Heart Disease continues to remain the leading cause of death among the Indian population. With the emergency treatments for heart attacks becoming more sophisticated and precise, why is it that heart attacks kill 1 person every 33 seconds in India?
What is a heart attack?
A heart attack or Myocardial Infarction (MI) happens when there is a blockage in an artery that supplies blood to the heart. The lack of oxygen to the heart muscles due to the shortage of blood supply causes that part of the heart muscle to die.
The common symptoms that accompany a heart attack include tightness in the chest, pain that radiates from your left arm to your neck, back, and jaw, shortness of breath, nausea, and indigestion, to name a few. Not everyone experiences the same symptoms, and for some people, symptoms may be very mild.
Diagnosing a heart attack
An ECG measures the electrical signals from your heart. Any irregularities in these electric impulses could indicate heart damage.
Another factor that determines the severity of damage to your heart muscle is the ejection fraction. Ejection fraction is the percentage of blood that is pumped out from your ventricles each heartbeat. A normal ejection fraction ranges anywhere between 50% and 75%. A percentage below this indicates that your heart is not functioning effectively as a result of muscle damage.
In addition to confirming a heart attack, an ECG also helps determine the type of heart attack you are likely to have suffered:
- STEMI: a complete blockage and prolonged interruption in blood supply to the heart
- NSTEMI: partial blockage with a decrease in blood supply to the heart
Apart from an ECG, other diagnostic tests, such as troponin test or coronary angiography, may also be conducted to assess the level of damage.
What causes a heart attack?
Blockages that cause heart attacks develop due to damage and inflammation to coronary arteries resulting in Coronary Artery Disease (CAD). It can develop over years and go undetected until blood flow has been significantly compromised.
Treatment for a heart attack involves a combination of medication and surgery.
The first line of treatment is to manage the symptoms and this involves administration of aspirin to decrease blood clotting and maintain blood flow; thrombolytics to help dissolve the clot that is blocking the blood flow, and antiplatelet drugs to prevent existing clots from growing and new clots from forming.
After the emergency medication has been administered, cardiologists assess the level of damage to the heart before deciding on an angioplasty or Coronary Artery Bypass Graft (CABG) surgery.
Angioplasty and stenting
An angioplasty is a minimally invasive procedure that is used to restore blood flow by using a balloon-tipped catheter. The catheter is inserted through an artery and once it reaches the blocked artery, the balloon at the tip expands and presses a stent into the artery wall to restore and maintain blood flow.
CABG or Bypass Surgery
A bypass surgery is usually recommended when there are blockages in multiple coronary arteries or if angioplasty was already performed before. A CABG procedure involves placing grafts above or below the blocked section of the arteries, to bypass the blockage and to restore blood flow to the heart.
Recovery after a heart attack
After a heart attack, secondary prevention is key to cardiac recovery. A comprehensive approach to recovery ensures the underlying risk factors are corrected and prevent a recurring event. Typically, recovery involves interventions through the following:
Medication maintains heart health and helps with managing other contributing factors. The most commonly prescribed drugs include:
- Ace Inhibitors: ACE inhibitors are drugs that are used to lower blood pressure.
- Beta-blockers: Beta-blockers are drugs that lower your heart rate, helping reduce the strain on your heart.
- Statins: Statins are drugs that are used to lower certain cholesterol levels in the blood.
- Antiplatelets: Antiplatelets are drugs that help inhibit the clotting or coagulation function of blood platelets.
- Aspirin: Aspirin is most often prescribed in combination with another antiplatelet drug. It can decrease the risk of heart attack and ischemic stroke.
Reframing the proportion and balance of macro and micronutrients helps in several measurable ways. Recalibrating the proportion of these elements helps improve metabolic function while also minimizing the risk of plaque formation in coronary arteries.
Improving aerobic fitness enables secondary prevention. It improves cardiovascular conditioning, which consequently helps with weight management, stabilizes blood pressure and heart rate, and helps manage cholesterol levels and blood sugar levels.
Decompressing from daily life events and identifying situations that are triggering is part of recovery. Long-term stress has a significant impact on triglyceride levels, blood pressure, and blood sugar levels - all factors that play a significant role in the recurrence of an event. Additionally, it also affects a person’s motivation to stick to a structured recovery regime.
Research has shown that knowing one’s condition is directly linked to long-term compliance to a recovery regime, which in turn, significantly reduces risks of rehospitalization.
Mitigating risk factors
A bonus of following a recovery regime is that it helps manage risks and reduces the chances of new complications through secondary and primary prevention methods.
The phrase ‘Prevention is better than cure’ does ring true about CVD. While it is a chronic condition, the tools for recovery can be easily adapted to a daily routine. With the right guidance and support, you can feel yourself getting back to your old self. Highlighting and implementing efforts of preventative care might even bring down the national average of CVD-related deaths in the future.