What is a Heart Attack?

Heart attacks are the most common cause of death in industrialised countries - and usually outside a hospital. Fortunately, the symptoms and treatments are known today. If emergency treatment can be delivered quickly, the chance of survival is increased.

What is a Heart Attack and What Happens During a Heart Attack?

Various factors (see below on causes and risk factors) can cause fats to build up in our blood vessels, narrowing them. Blood supply is essential for the survival of all cells, whether they are muscle cells, brain cells or cells in the heart. Blood delivers important nutrients, hormones and oxygen and removes waste products and CO2. 

A heart attack occurs when fatty deposits (LDL cholesterol) and fibrous plaque hardened with calcium suddenly rupture at a narrowed spot in an artery. A blood clot can form that can completely occlude an artery. This interrupts the vital blood flow to the tissue, which immediately begins to die. Depending on the artery affected, this can cause a heart attack or stroke. If tissue in the heart is affected, the dead cells no longer transmit the electrical impulse that moves the heart muscle. Catastrophic cardiac arrhythmias such as sinus tachycardia, atrial fibrillation or ventricular fibrillation occur and can lead to death.

In this case, every minute is critical: If the relatives immediately initiate emergency treatment in the event of a heart attack, this increases the chances of survival (70-80%). Without medical help, experience shows that the chances are around 40%. In the ambulance, the rescue team begins to monitor the heart rhythm and sends the ECG to the alert team at the hospital. With the emergency intervention there within 60 to 120 minutes, e.g. a balloon dilatation via arterial catheter, the damage to the heart is limited. After a few days, the affected person recovers. With consistent lifestyle changes and treatment of any secondary diseases, an almost normal life span can then be expected.

How Does a Heart Attack Announce Itself? - Symptoms and Signs

In healthy people, signs may appear a long time before or shortly before, e.g.:

• sensations of a heart
• stabbing pain that cannot be localised
• fear of death
• sweating
• Weakness and pale complexion
• irregular pulse
• Pain radiating to upper abdomen
• Pain radiating to extremities
• Pain radiating to shoulders and jaws
• shortness of breath

These should be taken more seriously if they occur more frequently, for longer periods (e.g. 15 minutes) and at rest and, if you are already receiving cardiological treatment, cannot be alleviated with a nitroglycerine spray.

In diabetics, women and elderly persons, shortness of breath, unexplained nausea, feelings of pressure in the upper torso and vomiting may also occur as warning signs.

What to Do in Case of a Heart Attack?

1. Alert the emergency number 144 (Switzerland), 122 (Austria), 112 (Germany).
2. Give address (location), name and age of the person affected 
3. Position the affected person on a bed, sofa or on the floor with the upper body raised (with pillows and blankets under the head, neck and back) 
4. Open tight clothes, tie or brassiere 
5. Light the flat, staircase and front door at night. 
6. Ask a neighbour to call in the ambulance while you stay with the patient and reassure the person.
   
   

Risk Factors and Causes of a Heart Attack

There are factors that make a heart attack more likely. The good news is that many of these factors are in our own hands. They are often interdependent and are also classic risk factors for other heart diseases.

• unhealthy diet
• lack of exercise 
• overweight
• elevated cholesterol levels
• diabetes
• arteriosclerosis
• excessive consumption of nicotine, alcohol
• stress
• high blood pressure
• hereditary predisposition
• injuries during surgery
• Hyperthyroidism
• Deficiency of red blood cells

A regular heart check is a good prevention and early detection of a cardiological problem!

Therapy of a Heart Attack

Schematic representation of a catheter and stent in blood vessel with stenosis

Therapy begins at the emergency admission. The affected person is given pain-relieving medication and he or she is supported with oxygen via a nasal tube. The heart rhythm, heart rate, oxygen saturation and blood pressure are monitored. A defibrillator is available. Various medications are administered to help defuse the situation at hand, which can vary greatly. 

Between the 90th and 120th minute, the occluded blood vessel should be reopened. This must first be localised with a coronary angiography (also called left catheter). A heart catheter specialist inserts a thin tube through a hand or groin artery to the heart. This person applies a contrast medium that makes the narrowed area (stenosis) visible in an X-ray.

In the same operation, the heart vessel is widened by inflating a small balloon (coronary angioplasty). To prevent a new life-threatening narrowing, a mesh tube made of drug-coated precious metal (stent) is inserted and stretched open.

Alternatively, if the local hospital does not have the appropriate equipment, an attempt can be made to dissolve the narrowing or blood clot with medication and later refer the patient for coronary angioplasty elsewhere.

The patient is then monitored in the intensive care unit for 2-3 days and mobilised under gymnastic guidance. After 7-14 days, if the course is uncomplicated, the patient is discharged and given exercise therapy, the start of health training (nutrition and behaviour) and psychological support.

How Long Can You Live after a Heart Attack? - Life Expectancy

As we have seen, 40% of those affected do not survive the first 48 hours. Experiencing a heart attack is a drastic experience, and some struggle with depression as a result. If heart muscles are dead and later scarred, permanent heart failure can result, as well as further ventricular fibrillation or atrial fibrillation. The prognosis and life expectancy depend crucially on adjusting one's own consumption and exercise behaviour.

Below you will find an overview, recommendations and further reading on the topic of heart attacks. Regular cardiological heart checks are worthwhile as a preventive measure. We are pleased to be at your disposal at the Heart Centre in Zurich.