muscle or tendon thread (chorda tendinea) and myocardial rupture (myocardial rupture) are possible complications. In addition, early pericaritis, an inflammation of the pericardium, can occur.
In the further course, complications such as late pericarditis and inflammation of the heart muscle and pericardium (perimyocarditis) are also conceivable. In mitral regurgitation, a heart valve fails, namely the mitral valve. A septic infarction can lead to blood poisoning (sepsis). This is potentially fatal and must therefore be treated professionally.
Another complication of septic infarction is peritonitis. The fluid loss that accompanies peritonitis can cause other symptoms. If the pleura or pleura becomes inflamed (pleurisy), the affected person usually suffers from severe pain that increases and decreases with breathing. The patient usually feels sick and listless and has a fever.
In addition, after various types of heart attacks, an infarct aneurysm can form, in which a sac forms in the wall of a blood vessel or the wall of the heart. Thrombi can form in such a sac, which can detach and restrict blood flow, potentially leading to another heart attack. It is also possible for large amounts of blood to leak into an aneurysm, resulting in a lack of circulation.
When should you go to the doctor?
A heart attack must always be treated by a doctor. Anyone who keeps noticing symptoms such as chest pain or palpitations should consult their family doctor and have this clarified. If the symptoms increase or occur more frequently, this indicates a serious heart disease that can lead to a heart attack. A visit to the doctor is indicated at the latest when the symptoms affect well-being or cause anxiety. Other warning signs that require immediate clarification are a decrease in physical performance or breathing difficulties.
People who have heart disease should see a doctor right away if they have any unusual symptoms. If symptoms such as a stabbing pain in the heart, signs of paralysis in the left arm or neck pain appear, the emergency doctor must be called. In the event of severe symptoms or even a heart attack, first aid measures must be taken until the emergency services arrive. If heart disease has been diagnosed, regular examinations by the doctor are necessary. The right person to talk to is your general practitioner or a cardiologist. In case of doubt, the medical emergency service can be contacted.
Treatment & Therapy
In most cases, the therapy of infarcts always promises success if it is started as soon as possible after the infarction is noticed. However, a heart attack is not always immediately recognized as such. In the case of the so-called stroke – the cerebral infarction – the therapy is very extensive and can last months or years. Intensive care treatment and possibly an operation is usually used to monitor blood values and breathing.
The laboratory examines excreted metabolites for clues. Cholesterol-lowering drugs help to normalize blood levels and physical therapy trains the brain to compensate for the function of dead tissue if possible. In the case of an eye attack, the doctor will check whether an arterial or venous eye attack is present. With a special massage he can try to open the closed vessel.
Blood circulation can be normalized by injecting blood circulation-enhancing agents. This is done through outpatient eye surgery under local anesthesia. Laser or cold therapy avoids the increase in eye pressure if necessary.
Outlook & Forecast
A heart attack has an unfavorable prognosis. Without immediate intensive medical care, the condition ends fatally. The prospect of survival is linked to the general state of health of the person affected, the possibility of first aid being provided by those present and the intensity of the infarction.
The person concerned is subject to an emergency and in most cases is not able to independently initiate measures for self-help or to call a doctor immediately. Therefore, the fellow human beings are required in the immediate vicinity. The better they are trained to deal with an emergency situation, the higher the chances of survival for those affected. If a rescue team is alerted immediately and first aid measures are initiated immediately, the person affected has a good chance of surviving the condition. If intensive care is provided within an hour or two, the chances of survival increase.
Long-term consequences are to be expected for every heart attack suffered and survived. Disorders of the musculoskeletal system, limitations in cognitive performance, functional disorders or paralysis can occur. Despite rehabilitation measures, targeted training and comprehensive medical care, some complaints remain for life. With a healthy lifestyle, a stable psyche and the cooperation of the patient, many symptoms can be alleviated. However, complete freedom from symptoms occurs only very rarely, even under favorable circumstances.
Aftercare
A heart attack is a serious illness that requires consistent follow-up care. The most important factor in the context of aftercare are the regular check-ups with the attending physicians such as the cardiologist or internist, but also with the family doctor. A pacemaker that may have been implanted must also be checked, as must the structure and function of the heart muscle. This can be checked with ECG and ultrasound as well as other imaging tests such as MRI and CT.
Restoring exercise capacity is also a factor in aftercare. There are special cardiac sports groups with specially trained rehabilitation sports teachers for heart attack patients. Those affected can also postpone their resilience by doing well-dosed activities such as walking or cycling, although it is important to consult a doctor in order to avoid being overwhelmed.
A healthy lifestyle with a cholesterol- and calorie-conscious diet, drinking enough water and reducing stress, as well as avoiding nicotine and alcohol, also helps to optimally organize the aftercare of the heart attack. Getting enough sleep is also important.
Anyone who also has to deal with a heart attack from a psychological point of view can integrate self-help groups into their personal aftercare. Going to the psychologist can also be helpful if the shock of the heart attack is deep in the affected person or the fear of a relapse noticeably restricts the quality of life. Social distraction can also help in this context.
Prevention
Heart and circulatory problems are the most common sign of a heart attack risk. Therefore, it is better not to smoke as a member of this risk group. Drinking alcohol in moderation and eating fresh fruit and vegetables is good for you and keeps you fit. Exercise in the fresh air and in nature also promotes the mobility of the veins and arteries.
The body likes to run regularly. Twice a week is the minimum amount of exercise for a body to stay healthy. In addition, drinking pure water is preferable to stimulants. At least the proportion of water intake should far exceed that of coffee, alcohol or soft drinks. All this is important for blood circulation, metabolism and vascular health.
You can do that yourself
A heart attack is a medical emergency, regardless of which organ is affected. The patient or the first responders must call the emergency doctor immediately.
Heart attacks are the most common. The best self-help measure when you are about to have a heart attack is to read the signs correctly and consult a doctor immediately. A heart attack is often announced by pain in the chest that spreads to the left arm, feelings of tightness and pressure behind the breastbone. Patients at risk, in particular, should not downplay such symptoms and consult a doctor immediately. The risk groups include in particular overweight people, smokers and people with high blood pressure. Avoiding these risk factors in combination with a healthy diet and sufficient exercise can prevent a heart attack.
If there is a threat of an acute heart attack, the patient should not lie down until the emergency services arrive, but rather sit in a chair. This reduces the volume pressure in the chest and relieves the heart. This effect can be intensified by the so-called Hauffe arm bath. The patient places their left arm or, if necessary, both arms in a basin with water, the temperature of which should be around 35 degrees Celsius. Hotter water is then slowly added until the temperature of the water rises to around 40 degrees Celsius. The bath increases blood flow in the arms, which diverts blood from the chest to the extremities, providing momentary relief to the heart.