How to Survive a Heart Attack

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There are two very good reasons why you should know how to survive a heart attack, also known as a myocardial infarction (MI). First, the odds are very high that you or someone you love will have a heart attack during your lifetime. And second, whether you survive that heart attack may depend on what you and your healthcare providers do about it in the first few hours.

A heart attack occurs when there is a blockage or severe reduction in blood flow to part of the heart. This is a life-threatening medical emergency, and the longer it goes untreated, the more damage is done to the heart.

Studies have found that the survival rate of people hospitalized for a heart attack is around 90%. to 97%. This varies based on the type of heart attack, the arteries involved, and additional factors such as age and gender.

Verywell / Brianna Gilmartin

About heart attack

Heart attack is the most severe form of acute coronary syndrome (ACS). This is a term for a medical emergency involving the arteries of the heart.

Like all forms of ACS, a heart attack is usually triggered by the rupture of atherosclerotic plaque in the coronary arteries (the arteries that supply oxygen to the heart muscle). Rupture of this plaque causes a blood clot to form, leading to an artery blockage. The heart muscle supplied by the blocked artery then begins to die.

A heart attack is diagnosed when part of the heart muscle dies.

Types of heart attacks

Most heart attacks are caused by blockage of a coronary artery, but in rare cases they can be caused by a sudden spasm or tear of an artery.

The two main types of heart attack are:

  • ST-elevation myocardial infarction (STEMI) is when there is a complete blockage in a coronary artery. This is the most serious type of heart attack.
  • Non-ST-elevation myocardial infarction (NSTEMI) is when an artery becomes partially blocked and severely reduces blood flow to the heart. NSTEMI is slightly more common than STEMI.

Other types of heart attack, less common than STEMI or NSTEMI, are:

  • Coronary artery spasm is when an artery is severely constricted or constricted. This narrows the artery and reduces blood flow to part of the heart muscle.
  • Coronary artery dissection is a rare type of myocardial infarction in which there is a spontaneous tear of the coronary artery wall.

Survival depends on which arteries are affected. Obstruction in the left anterior descending artery (LAD), a branch of the left coronary artery, carries the highest risk of death.

Widow heart attack is also associated with an increased risk of heart failure and stroke, but it is less common than right coronary artery (RCA) occlusion.

One study found that the unadjusted mortality rate for STEMI of LAD was 7.1%, compared with 5.4% for the other branch of the left coronary artery (left coronary artery, LCx) and 4.8. % for right coronary artery.

There may also be significant differences in outcomes between men and women. Research has found that among those hospitalized for a first heart attack, women have higher mortality rates than men for both STEMI (9.4% vs 4.5%) and NSTEMI ( 4.7% versus 2.9%). However, the gap was not pronounced for NSTEMI when additional factors were taken into account.

The study also found that women who have had a severe heart attack (STEMI) have a 20% increased risk of dying or developing heart failure within 5 years compared with men.

Consequences and Dangers

To a large extent, the outcome of a heart attack depends on the degree of death of the heart muscle. This is largely determined by which coronary artery is blocked, where the blockage occurs in the artery, and how much time passes before the artery can be reopened.

Obstruction near the origin of the artery affects the myocardium more than the obstruction distal to the artery. An obstruction that persists for five or six hours will cause substantially more myocardial death than an obstruction that is rapidly restored.

If the extent of heart damage is severe, acute heart failure can occur along with myocardial infarction, a dangerous combination. Even if the extent of the damage is small to moderate, heart failure is still more likely to occur later in life because of the damage the heart muscle suffers.

A heart attack can also create dangerous heart rhythm problems called arrhythmias, including tachycardia (tachycardia) and fibrillation (abnormally fast heartbeat). After a heart attack, scarred heart tissue can lead to permanent electrical instability and recurrent arrhythmias.

Cardiac arrest and sudden death are risks both during an acute heart attack and to a lesser extent after recovery.

According to the Centers for Disease Control and Prevention, about 805,000 Americans have a heart attack each year. Of these, 605,000 were the first cases of myocardial infarction.

Why are the first hours important?

For anyone who has had a heart attack, getting medical attention quickly is absolutely crucial. Both the short- and long-term consequences of a heart attack are largely determined by the degree of death of the heart muscle. With aggressive and prompt medical treatment, a blocked artery can often be opened quickly, thus preserving most of the heart muscle.

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If treatment is given within three or four hours, most permanent muscle damage can be avoided. But if treatment is delayed more than 5 or 6 hours, the amount of heart muscle that can be saved is significantly reduced. After about 12 hours, the damage is usually irreversible.

Cardiac arrest can occur in the first few hours after a heart attack or during recovery. If a cardiac arrest occurs in the hospital, it will most likely be treated. Unfortunately, the risk of sudden cardiac arrest is increased after a heart attack, especially during the first year.

Know the signs

Getting prompt and appropriate medical attention requires you to recognize the signs of a heart attack and seek medical help as soon as you think you may be having a heart attack.

While chest pain, especially in the center or left side of the chest, is a classic symptom of a heart attack, other types of symptoms can occur in addition to (or instead of) chest discomfort.

Symptoms of a heart attack include:

  • Pain or discomfort in the chest
  • Pain or discomfort in the arms (one or both), shoulders, back, neck, jaw, or stomach
  • Feeling weak, light-headed, or fainting
  • Cold sweat
  • Shortness of breath
  • Nausea or vomiting
  • Unusual or explained fatigue

Chest pain or discomfort is the most common symptom in both men and women. It may feel uncomfortable, tight, full, or painful that lasts more than a few minutes or may go away and come back.

However, women are more likely to experience some other symptoms than men. The first symptoms in women may be shortness of breath, nausea or vomiting, and back or jaw pain.

Anyone with risk factors for coronary heart disease should be on the lookout for these symptoms. Even so, sometimes symptoms can be more uncertain or less obvious, and people won’t act right away because the signs aren’t as “severe” as they think they are.

Silent heart attacks

According to the Centers for Disease Control and Prevention, one in five heart attacks is “silent” and will have very few symptoms, if any. Even if the underlying obstruction is less profound, the risk of death may be higher simply because of delayed treatment.

Silent heart attacks can cause subtle symptoms such as:

  • Tiredness is inexplicable
  • Shortness of breath
  • Discomfort in throat, neck, jaw or arms
  • Chest pain can be mistaken for heartburn

What to do if you notice a heart attack

If you think it’s possible that you or someone else is having a heart attack, you should get medical help as quickly as possible. Even if it turns out to be something else, it’s better to act quickly than risk your life.

If you recognize the signs of a heart attack, call 9-1-1 right away. The earlier treatment begins, the better the chance that you can minimize damage to your heart.

People with symptoms should not drive. Always have someone else drive you to the hospital if you cannot be taken by an ambulance.

If the person is unconscious, you can start cardiopulmonary resuscitation (CPR) while you wait for emergency medical services (EMS). If you are in a public place, ask if there is an AED (automatic external defibrillator) on the site. An AED is a portable device that can check someone’s heart rate and, if necessary, deliver an electric shock to help someone in cardiac arrest.

What can you do now

There are lifestyle changes you can make to reduce your risk of having a heart attack and increase your odds of surviving a heart attack.

According to the CDC, 47% of Americans have at least one of the three main risk factors for heart disease: high blood pressure, high cholesterol, and smoking.

Check your blood pressure and cholesterol regularly. If this number is high, you can lower it with diet and physical activity, or your healthcare provider can recommend medications to help reduce your risk of heart attack and stroke. stroke.

In addition, these lifestyle changes can help:

  • Stop smoking.
  • Eat a diet rich in vegetables, fruits, and whole grains.
  • Limit sweets, sugary drinks and red meats.
  • Physical activity every day.
  • Limit alcohol.

frequently asked Questions

How long does a heart attack last?

Symptoms of a heart attack can last from minutes to hours, and the extent of heart damage depends on how quickly treatment is received.

How do you prevent a heart attack?

You cannot stop a heart attack while it is happening. Medications and surgical procedures help restore blood flow to the heart.

Can coughing help you survive a heart attack?

According to the American Heart Association, this usually isn’t helpful. In a hospital setting, a nurse or other healthcare provider can instruct someone to cough forcefully and repeatedly during the first seconds of sudden heart rhythm problems. This is to try to maintain blood flow to the brain for a few seconds. Outside of the hospital, coughing really isn’t helpful, and “cough artificial respiration” is a myth.

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