HEART ATTACK: MYOCARDIAL INFARCTION

HEART ATTACK: MYOCARDIAL INFARCTION
No one wants to think about heart attack. It’s the boogey man that causes more deaths worldwide than any other medical condition. In the U.S. alone there are 1.2 million heart attacks every year: somewhere around 25% to 30% end in fatality. Around 20% of people die before they ever reach medical care. So why would we want to think about such a depressing subject? The answer is simple: the more you know, and act on what you know, the less likely you’ll fall victim to this condition. You can start right now on a program to reduce your chances of having a heart attack
We have known for many years that smoking causes heart disease and contributes to heart attacks. It seems that the constituents of cigarette smoke damage the intricate and very sensitive cells which line our blood vessels. These “endothelial” cells, of course, line the coronary arteries which deliver blood and oxygen to the individual heart muscle cells and electrical conduction cells. The smoke damages arteries all over the body, making the heart work harder to pump the blood to these other arteries. The harder pumping can lead to high blood pressure which in and of itself damages the heart. It’s like a cycle of one bad thing causing another then working its way around again to cause further bad effects.
We know that having too much of a certain fat substance called cholesterol damages the arteries and heart. It does this by depositing in all the body’s arteries like sludge in a pipe. As the cholesterol “sludge” increases, the diameter inside of the artery decreases (lumen). The artery becomes more brittle, rather than the gently pulsing and distributing mechanism which distributes the heart’s energy throughout the body. The really catastrophic event for the heart is when one of these cholesterol deposits ruptures causing bleeding and a clot to form in a coronary artery. This clot can very quickly block all flow through the artery and cause blood flow to cease in heart muscle supplied by the particular blood vessel. When heart cells are deprived of oxygen and blood they begin to die, and that is what we call a “heart attack”.
So what can we do about that cholesterol? Well, one thing is to investigate our family medical history. Did several members have early heart attacks or strokes or problems with circulation that may have caused an amputation? A big part of our measured cholesterol is simply due to heredity. Either we make too much or we don’t get rid of enough. A second thing we can do is actually have our cholesterol tested before age 21, and then rechecked on physical exams thereafter if there is a problem noted. We can put ourselves on a “heart smart” diet, avoiding excessive animal fat and consuming plenty of fibrin in our daily food intake. One recurring theme in proactive care of one’s heart is regular exercise. It helps elevated cholesterol. It strengthens the heart, and helps repair damage to the endothelial cells of our blood vessels.
Sometimes these self-care activities, though they help, may not be enough to get cholesterol down to healthy levels. What we’d like to see is total cholesterol below 180, LDL cholesterol (the “bad cholesterol”) below 100, and HDL (the “good cholesterol) above 40. There are a couple of ways to achieve this medically. One way is to prescribe a medicine which sequesters the cholesterol in the intestine by blocking its absorption. Another way is to give medicines which cause the body to make less cholesterol, mostly in the liver. The body makes its own cholesterol. This is either by the blood vessels or their food.HDL removes cholesterol from the blood vessels and brings it back to the liver to be destroyed Your doctor can look at your cholesterol pattern and prescribe the right medicine to achieve this goal.
So, how does this all come together in discussing heart attack? We’ve discussed how important smoking cessation is: you reduce your chance of heart attack by 50% in just one year of not smoking, if you were a smoker. We know that exercise reduces many factors in the evolution of a heart attack. We know that having ideal levels of cholesterol reduces your chance of heart attack. And we’ve mentioned that a heart attack occurs when a coronary artery is blocked and the cardiac cells fed by it begin to stress and die.
What is it like to have a heart attack? It may be the same symptoms for men and women, but women often have a different pattern of symptoms. One common complaint is squeezing pain under the breast bone. It may radiate to, or altogether be felt in, the shoulder, neck, jaw, or left arm. There can be shortness of breath or pronounced fatigue, which is particularly present in women. There can be delirium or dizziness because of decreased blood flow to the brain as a result of the heart attack. There can be nausea or pain in the vicinity of the stomach. It’s not uncommon to see a heart attack victim break out in a profuse sweat or have an ashen gray skin color skin appearance because of low blood pressure. When these symptoms occur in their extremes, the diagnosis of heart attack is fairly straight forward. However, when they are subtle or different, it can take complex medical testing and an extremely competent medical doctor to make the diagnosis.
So, what’s the take-home message? One part of it is being aware of where one dwells on the cardiac risk scale. The above-described symptoms in a middle or later-aged male, who is an obese smoker and never exercises certainly sends an alarm message. But other people obviously get heart attacks, too. So if you or another person suffers from the above symptoms, and there is no apparent reason why, “Hang up and call 911!!!” Getting a person on to early medical treatment is the most important factor in his or her survival and return to a satisfactory quality of life.
Take care of your heart. Never take it for granted. Do the daily maintenance you would do if it were a Rolls Royce parked in your garage, and more. Your heart is essentially your engine, and allows or limits everything you do or would like to do in every minute of your life.
John Drew Laurusonis

Doctors Medical Center

www.doctorsmedicalctr.com