Tuesday, June 17, 2008 Heart attack: Are you at risk By Henrylito D. Tacio Health 101
REY Elmido was attending church in Baguio City. Since the church was very full, he just stood up in the left side of the entrance. At his left was another man, Frank, standing. Rey observed that he was touching his chest.
Rey was listening to the preacher attentively, when he heard a commotion. Frank had a fit and collapsed. "That man has fainted," one lady said. "We need to fan him," another churchgoer suggested.
Rey tried to peep and when he saw that the Frank was not moving, he suspected of a heart attack. So, he came nearer to the victim. He told the group his name and informed them that he had gone first aid training. He immediately asked if there was a doctor. When no one responded, he immediately checked Frank's pulse. He felt nothing.
He wiped Frank's mouth with his handkerchief and did a CPR. After doing it three times, Frank coughed. Since he was not from the said place, he asked someone to accompany him in bringing Frank to Baguio General Hospital. The following day, Frank's daughter, Vanessa*, came to the hotel where he was staying. "I want to thank you for saving my father," she said.
Heart attack is one of the most treacherous diseases as it strikes anytime in the office, while attending a party, going to the church, or even resting at home. "A heart attack usually occurs when a blockage in a coronary artery, which supply the heart with oxygen and nutrients, severely restricts or cuts off the blood supply to a region of the heart," explains The Merck Manual of Medical Information. "If the supply is cut off or greatly reduced for more than a few minutes, heart tissue dies."
Coronary thrombosis, as heart attack is known in medical parlance, may cause sudden death, usually due to abnormal heart rhythm, which prevents effective pumping. Severe persistent pain in the center of the chest is common, and it may lead to shock or lung congestion.
A blood clot is the most common cause of a blocked coronary artery. "Usually, the artery is already partially narrowed by atheromas," the Merck manual says.
Atheroma is a degenerative condition of the arteries. The inner and middle coats of the arterial walls become scarred, and fatty deposits (cholesterol) are built up at these sites. Blood circulation is impaired, and it may lead to such problems as stroke and heart attack.
"An atheroma may rupture or tear and create more blockage, which promotes clot formation. The ruptured atheroma not only restricts the flow of blood through an artery, but also makes platelets stickier, further encouraging clots to form," the Merck manual points out.
An uncommon cause of a heart attack is a clot from part of the heart itself. Sometimes, a clot forms in the heart, breaks away, and lodges in a coronary artery. Another uncommon cause is a spasm of a coronary artery that stops blood flow. Spasm may be caused by drugs such as cocaine or by smoking, but sometimes the cause is unknown.
Are there telltale signs that a person will know that he's experiencing a heart attack? Yes, according to the Merck manual. It says that about two out of three people who have heart attacks experience intermittent chest pain, shortness of breath, or fatigue a few days beforehand. The episodes of pain may become more frequent even after less and less physical exertion. "Such unstable angina may culminate in a heart attack," warns the Merck manual.
Generally, the most recognizable symptom is pain in the middle of the chest that may spread to the back, jaw, or left arm. It may also spreads to the right arm, although this is less often. The pain may occur in more or more of aforementioned places and not in the chest at all.
"The pain of a heart attack is similar to the pain of angina but is generally more severe, lasts longer, and isn't relieved by rest or nitroglycerin," the manual states. Angina is a suffocating, choking pain, usually used in reference to angina pectoris, which is felt in the chest. The pain if felt or brought on by exercise and relieved by rest, and occurs when the blood supply to the heart muscle is inadequate.
Other symptoms of a heart attack include a feeling of faintness and a heavy pounding of the heart. Irregular heartbeats may seriously interfere with the heart's pumping ability or may cause the heart to stop pumping effectively (cardiac arrest), leading to a loss of consciousness or even death.
