During a heart attack, cells of the heart muscle (myocardium) perish. This happens when parts of the muscle are temporarily starved of oxygenated arterial blood. Most often, the cause is a blood clot that is severely narrowing or blocking a coronary artery – one of the arteries that supply the heart muscle. Such blockages almost always occur in places where the walls of the coronary arteries have changed due to arteriosclerosis (coronary heart disease).
Heart attacks are one of the most common causes of death in industrialized nations and medical emergencies where time is of the essence: around one in three sufferers dies before being admitted to the hospital. The medically correct term is myocardial infarction, in colloquial language we often speak of a heart attack, a heart attack or a heartbeat. Heart attacks, along with unstable angina pectoris and sudden cardiac death, fall under the umbrella term acute coronary syndrome.
Heart Attack Causes And Risk Factors
By far the most heart attacks are the result of coronary heart disease. In turn, it goes back to “calcified” coronary vessels – arteriosclerosis. Their emergence is accelerated by several risk factors that the lifestyle in industrialized nations brings with it or favors. In arteriosclerosis, deposits form on the walls of the arteries, often in the coronary arteries. When such deposits or plaques rupture, blood clots (thrombi) form, and sometimes material from the deposits also detaches. Both types of "lumps" can block blood flow locally or elsewhere if they are washed away. If the blockage occurs in a coronary artery, the cells in the supply area receive little or no oxygen. They only survive the shortage for a short time, then they die - the heart attack has occurred. The body replaces the dead heart muscle cells with connective tissue cells, which form a scar in the heart muscle. He can often cope with small scars, but the function of the heart breaks down as a result of large scars, mostly due to cardiac arrhythmia.
Not all atherosclerotic deposits are equally dangerous, there are stable and unstable plaques. Stable plaques develop over years. Although they are often thick, they are hard, rich in lime and robust - they rarely tear. In addition, they usually cause symptoms long before a heart attack occurs. The typical symptoms of angina pectoris usually indicate the risk of a heart attack. Unlike stable plaques, unstable plaques are younger and smaller, but they are also softer and more vulnerable—they tear more easily. The risk of heart attack is higher, and events usually happen without warning.
Other causes of heart attacks, such as tumors, are rare.
Risk factors
Abundance and everyday life in industrial societies seduce many people into an unhealthy lifestyle. You move too little, eat too much, too fat, too sweet or salty, are overweight, have high blood pressure, high blood sugar or blood lipid levels. Tobacco consumption also contributes massively to the development of arteriosclerosis and cardiovascular diseases. The main risk factors are:
- Elevated arterial blood pressure (high blood pressure)
- Elevated blood sugar levels (diabetes mellitus)
- Elevated blood fats (hyperlipidemia)
- Overweight
- Lack of exercise
- Smoking
Every person influences these factors through their lifestyle. In terms of prevention and treatment, it is extremely important to change one's lifestyle in such a way that these risks are eliminated or at least greatly reduced in importance. Even those who exercise for at least 30 minutes two to three times a week lower their cardiovascular risk by an average of 35%. Quitting cigarettes and eating a healthy diet have similar effects.
Heart Attack Symptoms
Heart attacks can take different courses, some cause no symptoms at all, but the majority are very severe. There are "typical" symptoms that are most common in men, and there are less typical ones. They are more likely to occur in women and the elderly. Although heart attacks often occur suddenly, “out of the blue”, there are sometimes warning signs beforehand.
Possible signs
Circulatory disorders in the heart muscle often develop evenly over years (stable angina pectoris or chronic coronary heart disease). The symptoms do not change for a long time or hardly change and initially only appear with physical exertion or severe stress. Typical signs are tightness and pain behind the breastbone. The pain can radiate to the head, lower jaw, neck, neck, back, left arm and upper abdomen. Shortness of breath, feelings of anxiety, sweating and nausea may also appear. Because the disease usually progresses slowly, sufferers often already have a diagnosis and treatment. They know about their increased heart attack risk. Stable angina pectoris can suddenly turn into unstable angina pectoris, where the risk of a heart attack is even higher. Warning signs can be rapid deterioration, i.e. if symptoms
- occur at rest, i.e. without physical exertion.
- last longer and be stronger than usual.
- persist despite the usual medication.
In patients who have already had heart surgery due to circulatory disorders, the risk of a heart attack increases if the typical symptoms (e.g. pain behind the breastbone, tightness) become noticeable.
In women, comparatively “unusual” symptoms can herald a heart attack. Many of them feel symptoms such as general weakness, insomnia, abdominal pain, indigestion, nausea and headaches, sometimes weeks in advance. Pain in the back, neck, jaw, left shoulder blade or between the shoulders is also common, while pain behind the breastbone is less common than in men.
The acute heart attack
The usual, typical symptoms of acute heart attacks include:
- Sudden sharp pains in the chest, the center is behind the breastbone. The pain can radiate into the arms - with the left one being affected more often - up to the shoulders, throat, neck, lower jaw and down to the upper area of the abdomen. Some patients experience the pain as burning, others as pulling, tearing, like a stab or a cut with a knife. The pain feels so intense and life-threatening that many describe it as "devastating."
- Pressure and oppression in the chest. Patients often perceive this as if someone is sitting on their chest or a tight steel band is squeezing the chest.
- Extreme fear, feelings of annihilation, fear of death, sweating
- Nausea, which may be accompanied by nausea and vomiting
- Pale complexion
- Severe physical weakness. In some patients, the circulation collapses, some lose consciousness.
- Shortness of breath
- Cardiac arrhythmias (palpitations, tachycardia)
Call an ambulance immediately!
Affected persons, partners, friends or colleagues should call an emergency doctor immediately if the symptoms mentioned occur or other signs that indicate a high risk of a heart attack - i.e. in the following cases:
 |
| Heart attack symptoms |
- When such symptoms appear for the first time, they are extremely severe for the first time or get worse and do not go away after 15 minutes - especially severe pain in the chest associated with tightness, fear of death, sweating or other of the symptoms mentioned.
- If a person has been diagnosed with coronary heart disease, but the known symptoms do not disappear within 20 minutes, even though the affected person is resting, i.e. not exerting themselves.
- When pain attacks recur with increasing frequency in people diagnosed with angina pectoris.
- If typical symptoms suddenly occur even with very little physical exertion, at rest or at night.
- When patients need higher and higher doses of their drug - usually nitrates - to improve their symptoms during acute attacks, or the drugs do not significantly relieve their symptoms within five minutes.
Heart attack symptoms in women
Heart attacks in women are sometimes called "Eva infarcts" because they sometimes trigger a different pattern of symptoms. Only one in three sufferers experience the typical chest pain, which can radiate into the arm and jaw. Instead, feelings of pressure or tightness prevail. "Female" symptoms can accompany "male" symptoms or appear alone. Unfortunately, many of these do not specifically indicate impending heart attacks, but could also have many other causes. These include weakness, nausea, headaches, sleep and digestive disorders or feelings of anxiety, pain in the back, neck, jaw, left shoulder blade or between the shoulders. These symptoms even appear up to a month before the event in a large number of subsequent heart attack patients.
Silent heart attacks
If heart attacks do not bring any or only weak, unusual symptoms, one speaks of "silent" heart attacks. Doctors discover this only in later examinations. Silent heart attacks are more common in women, the elderly and diabetics. According to estimates, about one in three infarctions is probably "silent". But the heart suffers permanent damage that weakens it. Because those affected do not feel a heart attack, they also do not take any therapy for their disease and existing risk factors. This increases the risk of another heart attack, which is often very severe.