Heart Attack

December 11, 2012

Article by: Dr Billy M. Tsima 

The words ‘heart attack’ always  instil fear. It signify a medical emergency and a scare for dear life. In many Western countries, heart attacks claim the lives of thousands of people every year and are the commonest cause of death in those countries. In Botswana, heart attacks are overtaken by other diseases and conditions such as HIV/AIDS and road traffic accidents, as leading causes of death.

 Although the problem does not seem so big in this country, it is still a problem that needs to be recognised. There is still a lot of misconception about heart attacks despite continued efforts to educate people about this disease.

 A lot of people believe that heart attack is a disease of the developed countries and does not pose any real threat for those in developing countries like Botswana. However, the World Health Organisation (WHO) estimated that of all the deaths caused by diseases such as heart attack and stroke in 2008, four out of five of these deaths occurred in the developing world. These figures are frightening and should be a cause of concern for us in the developing world.

 What is a heart attack?

A heart attack is a sudden damage to the heart muscle. It occurs when blood supply to the heart through the small blood vessels surrounding the heart suddenly and rather abruptly become blocked. When this happens, little or no blood reaches some parts of the heart muscle. As a result of lack of blood supply, the heart muscle gets damaged and begins to die. This is associated with pain felt on the chest. This mechanism is similar to what happens when someone has a stroke where blood supply of the brain is disturbed by either a clot or a bleeding blood vessel.

 What causes a heart attack?

A heart attack is a result of diseases of the blood vessels that supply the heart with nutrients and oxygen. These very important blood vessels are affected by the food we eat and our lifestyles also contribute to the health of the blood vessels. Fat from fatty food becomes deposited inside these blood vessels and cause them to become narrow and hardened. A rupture or cut in the attached fat deposits causes blood clots to form within the walls of the blood vessels. By forming these clots, the size of the blood vessel is reduced and less and less blood is able to pass through. When this occurs suddenly, a heart attack takes place.

 What are the risk factors for heart attacks?

The risk factors for heart attack are many. Most of these risk factors are things we can control. It is thought that more than 80% of the risk factors for heart attack are behavioural. Unhealthy diets including food rich in cholesterol and other fats are generally bad for your health. Lack of exercise is also responsible for developing heart attacks. The benefit of regular exercise is not only on maintaining an ideal body weight but also for the health of your heart. Thirty minutes of moderately intensive exercise such as walking up to five times a week is all that is needed to reap the benefits of physical activity. The use of tobacco from smoking and alcohol also puts you at risk for developing heart attacks. Illegal drugs like cocaine are also known to cause death by heart attack. Other diseases like diabetes and high blood pressure eventually lead to increased risk for having a heart attack. The risk for heart attacks increases with age and men appear to be at greater risk than women. Family history also has an impact.

 What are the symptoms of heart attack?

The main symptom is chest pain. The pain is usually severe, crushing and felt in the centre of the chest. The pain may appear to travel to the back, the neck, the jaw and the left arm. Other people describe the pain as a discomfort rather than pain per se, as if something is sitting on ones chest. Sometimes there is a feeling of nausea as though you are about to vomit. There may also be breathing difficulties and abnormal sweating. In the worst case scenario, there is sudden collapse and death.

 What should I do if I experience these symptoms?

A heart attack is a medical emergency and so medical attention should be sought as soon as possible if one experiences symptoms suggestive of a heart attack. It is imported to go to the nearest hospital or call ambulance emergency number as soon as possible. Chest pain does not always mean that you are having a heart attack. There are many other causes of chest pain that mimic a heart attack. However, if the chest pain or discomfort lasts for more than ten minutes you should assume that it signifies a heart attack and therefore call for help. If you are not allergic to Aspirin and you have it available, you should chew or sallow one tablet while waiting for the ambulance. You should never wait for the next day to seek help if you suspect that your heart could be in trouble.

 Is it possible to have a heart attack and not realise it?

It is possible to have a “silent” heart attack. About 20% of people who have heart attacks are not aware that they are having one as they experience no pain at all. This group of people include those who have diabetes. The damage to the heart may only be picked up from blood tests or a heart tracing called the ECG.

 Are there any tests to diagnose heart attacks?

Usually several tests are done to find out if a heart attack has occurred. These need to be repeated over time. The test may be negative immediately after a heart attack but may become positive as time passes by. The damaged heart muscle releases certain enzymes in to the blood and it is the presence and quantity of these enzymes that suggest that indeed a heart attack has occurred. A heart tracing (ECG) will show characteristic changes if a heart attack has occurred.

 How can heart attacks be prevented?

 Prevention is always better than cure. Prevention is often simple and straight forward but also requires discipline and motivation. It is recommended that heart attacks should be prevented by taking part in regular physical activity (exercises) avoiding tobacco as well as second-hand tobacco smoke(non smokers get exposed to tobacco smoke by being in a smoking environment,) eating a diet rich in fruits and vegetables. In addition foods high in fat, sugar and salt should be avoided as much as possible. As our nation strives to be a healthier one by the year 2016, let us all seriously consider exercising and healthy eating habits as part of the map to 2016. We can overcome a lot of health risks like heart attacks by choosing healthier lifestyles.