Hello, in this HealthSketch we’re going to talk about Heart Attacks
and their main cause, Heart Disease, which is also called ‘coronary’ or ‘ischaemic’ heart disease
Heart disease is the leading cause of death worldwide, causing around 1 in every 5 deaths.
It affects both men and women, and becomes more common with age, though it can occur
at younger ages too, particularly in people who lead unhealthy lifestyles.
First, let’s look at how the heart works.
The heart’s job is to pump blood around the body, providing cells with the oxygen
they need to survive.
The constant pumping action is produced by heart muscle in the wall of the heart.
This heart muscle itself requires blood, and so the heart is surrounded by blood vessels,
called the coronary arteries, which provide this blood supply.
Heart disease happens when fatty material builds up in these blood vessels over many years,
reducing the blood flow and its supply of oxygen to the heart muscle.
This results in pain or discomfort around the chest or upper body, called ‘angina’.
It is often triggered by physical activity or stress, but can also occur at rest.
Angina is an important warning sign of heart disease, so you should see a doctor if you get it.
Heart attacks happen when this fatty material ruptures and clots,
blocking the blood supply completely , and leading to damage to the heart muscle.
This damage can also lead to other heart problems such as heart failure (when the heart can’t
pump as well), heart rhythm problems, and cardiac arrest (when the heart stops pumping).
That’s why it’s important to get treated quickly.
Heart attacks happen suddenly, even in people who might never have had angina before.
The symptoms vary in different people, but might include: pain or discomfort in the chest
or upper body, and feeling sick, sweaty, lightheaded, and breathless.
It is also possible to have silent heart attacks, with fewer symptoms, particularly in elderly
people and those with diabetes.
If you think you might be having a heart attack, call an ambulance immediately as emergency
treatment may be needed to restore blood flow and limit damage to the heart.
So how is heart disease diagnosed?
If it is suspected, a doctor will ask more about your history of symptoms, and assess
your risk factors for heart disease, including your family history.
After this, a range of tests might be used to confirm the diagnosis, including blood
tests, an ECG or EKG (which traces the electrical pattern of the heartbeat), exercise stress
tests, and an Echocardiogram (which is an ultrasound scan of the heart).
Various imaging tests can be used, such as CT or MRI scans, or radionuclide tests.
Finally, a procedure called an ‘angiogram’ is done, where a contrast dye is inserted
into the blood during x-ray imaging.
This is used to find out precisely which blood vessels around the heart are affected and
what to do about them.
Heart disease is treated through a combination of lifestyle changes, medications, and surgical
procedures.
Lifestyle changes include stopping smoking, becoming more active, eating healthily, reducing
alcohol intake, reducing weight, and controlling blood pressure, blood cholesterol and blood
sugar levels.
A wide range of medications are used both to treat the heart disease itself and address
risk factors.
These include medications which lower blood pressure, lower cholesterol, and make the
blood thinner.
Nitrates, which come in various forms, widen and relax the coronary vessels to provide
immediate relief of chest pain symptoms.
If the vessel blockage is severe, two main types of procedure are used: angioplasty,
and bypass surgery.
• Angioplasty can either be a planned procedure or an emergency procedure during a heart attack.
Here, a guide wire is passed into the blood vessels to the site of the blockage, and a
small balloon is inflated to expand the vessel.
A wire mesh, called a stent, can be left at the site to hold it open.
• In bypass surgery, a different blood vessel from the body (usually either from the leg
or the chest wall) is grafted onto the heart beyond the point of the blockage.
By doing this, blood flow is diverted around the diseased section and can reach the heart
muscle beyond it.
Heart disease is a serious condition, but it is also both preventable and treatable.
Doctors, nurses and support groups are available to provide advice and support.
By making lifestyle changes, controlling risk factors, and taking medication as prescribed,
the condition can be managed, reducing the risk of future heart attacks.
Because heart disease is so common, these lifestyle changes should be adopted by everyone
in order to lead longer and healthier lives.
We hope this HealthSketch has been useful to you and those around you