What Happens During a Heart Attack?
The heart
muscle requires a constant supply of oxygen-rich blood to nourish it.
The coronary arteries provide the heart with this critical blood supply.
If you have coronary artery disease, those arteries become narrow and
blood cannot flow as well as they should. Fatty matter, calcium, protien,
and inflammatory cells build up within the arteries to form plaques of
different sizes. The plaque deposits are hard on the outside and soft
and mushy on the inside.
When the plaque is hard, the
outer shell cracks (plaque rupture), platelets (disc-shaped particles
in the blood that aid clotting) come to the area, and blood clot
form around the plaque. If a blood clot totally blocks the artery, the
heart muscle becomes "starved" for oxygen. Within a short time, death of
heart muscle cells occurs, causing permanent damage. This is a heart
attack.
While it is unusual, a heart attack can also
be caused by a spasm of a coronary artery. During a coronary spasm, the
coronary arteries restrict or spasm on and off, reducing blood supply to
the heart muscle (ischemia). It may occur at rest, and can even occur
in people without significant coronary artery disease.
Each
coronary artery supplies blood to a region of heart muscle. The amount
of damage to the heart muscle depends on the size of the area supplied
by the blocked artery and the time between injury and treatment.
Healing of the heart muscle begins soon after a heart attack and takes about eight weeks. Just like a skin
wound, the heart's wound heals and a scar will form in the damaged
area. But, the new scar tissue does not contract. So, the heart's
pumping ability is lessened after a heart attack. The amount of lost
pumping ability depends on the size and location of the scar.
Heart Attack Symptoms
Symptoms of a heart attack include:
- Discomfort, pressure, heaviness, or pain in the chest, arm, or below the breastbone
- Discomfort radiating to the back, jaw, throat, or arm
- Fullness, indigestion, or choking feeling (may feel like heartburn)
- Sweating, nausea, vomiting, or dizziness
- Extreme weakness, anxiety, or shortness of breath
- Rapid or irregular heartbeats
During a heart attack, symptoms last 30 minutes or longer and are not relieved by rest or nitroglycerin under the tongue.
Some
people have a heart attack without having any symptoms (a "silent"
myocardial infarction). A silent MI can occur in anyone, but it is more
common among people with diabetes.
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