Heart attack

Overview

A heart attack is the death of a segment of heart muscle when the blood flow to the heart is cut off by obstruction of the artery. There is pain or pressure in the chest or neck, lower jaw, shoulders, arms or upper abdomen. The most important thing is to receive medical treatment as soon as possible.

Symptoms

Main symptoms

• Massive pain or pressure in the chest
• Pain can radiate to the neck, lower jaw, shoulders, arms (mostly left) or between the shoulder blades
• Heart palpitations
• Shortness of breath
• Anxiety
• Sweating
• Clammy and pale skin
• Digestive disorders

The symptoms of a heart attack are often different for women and men. The above symptoms mostly apply to men. Women are more likely to have the following symptoms:

• Shortness of breath
• Nausea
• Vomiting
• Upper abdominal pain
• Generally non-specific symptoms

The reasons for these gender-specific differences lie in how the heart attack develops: in the case of men, a blood clot obstructs the coronary arteries, while women are more likely to experience a spasm-like narrowing of the arteries.

Around 20% of patients suffer a “silent heart attack” with no or only slight symptoms.

Complications

When cardiac muscle tissue begins to die, the heart can no longer pump efficiently. This leads to the following problems:

Short-term:

• Impaired blood flow to various organs, in particular the brain and kidneys
• Heart arrhythmia
• Loss of consciousness
• Cardiac arrest, sudden cardiac death
• Pericardial bleeding
• Post myocardial syndrome (with fever and inflammation of the heart sac and visceral pleura)

Long-term:

• Myocardial insufficiency (cardiac insufficiency)
• Pathological weakening of the arteries (aneurysms)
• Heart valve defects
• Conduction disorder, arrhythmia

Causes and treatment

Causes

• The blood vessels supplying the heart (coronary arteries) slowly narrow from the build-up of various substances
• When a clot forms (thrombosis), the artery is blocked suddenly
• The segment of heart muscle behind the obstruction no longer receives any blood and the tissue dies
  

Main risk factors for constriction of the blood vessels

• High blood fat levels (LDL cholesterol)
• High blood pressure
• Diabetes
• Smoking
• Close family members have suffered heart attacks
• Obesity

See Arteriosclerosis for more information about constriction of the blood vessels (vasoconstriction).

Further treatment by your doctor / in hospital

Tests

• Electrocardiogram (ECG)
• Blood test (heart enzymes)
• Ultrasound (echocardiogram)

Possible therapies (these are the same for women and men in spite of the differences in development mechanisms and symptoms)

• Heart catheter (stent)
• Operation (bypass)
• Medication to dissolve the blood clot
• Permanent use of blood-thinning medication (usually ASS), blood pressure reducers and cholesterol-lowering drugs

What can I do myself?

• For typical heart problems:
  • Call an ambulance as quickly as possible
  • Elevate the upper body and put the patient in as relaxed a position as possible
  • Ensure fresh air
  • Open tight clothing
  • Comfort the patient if possible
• Immediately start first aid treatment (reanimation) if patient is unconscious and doesn't appear to be breathing
  
  

Prevention

• Reduce excess weight
• Balanced diet
• Sufficient exercise
• Stop smoking
• Control blood sugar, blood pressure and blood fat levels
  

When to see a doctor?

• Sudden pressure / pain in the chest
  • In particular if pain radiates to the chin, shoulder or arm
• Increasing breathlessness
• Unexplained nausea for women
  

Further information

Swiss Heart Foundation (Schweizerische Herzstiftung)
www.swissheart.ch