Marie Berry, Pharmacist, Vimy Park Pharmacy, Winnipeg, MB
Heart disease is the most common cause of death for both men and women in North America. A heart attack is the most obvious sign of heart disease. Thirty per cent of people who have a heart attack die from it, and half of those die before they reach the hospital. For this reason, it is important to seek immediate medical attention at the first sign of a heart attack.
Your heart muscle contracts, or beats, regularly and automatically. Just like any other muscle in your body, it needs oxygen. Coronary arteries supply this oxygen by delivering oxygen-rich blood to your heart. If blood flow is decreased as a result of heart disease, your heart does not get the oxygen it requires. The term for this lack of blood flow is ischemia.
Coronary arteries can get narrower over time when fatty deposits build up inside, just like a plugged drain pipe in your kitchen sink. Fatty deposits are linked to increased blood levels of lipids or cholesterol. Studies have shown that a 1% rise in blood lipid levels increases the risk for coronary artery disease by 2%. Blood platelets stick to these porridge-like fatty deposits causing a blood clot that may eventually completely block the coronary artery.
If blood flow to the heart is reduced, it is felt as a pain or angina. If blood flow stops completely, then heart tissue can die. This is referred to as a heart attack, or an acute myocardial infarct.
The symptoms of a heart attack vary from person to person. They may include pain, discomfort, pressure, heaviness in the chest lasting 30 minutes or more or not relieved by rest, shortness of breath, light headedness, weakness, nausea, and anxiety. For about 15 to 20% of people, especially older people and those with diabetes, symptoms may be mild or even completely absent.
A combination of tests is performed to confirm a heart attack. An electrocardiogram and measurement of blood enzyme levels ar the most common tests.
Several different drugs are used to treat heart attacks. Thrombolytic drugs can dissolve the blood clot in the coronary arteries that caused the heart attack. The earlier these drugs are given, the more likely they are to limit the damage caused by the heart attack. To be at all effective, they must be given within 4 hours. Unfortunately, the average delay before treatment is four and a half hours. Acetylsalicylic acid, or ASA, and anticoagulants stop blood cells from sticking to each other. Nitrates, beta blockers and ACE inhibitors restore blood flow by opening up coronary arteries, thereby reducing the the risk of further heart damage. Other medications include pain relievers and drugs for anxiety.
While it is possible to successfully treat heart attacks, it is better to prevent them:
- Reduce blood cholesterol levels by reducing the amount of fat in your diet.
- Control high blood pressure.
- Stop smoking – it reduces the blood’s ability to carry oxygen.
- Be physically active, and if obese, lose weight.
- Diabetes increases the risk for heart attacks; keep good control of diabetes.
Some risk factors such as a family history of heart disease, increased age, male sex and ethnic background cannot be changed. However, if any of these factors already place you at increased risk for heart disease, it’s even more important to control the risk factors that can be changed.
Heart attacks occur rapidly and are life-threatening emergencies. If you experience symptoms of a heart attack, seek medical attention immediately. Getting to the hospital even a few minutes quicker can mean the difference between life and death.