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WHAT HAPPENS WHEN YOUR PATIENT GOES HOME?

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Mar.26.2020
 Heart Attack

Heart Attack

The heart is a muscle that needs oxygen to survive. A heart attack is a condition that occurs when your heart does not get enough oxygen. When this happens, the heart muscle begins to die. This can cause permanent damage if not treated right away. A heart attack is a medical emergency.

This condition may be called a myocardial infarction, or MI. It is also known as acute coronary syndrome (ACS). ACS is a term used to describe a group of conditions that affect blood flow to the heart.

What are the causes?

This condition may be caused by:
  • Atherosclerosis. This occurs when a fatty substance called plaque builds up in the arteries and blocks or reduces blood supply to the heart.
  • A blood clot. A blood clot can develop suddenly when plaque breaks up within an artery and blocks blood flow to the heart.
  • Low blood pressure.
  • An abnormal heartbeat (arrhythmia).
  • Conditions that cause a decrease of oxygen to the heart, such as anemiaorrespiratory failure.
  • A spasm, or severe tightening, of a blood vessel that cuts off blood flow to the heart.
  • Tearing of a coronary artery (spontaneous coronary artery dissection).
  • High blood pressure.

What increases the risk?

The following factors may make you more likely to develop this condition:
  • Aging. The older you are, the higher your risk.
  • Having a personal or family history of chest pain, heart attack, stroke, or narrowing of the arteries in the legs, arms, head, or stomach (peripheral artery disease).
  • Being male.
  • Smoking.
  • Not getting regular exercise.
  • Being overweight or obese.
  • Having high blood pressure.
  • Having high cholesterol (hypercholesterolemia).
  • Having diabetes.
  • Drinking too much alcohol.
  • Using illegal drugs, such as cocaine or methamphetamine.

What are the signs or symptoms?

Symptoms of this condition may vary, depending on factors like gender and age. Symptoms may include:
  • Chest pain. It may feel like:
    • Crushing or squeezing.
    • Tightness, pressure, fullness, or heaviness.
  • Pain in the arm, neck, jaw, back, or upper body.
  • Shortness of breath.
  • Heartburn or upset stomach.
  • Nausea.
  • Sudden cold sweats.
  • Feeling tired.
  • Sudden light-headedness.

How is this diagnosed?

This condition may be diagnosed through tests, such as:
  • Electrocardiogram (ECG) to measure the electrical activity of your heart.
  • Blood tests to check for cardiac markers. These chemicals are released by a damaged heart muscle.
  • A test to evaluate blood flow and heart function (coronary angiogram).
  • CT scan to see the heart more clearly.
  • A test to evaluate the pumping action of the heart (echocardiogram).

How is this treated?

A heart attack must be treated as soon as possible. Treatment may include:
  • Medicines to:
    • Break up or dissolve blood clots (fibrinolytic therapy).
    • Thin blood and help prevent blood clots.
    • Treat blood pressure.
    • Improve blood flow to the heart.
    • Reduce pain.
    • Reduce cholesterol.
  • Angioplasty and stent placement. These are procedures to widen a blocked artery and keep it open.
  • Coronary artery bypass graft, CABG, or open heart surgery. This enables blood to flow to the heart by going around the blocked part of the artery.
  • Oxygen therapy if needed.
  • Cardiac rehabilitation. This improves your health and well-being through exercise, education, and counseling.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Do not take the following medicines unless your health care provider says it is okay to take them:
    • NSAIDs, such as ibuprofen.
    • Supplements that contain vitamin A, vitamin E, or both.
    • Hormone replacement therapy that contains estrogen with or without progestin.

Lifestyle

  • Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.
  • Avoid secondhand smoke.
  • Exercise regularly. Ask your health care provider about participating in a cardiac rehabilitation program that helps you start exercising safely after a heart attack.
  • Eat a heart-healthy diet. Your health care provider will tell you what foods to eat.
  • Maintain a healthy weight.
  • Learn ways to manage stress.
  • Do not use illegal drugs.

Alcohol use

  • Do not drink alcohol if:
    • Your health care provider tells you not to drink.
    • You are pregnant, may be pregnant, or are planning to become pregnant.
  • If you drink alcohol:
    • Limit how much you use to:
      • 0–1 drink a day for women.
      • 0–2 drinks a day for men.
    • Be aware of how much alcohol is in your drink. In the U.S., one drink equals one 12 oz bottle of beer (355 mL), one 5 oz glass of wine (148 mL), or one 1½ oz glass of hard liquor (44 mL).

General instructions

  • Work with your health care provider to manage any other conditions you have, such as high blood pressure or diabetes. These conditions affect your heart.
  • Get screened for depression, and seek treatment if needed.
  • Keep your vaccinations up to date. Get the flu vaccine every year.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You feel overwhelmed or sad.
  • You have trouble doing your daily activities.

Get help right away if:

  • You have sudden, unexplained discomfort in your chest, arms, back, neck, jaw, or upper body.
  • You have shortness of breath.
  • You suddenly start to sweat or your skin gets clammy.
  • You feel nauseous or you vomit.
  • You have unexplained tiredness or weakness.
  • You suddenly feel light-headed or dizzy.
  • You notice your heart starts to beat fast or feels like it is skipping beats.
  • You have blood pressure that is higher than 180/120.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

  • A heart attack, also called myocardial infarction, is a condition that occurs when your heart does not get enough oxygen. This is caused by anything that blocks or reduces blood flow to the heart.
  • Treatment is a combination of medicines and surgeries, if needed, to open the blocked arteries and restore blood flow to the heart.
  • A heart attack is an emergency. Get help right away if you have sudden discomfort in your chest, arms, back, neck, jaw, or upper body. Seek help if you feel nauseous, you vomit, or you feel light-headed or dizzy.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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