Understanding Arterial Plaque

Definition

A heart attack occurs when blood flow to the heart muscle is interrupted. Oxygen can't get to the heart muscle, causing tissue damage or tissue death.

Heart Attack

© 2009 Nucleus Medical Media, Inc.

Causes

A heart attack may be caused by:

• Thickening of the walls of the arteries feeding the heart muscle (coronary arteries)
• Accumulation of fatty plaques in the coronary arteries
• Narrowing of the coronary arteries
• Spasm of the coronary arteries
• Development of a blood clot in the coronary arteries

Risk Factors

These factors increase your chance of developing heart attack. Tell your doctor if you have any of these:

• Sex: male
• Increased age
• Obesity
• Smoking
• High blood pressure
• Sedentary lifestyle
• High blood cholesterol (specifically, high LDL cholesterol, and low HDL cholesterol)
• High blood triglycerides
• Diabetes
• Stress
• Family members with heart disease

Symptoms

Symptoms include:

• Squeezing, heavy chest pain, especially with:
  • Exercise or exertion
  • Emotional stress
  • Cold weather
  • A large meal
• Pain in the left shoulder, left arm, or jaw
• Shortness of breath
• Sweating, clammy skin
• Nausea
• Weakness
• Loss of consciousness
• Anxiety , especially feeling a sense of doom or panic without apparent reason

Unusual symptoms of heart attack (may occur more frequently in women):

• Stomach pain
• Back and shoulder pain
• Confusion
• Fainting

Diagnosis

If you think you are having a heart attack, call 911 right away.

Tests may include:

• Blood tests—to look for certain enzymes found in the blood within hours or days after a heart attack
• Urine tests—to look for certain substances found in the urine within hours or days after a heart attack
• Electrocardiogram (EKG) —records the heart's activity by measuring electrical currents through the heart muscle, changes can show if there is blockage or damage
• Echocardiogram —uses high-frequency sound waves (ultrasound) to examine the size, shape, function, and motion of the heart
• Stress test —records the heart's electrical activity under increased physical stress, usually done days or weeks after the heart attack
• Nuclear scanning—uses radioactive material to show areas of the heart muscle where there is diminished blood flow
• Electron-beam computed tomography (EBCT) —a type of x-ray that uses a computer to make detailed pictures of the heart, coronary arteries, and surrounding structures; may be helpful if you are at immediate risk of coronary artery disease
• Coronary angiography —uses dye and x-rays to look for narrowing or blockage in the coronary arteries

Treatment

Treatment includes:

• Oxygen
• Pain-relief medications (such as morphine)
• Nitrate medications
• Aspirin and other antiplatelet agents
• Beta-blocking and/or ACE inhibitor medications (frequently given)
• Anti-anxiety medications
• Clot-dissolving agents (thrombolytics)—Within the first six hours after a heart attack, you may be given medications to break up blood clots in the coronary arteries.
  • Other medicines that may be given include those that block the function of platelets (called platelet IIb/IIIa receptor blockers).
• Cholesterol-lowering medications (eg, statin drugs)

Prevention

Preventing or treating coronary artery disease may help prevent a heart attack.

• Maintain a healthy weight .
• Begin a safe exercise program . Follow your doctor's advice.
• If you smoke, quit .
• Eat a healthful diet . Your diet should be low in saturated fat and rich in whole grains, fruits, and vegetables.
• Treat high blood pressure , diabetes and high cholestrol .
• Manage stress .
• Ask your doctor about taking a small, daily dose of aspirin.
  • Although most people are able to tolerate such a low dose of aspirin, even this small amount can rarely lead to serious bleeding, particuarly from the gastrointestinal (GI) tract .
  • Aspirin may not work as well when combined with other pain medications.