Heart Attack FAQs – Frequently Asked Questions

What is a heart attack?

An acute heart attack is a life-threatening condition. It occurs due to sudden and total occlusion of a preexisting partial block in the coronary artery, thereby completely cutting off the blood supply of a part of the heart muscle. The patient presents with sudden onset of chest pain.

Which patients are more prone to a heart attack?

There are certain individuals in whom the risk of heart attack is higher. The patients with diabetes mellitus, hypertension, and disturbed cholesterol level have three times higher risk of heart attack compared to those not having these diseases. Similarly, smokers also have three times more risk of heart attack than nonsmokers. The risk in smokers depends on a number of cigarettes he or she consumes. If your parents or siblings had a heart attack at an early age, you are more prone to a heart attack. Nowadays increased stress level due to rapid urbanization and changing lifestyle (lack of a healthy diet and daily exercise) also contribute significantly to the rising rates of a heart attack. Lastly, our genetics also play a significant role.

What is the reason for increasing rates of a heart attack in young age?

Increased use of tobacco in any form like smoking pan mava, gutkha, mishri, lack of exercise, diet containing high saturated fats and high stress among young individuals are common causes for increasing rates of a heart attack in the younger age group.

Can we prevent a heart attack?

Yes. The risk of heart attack can be reduced to some extent by regular exercise and the following of a  healthy diet recommended for heart health.

What are the symptoms of a heart attack?

Any kind of chest pain like chest discomfort, heaviness, tightening around the chest, feeling of impending doom could be the symptoms of a heart attack. Some patients may present with discomfort in the arm, neck or jaw, shortness of breath, nausea, lightheadedness or profound weakness. Sometimes symptoms are very subtle and the patient may misdiagnose themselves like having gas or acidity. It is always advisable to consult a physician if any person develops chest pain which is new in onset especially those who have risk factors.

What should be done if someone has chest pain?

It is always advisable to consult a physician on an emergency basis. Risk of death due to a heart attack is more common during the first hour after the onset of chest pain. So rush to the nearest hospital. Depending upon your symptoms, ECG, 2D ECHO (it is like sonography of heart) and blood tests, a doctor will diagnose the heart attack. Consumption of tablet DISPRIN, CLOPIDOGREL, AND ATORVASTATIN or ROSUVASTATIN in the early stage may help to reduce mortality associated with a heart attack. One can keep this in stock for future use.

How to behave in an emergency?

Always keep the contact number of hospitals /ambulance at home and in a cell phone. Recognize the symptoms of a heart attack. Call for the help immediately. Try to reach the nearby hospital immediately as early as possible rather than wasting time traveling to the hospital of your choice, which may be far away. Shorten the timing of decision making. Faster you act; less is the damage to your heart.

What is the golden hour?

Appropriate medical intervention within the first 60 minutes of a heart attack can reverse its effect. The first hour after the onset of a heart attack is called “golden hour”.  This concept is extremely important to understand because most deaths due to heart attack occur during this period. However, if the person reaches the hospital and gets treated well within this period, he/she can expect near complete recovery.

Can you explain in details about this?

As I said before, an acute heart attack is a life-threatening disease which occurs due to sudden and total occlusion of a preexisting partial block in the blood vessel of the heart. This leads to complete loss of blood supply to the part of the heart muscle. This 100% blockage needs to be removed as early as possible; else muscles of the heart get damaged permanently. Earlier the blood supply is reestablished, lesser would be the damage to the heart, and so lesser the chance of death and functional disability. The most common killer in the early period following a heart attack is the abnormal heart rhythm called “ventricular tachycardia” and chances of this can be reduced with early treatment.

What are the treatment options for heart attack?

Treatment of acute heart attack has changed dramatically since the last decade. Initial treatment should be started as soon as possible at first medical contact. This involves the consumption of blood thinner and statin, cholesterol-reducing medicine. Final treatment involves removal of the blockage. Here, we have two options.

The first option is giving “clot-dissolving medicine” (Thrombolysis). This is available all over including smaller hospital setups and can be easily administered; however, this works only in 60-65% of the patients. In the remaining 35-40% cases, it fails and leads to multiple complications including very weak heart at discharge.

An alternate best option is “primary angioplasty” which is the gold standard. Angioplasty involves the removal of the blockage with the help of wire, balloons, and stent. Primary angioplasty is done as a life-saving emergency procedure in a patient with an ongoing heart attack (PAMI). The success rate of this procedure is 95-97%. Though costly, this is the best kind of treatment during a heart attack. The success of both therapies depends upon how early the treatment is started.

What is a stent?

Stents are small expandable tubes used to treat narrowed or weakened arteries in the body. First generation stent was made up of bare metal. Though they are better than balloon angioplasty, they have a high risk of closure in 25-30% cases. Presently, they are less frequently used.

A drug-eluting stent has drug coating over them and they are nowadays preferred stents and works well in 95% of patients. Still, they have a risk of closure at approximately 5% over the first year. They become permanent members of our body. A newer innovation is a biodegradable stent. These stents start degrading after the first year and there is no stent material in the body after 3 years.

How to behave in an emergency?

• Always keep the contact number of hospitals /ambulance at home and in a cell phone.

• Recognize the symptoms of heart attack

• Call for help immediately

• Try to reach the nearby hospital immediately as early as possible rather than wasting time in traveling to the hospital of your choice, which may be far away

• Shorten the timing of decision making