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Heart attack

What is Heart attack?

A heart attack (medically known as myocardial infarction) occurs when the blood flow to the heart is reduced or blocked. This blockage occurs due to the build-up of fatty deposits in the walls of the arteries supplying blood to the heart and results in a poor oxygen supply to the heart muscle. If the blood flow is not restored promptly, the affected heart tissue dies.

Some patients experience chest pains when a heart attack occurs, but others present with no evident symptoms at all. It is crucial to recognise the warning signs of a heart attack so that it can be treated early. Heart attack is the third leading cause of death in Singapore after cancer and is the leading cause of death in some parts of the world.

Causes

The most common cause of a heart attack is the narrowing of one or more of the arteries that supply blood to the heart. This results from the build-up of cholesterol deposits in the wall of these arteries (a process known as atherosclerosis). This restricts blood flow to the heart muscle, compromising the supply of oxygen.

There are modifiable and non-modifiable risk factors associated with a heart attack.

  • Modifiable risk factors:
    • Lifestyle factors like smoking, lack of exercise and an unhealthy diet
    • Treatable conditions including high blood pressure, high cholesterol, and diabetes
  • Non-modifiable risk factors:
    • Age, a strong family history of the disease, ethnicity, gender (men are 3 to 5 times more prone to having a heart attack than women)
    • Menopause (loss of natural oestrogen increases a woman’s risk of heart disease)

Symptoms

If you are experiencing a heart attack, you may experience the following symptoms:

  • Chills and sweating
  • Cold and sweaty skin
  • Dizziness
  • Nausea
  • Pain that spreads from the chest to the neck, arms, shoulders or jaw
  • Prolonged and severe central chest pain (heavy and crushing sensation)
  • Shortness of breath
  • Weak pulse

Treatment

The aim of the treatment is to unblock the affected artery promptly to minimise damage to the heart muscles. The doctor will evaluate the severity of your condition and perform the most effective way to unblock the artery. This may include:

  • Performing a coronary angioplasty, where a small balloon or stent is inserted into the blocked artery to help re-open it and restore blood flow.
  • Cardiac rehabilitation: A programme that aims to help you achieve a healthier heart after your heart attack by reducing risk factors.
  • Medicines:
    • Anticoagulants to dissolve blood clots
    • To reduce the risk of another heart attack
    • To relieve chest pain
    • To control diabetes, high blood pressure and high cholesterol

Complications and related diseases

  • Arrhythmia, or abnormal heart beat
  • Cardiogenic shock, which is similar to heart rupture, but more serious
  • Damage to the heart valves
  • Heart failure, resulting in the inability of the heart to pump blood effectively around the body
  • Heart rupture, where the heart’s muscles, valves and walls split apart

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