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Myocardial In-What? : Understanding a Heart Attack

S E Hurst graduated from the University of Tennessee with a PhD in Comparative and Experimental Medicine in 2012.

Heart Attacks = Heart Break

It was a Wednesday night in 1993 when my mother came home from church complaining of weakness and nausea. I remember that it was Wednesday not only because the mid-week church service, but also because In the Heat of the Night was on and I was allowed to watch it. It amazes me how the human mind can remember such mundane things when surrounded by such serious events. So was the case on this particular Wednesday night. As a nurse, my mother had a pretty good idea about what was happening to her body, but as a child of 12 years old, I didn’t have a clue. I recall being very scared that my mother was sick. When we arrived at the hospital, my mother was rushed in, and they next thing I knew, I was escorted to her bedside to tell her “good night”. My mom was staying overnight in the hospital while I headed to my grandmother’s house. No one told me what was wrong with my mom, so that added to the scariness. Long story short, the next day, I was told my mom had suffered from a heart attack caused by a blockage in one of the arteries in her heart. Later, we found out that my mother had abnormally small arteries compared to other individuals, and that more than likely, her heart attack was caused by a blood clot that had dislodged, thus blocking the affected artery. Her prognosis was very good and as of today, she has been free of any cardiac complications for many years. Other members of my family have not been as lucky. My grandfather (my mother’s father) died just a month later with cardiac failure five years after his first diagnosed heart attack (he had previously had a heart attack, but went un-diagnosed) and in 1998, my grandmother (my father’s mother) died after her second heart attack. Over two years ago, I lost my last grandparent (my mother’s mother) to heart disease.

Heart Attack: What is it?

A heart attack can have many names such as a myocardial infarction or MI, an acute MI, a ST-elevation myocardial infarction, a non-ST-elevation myocardial infarction, an acute coronary syndrome, a coronary thrombosis, or a coronary occlusion. Basically, a heart attack happens when blood flow to a part of the heart is blocked and part of the heart muscle is damaged or dies. Most heart attacks are caused by a blood clot that blocks one of the coronary arteries, which are responsible for carrying blood and oxygen to the heart. If blood flow isn't restored quickly, the section of heart muscle begins to die. However, the cause of all heart attacks is not always known.

Plaque build-up in the arteries can restrict blood flow. However, this issue is often hard to diagnose.

Plaque build-up in the arteries can restrict blood flow. However, this issue is often hard to diagnose.

There are several types of myocardial infarctions. More sensitive cardiac biomarker detection and lower diagnostic thresholds led to major revision of the guidelines.

There are several types of myocardial infarctions. More sensitive cardiac biomarker detection and lower diagnostic thresholds led to major revision of the guidelines.

Heart Attack: Statistics and Symptoms

Heart attacks are a leading killer of both men and women in the United States effecting about 1.2 million people each year, many of which die from complications. Often, survival or better recovery from heart attacks occurs with faster care and treatment. Of those who die from heart attacks, about half die within an hour of the first symptoms and before they reach the hospital.

Common heart attack signs and symptoms include, but are not limited to:

  • Pressure, tightness, and/or pain in your chest or arms that may spread to your neck, jaw or back
  • Nausea, indigestion, heartburn or abdominal pain
  • Shortness of breath
  • Cold sweats
  • Fatigue
  • Lightheadedness or sudden dizziness

As the most common symptom of a heart attack is chest pain, you may feel the pain in only that part of the body, or it may move from the chest to your arms, shoulder, neck, teeth, jaw, belly area, or back. Most sufferers describe the pain as an elephant sitting on one’s chest. Ranging from mild to severe, the pain can feel like a tight band around the chest, bad indigestion, and squeezing or heavy pressure. Chest pain is no joke, so seek medical attention. The pain associated with a heart attack usually lasts longer than 20 minutes, but the pain may also go away and come back off and on. Other symptoms can include, but are not limited to anxiety, coughing with no other causation, fainting, light-headedness, dizziness, nausea or vomiting, heart palpitations (irregular), shortness of breath, and sweating. Moreover, some people may present with little or no symptoms (especially women). This is referred to as a "silent heart attack".

However, it is important to note that not everyone experiences the same symptoms, or the same severity of symptoms. Moreover, others have no symptoms.

These are just some of the common signs and symptoms. However, some people don't experience any symptoms.

These are just some of the common signs and symptoms. However, some people don't experience any symptoms.

Heart Attack: What to Do Next

Whatever the cause, a heart attack is a serious medical emergency. If you have symptoms of a heart attack, call 911 (or your local emergency number if not in the USA). To avoid any other medical emergencies, do not drive yourself to the hospital and don’t delay on getting treatment as you are at greatest risk of sudden death in the early hours of a heart attack.

Again, if you experience any or all of the symptoms of a heart attack, seek immediate medical treatment. It may turn out to be nothing, but do you want to suffer the consequences if it is something?

Cardiac rehab isn't easy, but at least you are still alive!

Cardiac rehab isn't easy, but at least you are still alive!

Heart Attack Aftermath: Cardiac Rehabilitation

I’m not going to lie to you and say cardiac rehabilitation will be easy. Cardiac rehab is a medically supervised program that may help improve the health and well-being of people who have heart problems. Once you have been properly diagnosed with either a heart attack, or another heart condition, you may need to take medication for the rest of your life. My mom has taken the same medication now for 19 years, but she is glad she has had those 19 years of living. Under medical guidance in cardiac rehab program, you will begin to slowly increase your exercise level, learn how to follow a heart healthy lifestyle which includes keeping your blood pressure, blood sugar, and cholesterol under control. You will also be told to stop smoking (my grandmother quit cold turkey after her first heart attack even after smoking for 30+ years). Also, after a heart attack, you may feel sad and suffer with depression, anxiety and worrisomeness. These feelings are normal and for most people last about 2 to 3 weeks. Tiredness is also common after a heart attack. All these rehabilitations are important as after a heart attack, your chance of having another one is higher and your prognosis generally depends on several factors like the damage to your heart muscle and heart valves, and where that damage is located.

References

Chapman AR, Adamson PD, Mills NL. Assessment and classification of patients with myocardial injury and infarction in clinical practice. Heart 2017;103:10-18.

"Heart Attack". Mayo Foundation for Medical Education and Research. (2018). https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106

“Heart Attack”. National Heart, Lung, and Blood Institute. (2018). Retrieved from http://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/

My mother at a AHA Heart Walk a few years ago. She received a survivors hat :-)

My mother at a AHA Heart Walk a few years ago. She received a survivors hat :-)

I participated in the walk in honor of my family members with heart disease.

I participated in the walk in honor of my family members with heart disease.

© 2018 Sarah Hurst