Heart attack is scaring word used in common population.Very few of us has clear understanding about this.I want to provide clear message to all of my friends so that they can make a proper judgement about the condition.To understand this you need to to know few basic things.
1.Our all body parts need energy which comes from the burning of glucose.In our body glucose is made by the breakdown products of carbohydrates in our diet.
2.To burn the glucose in our body oxygen is essential which enters in our body when we do breathing.
3.So for obtaining energy for our body we need two things glucose as a fuel and oxygen as a burning gas.
4.Apart from this the most important thing is the transport service.Transportation of essential substances to all the parts of our body is done by blood which is pumped by heart (situated in our centre of chest) through elastic pipes to our whole bodyparts.So there are many pipelines to supply blood to the different parts of our body.And the pumping action of heart is essential for us to be alive. Heart starts beating when an individual is of one month age in mother’s womb and it continues beating till the life persists.
So we know till now glucose and oxygen is important things to survive and heart pumping blood is essential to transport those things to the whole bodyparts.Even the heart wall also needs in own blood supply through main three pipes 1.LAD(Left Anterior Descending Artery) 2.RCA (Right Coronary Artery)3.LCX(Left Circumflex Artery) you don’t need to remember these names.You can compare this with a water pump house of a city which pumps water supply to entire city but the pump house people also need water so they have three pipelines for their own pump house.Similarly the heart pumps blood to the whole body through pipelines and it has got three main pipelines for heart itself.
What happens in heart attack
one or more pipeline (Arteries)gets complete or incomplete blockage due to fat deposition as well as blood clot.
Guess what would happen if blood supply of any area of our body is blocked….Less or no oxygen supply.For this that area would have problem in burning glucose and produce energy.Without energy that bodypart start dying.Such death of a part of body is called infarct.Heart muscle is also known as myocardium so the condition is also called myocardial infarction or MI.
Let us write in a nutshell when any of the artery giving blood supply to the heart wall gets partial or complete blockage the heart wall gets deprived of oxygen which is coming along with blood,the heart wall starts getting damaged and the person feels chest pain (Angina),the outcome depends on blockage extent and other factors we would discuss later.To be continued!
So,I have discussed so far about heart attack;to summarize 1.Heart is a pump which keeps blood circulation to all body parts through pipelines(blood vessels).2.Heart’s own walls also need blood supply which is done via three main pipes( LAD,LCX,RCA).3.There may be blockage in any of the three pipes by blood clot or fat or both which leads to partial or complete obstruction of the supply.4.Blood supply is important for oxygen and glucose delivery since heart needs energy to survive and work and energy is produced by burning of glucose as a fuel and oxygen gas.5.If there is obstruction in blood flow there is mismatch of energy requirement and oxygen availability to produce energy.So in such mismatch caused by partial or complete obstruction the person complains chest pain which is called angina by medical terminology.
when we are at rest there is less energy requirement of body and heart pumping rate required to meet the energy need of the body is less,so the heart’s own energy requirement is also less.So many times when the obstruction of pipes supplying heart wall is partial;the angina can be relieved by rest.
Many persons gets confused regarding chest pain and they get apprehensive that they may have heart attack.I am providing you some insights about this to improve your understanding and clear your doubts.
1.If the chest pain increases on brisk walking, climbing ,dancing or any form of exertion and gets relieved by rest.This may be angina or pain originating from heart.
2.If you can locate your pain chest by single finger it is not anginal pain in the most cases and may be relieved by simple analgesics sold over the counter.
3.If chest pain increased or decreased by change of posture , folding and unfolding at shoulder or elbow joint,it is not anginal pain.Such pains can be relieved by muscle relaxants and general analgesics.
4.Angina is generally dull pain and poorly localized chest pain which appears during exertion or it may appear during extreme emotional stress.
5.Chest pain may appear in empty stomach due to distension caused by gas,such pain is also dull and can be relieved by food ,antacids,h2 blocker like ranitidine or proton pump inhibitor like omeprazole(not safe for pregnant women or children).Such pain would be worse,if you use analgesics like NSAIDS(Non Steroidal Anti Inflammatory drugs like disprin,ibuprofen,paracetamol,diclofenac sodium etc.
Note:Person suffering from diabetes may not have anginal pain and they may just feel chest discomfort or shortness of breathe during heart attack.
Risk factors for heart attack:
1.Smoking -Both active and passive smoking increases the risk of heart attack.
Smoking promotes the blood clottings so there is more chance of blockage in pipe supplying blood to the heart wall.
2.If you have truncal obesity you are at increased risk of heart attack.Truncal obesity means your belley is laden with fat.You can pinch your skin fold at the side of your abdomen and the thickness of fold can be can be assessed by your index finger and thumb.
3.If you are heavy alcoholic you are at increased risk.Though many people argues in favor of moderate drinking,but I opine that people seldom go for moderation those who claim to be moderate drinkers too frequently take heavy drinks on occasions.Further drinking also increases the risk for liver cancer ,peptic ulcer,psychosis secondary to vitamin B1 deficiency.
4.If you have uncontrolled diabetes,you are at risk.
5.If your life style is sedentary and you do not do exercise,you are at increased risk.You should do minimum 150 minutes exercise per week.Be careful in exercise.Don’t do heavy exercise at once.You are required to gradually increase the level and duration of exercise and try to maintain your hydration by taking liquids otherwise your exercise may land you in serious trouble.
6.If in your blood,bad cholesterol level is high and/or good cholesterol level is low you are at increased risk.First of all you need to understand good cholesterol and the bad cholesterol.After the dinner at around 9 P.M.do not eat anything except water.Next morning empty stomach go to clinical lab and give your blood sample for Lipid Profile testing.When you get the report, see the parameters tested
-HDL High Density Lipoprotein
-LDL Low density lipo protein
-VLDL Very low density lipoprotein
-Triglyceride additionally you may get IDL Intermediate density lipoprotein
In all those parameters the HDL is good cholesterol for your heart because it cleans your blood pipelines’fat.Rest all are bad for your heart.
Now the question is how we can increase good fat and decrease bad fat in our blood.
All the animal fats are bad except fat from small fish.
Sunflower oil,safflower oil,olive oil and soyabean oil are good fat.
Palm oil and hydrogenated vanaspati are bad for your heart.
One important message I have to give that the mustard oil is also rich in good fat but be careful about this and do not reheat or reuse the mustard oil after one cooking because it is converted on trans fat which is bad for your heart.
You can easily assess your lipid profile yourself by just checking the normal values of the parameter tested and the patient’s actual value.If the patient value in the report is within the given normal range of that parameter then It is O.K.
To be continued….
7.If you have high blood pressure and you have not controlled it with your life style modification or drugs;you are at increased risk of heart attack.High blood pressure in your pipelines causes your heart to work more against increased load,so the energy requirement of your heart increases,so the oxygen requirement is also increased.Apart from this chronic uncontrolled blood pressure also cause enlargement of heart which can not be reversed back if you control your blood pressure after that change.So person with high blood pressure should keep control on that by prescribed medicine or alternative methods.Medicine choice varies from person to person and your doctor would decide which medicine would be suitable to you.Apart from medicine,there are alot of alternative options for controlling blood pressure.Low salt diet is one option.By low salt I mean table salt that is sodium chloride.One should not take more than 5 gram table salt per day.If you are religious person and believe in fasting and fruit and salt free diet,it may be good thing for you to observe such fast to reduce your blood pressure.You may use natural diuretics like tea or coffee which will cause excessive urination and sodium would be reduced from your blood.
8.If you are a Type-A personality,very much ambitious and restless to achieve your hard goal,you are at increased risk of heart attack.You should do meditation and yoga.Further to relax yourself try to write diary to pour out your thoughts on paper which would release your burdens.Try to live your life in present only.Engage yourself with children,pets and optimistic people.
What would you do,if you are sure that the person is having chest pain or discomfort is characteristic of heart attack?
1.Make emergency call for medical assistance on number applicable to your local area.
2.Relieve his emotional stress by giving him assurance that nothing has happened.Since emotional stress would cause his heart to beat faster leading to increased energy and oxygen demand of the heart.And the situation would be worse.
3.Don’t allow the person to walk on his on.The person should be moved to hospital with least effort from his side.Ideally he should be moved on stretcher by other fellows.Any exertion done by the patient would increase the energy and oxygen demand of his heart and would spoil his condition.
4.Person should have fresh air for breathing,if one can avail oxygen cyllinder,it is a good idea to oxygenate the person in the way to hospital.
5.Some coronary dilater-medicine which dilates the pipelines supplying the heart wall like isosorbide dinitrate 5 mg is used below tongue to relieve the anginal pain.
6.Aspirin can be used as first aid measure if you are certain that the person has got heart attack.Since this prevents the clotting of the blood in the pipeline.
warning!the purpose of this article is educational in nature you are advised to act according to your doctors’advice.