Commonly called ‘heart attack‘, l’myocardial infarction turns out to be fatal in nearly 10% of cases.
What is a heart attack?
A heart attack is destruction of part of the myocardium, the muscle of the heart. This occurs when a coronary artery clogged and that, as a result, the heart muscle is not properly supplied with blood and oxygen. This lack of oxygenation will cause necrosis of cells and tissues and hinder the contraction of the myocardium. Then, the heart rhythm becomes disturbed – we speak of arrhythmia -, then, if nothing is done, the heart stops beating. To avoid dramatic consequences, a heart attack must be taken care of at the first signs. Complications of infarction vary depending on the extent of the necrotic myocardial area.
Identify a heart attackit is essential to limit the impact on our cardiovascular health and avoid (very) serious consequences. Symptoms of a myocardial infarction are:
- Sharp and continuous pain in the chest
- Diffusion of pain in the left arm, then in the neck, back, jaw
- Difficulty breathing, shortness of breath, sweating
- Nausea and dizziness in some cases
If you have these symptoms or if you observe them in someone else, you call the emergency services (15) as soon as possible and you try to detail the symptoms to your interlocutor. Sometimes the heart attack victim does not experience any symptoms, this is called a silent heart attack. What is a silent heart attack? If one can identify the symptoms of a heart attack, sometimes one can experience a silent heart attack, so called because it is not painful and does not cause any symptoms. In fact, this type of infarction is generally not diagnosed and we become aware of it after the fact, during a consultation with the cardiologist who will be interested in our cardiac liabilities.
What are the causes of heart attack?
At the origin of the infarction? A clogged artery … due to the formation of atheroma plaques – composed mainly of cholesterol – on its walls, which causes the narrowing of the diameter of the artery; therefore, if the atherosclerotic plaque ruptures and forms a clot, it can block the artery and cause myocardial infarction. The identified risk factors are as follows:
- smoking
- hypercholesterolemia
- diabetes
- obesity
- l’hypertension
- the stress
- physical inactivity
Age, sex and heredity can also play a role.
In some cases, myocardial infarction may follow some kind of coronary spasm causing imperfect myocardial irrigation and infarction. In the majority of cases, coronary spasm is motivated by factors such as tobacco and cocaine, but factors of drug or pharmacological origin can also (and more rarely) be involved.
The infarction can also follow a tear in the artery of the heart or occur in the event of too weak blood flow.
Myocardial infarction, who is concerned?
We count on average 80,000 myocardial infarctions per year in France. About 10% of victims die within an hour and the one-year mortality rate is 15%. Age is an aggravating factor: the risk of having a myocardial infarction increases with age (higher risk from the age of 55). In addition, the infarction concerns more the men since the women have 4 x less risk to make a infarction than the men until the menopause. At menopause, the risk of suffering from a heart attack becomes as important in women as in men.
The genetic factor must also be taken into account: having a family history increases the risk of cardiovascular disease.
Can a heart attack be treated?
Thanks to therapeutic progress, the speed of intervention of the Samu (provided you call it quickly) and the increased availability of interventional cardiology units operational 24/7, the 30-day mortality rate has however fell from 10.2% in 1995 to 2.1% in 2015*.
When a person is the victim of a myocardial infarction, they must be quickly taken care of by the emergency services. As soon as emergency services are taken care of, first aid will be provided before hospitalization. The medical team will try to unclog the artery via angioplasty. During this procedure, a balloon is introduced into the artery and will inflate and deflate in order to dilate the walls of the artery. Once blood circulation has been restored, the medical team will place a stent to keep the artery dilated. When the patient is not taken care of quickly enough or if there are complications, a thrombolytic agent – which facilitates the dissolution of the clot – can be administered.
But the best is still to prevent rather than cure. In the case of a heart attack, it is advisable to adopt a healthy lifestyle, a healthy diet and regular physical activity. It is also necessary to limit risk factors such as tobacco, alcohol, overweight, hypercholesterolemia (‘bad’ cholesterol too high)…
For people who have already had a heart attack, we will try to prevent recurrence via a treatment called BASIC for Beta-blocker, Antiplatelet agents, Statins (against cholesterol), Inhibitors of the converting enzyme and Control of risk factors (smoking, overweight, physical rehabilitation).
What is the difference between a stroke and a heart attack?
Between stroke and heart attack, it is sometimes difficult to distinguish between things. The difference ? With the infarction, it is question of the myocardium… while for stroke it’s an artery in the brain that gets clogged. Moreover, we also speak of cerebral infarction when it comes to stroke.
*For more information, you can refer to the inserm file on the subject: “Myocardial infarction, when the heart is deprived of oxygen“.