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A myocardial infarction (more commonly referred to as a “heart attack” in the foreign literature) is a medical emergency in which blood flow to the heart suddenly decreases or stops abruptly, causing the muscle to die from lack of oxygen.
Every year more than 1 million people in Russia suffer from a heart attack, and for many of them this is the first symptom of coronary heart disease. A heart attack can be severe enough to cause death, but it can also be asymptomatic. Nearly 5 in XNUMX people have only mild or no signs of a heart attack, and a heart attack is sometimes detected only by a routine electrocardiogram taken some time later.
What is a heart attack?
Often a heart attack is confused with sudden cardiac arrest. But it is important to understand that myocardial infarction is a violation of blood flow in a part of the heart, leading to the formation of necrosis (death) of a part of the muscle, where a scar is later formed.
A heart attack is not always fatal. However, it increases the risk of sudden cardiac arrest, as the heart is unable to pump properly, contracting worse, resulting in reduced or no blood flow to the rest of the body, causing unconsciousness, pulselessness, and (if the heart cannot work) death. .
Heart disease is one of the leading causes of death for men.
But thanks to a host of new life-saving strategies, heart attacks aren’t necessarily fatal—sometimes they don’t even make life very difficult if treated early. But it is important to know the signs of a heart attack in order to get help as soon as possible.
Signs of a heart attack in men
Symptoms can vary from man to man, and even first and second heart attacks are often very different in the same person. Some of the signs come on suddenly, while others come and go. However, in men there are some common signs of different localization.
Chest pain. This is the most common symptom of a heart attack in both men and women. Most often, it starts slowly, with mild pain or discomfort. The sudden onset of severe symptoms is sometimes referred to as a “Hollywood heart attack” due to the way such heart attacks are commonly portrayed in films and television. Such a heart attack is also possible, but it does not happen often.
Discomfort or pressure in the chest. The pain can be severe, but it doesn’t have to be. This may be a feeling of “fullness in the chest”, constriction or pressure. The sensation can even be mistaken for heartburn. Discomfort often occurs in the left or central part of the chest. The sensation may last for several minutes, may come and go.
Pain in other parts of the body. Pain or discomfort sometimes shows up in other areas because the tissues don’t get enough blood. This is usually the area of the body above the waist, including the upper abdomen, shoulders, one arm (usually the left) or both, the back, neck or jaw, and even the teeth.
Dyspnea. It can occur with or without chest pain and is sometimes the only symptom. It can occur during activity or at rest. Shortness of breath may be accompanied by coughing and wheezing.
Feeling tired for no reason. Another common symptom. In addition, there may be anxiety.
Other symptoms. Some people say they feel dizzy or feel dizzy. Another possible sign of a heart attack is cold sweat. Nausea and vomiting can also be caused by a heart attack, but these symptoms are rare in men and more common in women.
The more symptoms appear at the same time, the more likely it is a heart attack. But keep in mind that you may not have symptoms at all. These conditions are called silent heart attacks and are more common in the elderly and in men with diabetes.
Causes of a heart attack in men
Myocardial infarction is usually caused by a blood clot blocking an artery in the heart (coronary artery). The artery is often already narrowed due to fatty deposits on its walls (atherosclerosis). These deposits can crumble or rupture, reducing blood flow and releasing substances that make blood platelets sticky and more likely to form clots.
Sometimes a clot forms inside the heart itself, which then breaks off and lodges in an artery that feeds the heart. A spasm in one of these arteries can cause blood flow to stop.
Treatment of a heart attack in men
Because a heart attack can be life-threatening, men over 35 and women over 50 with chest pain should be evaluated to determine if they have signs of a heart attack or other heart conditions (such as angina pectoris).
However, such pain can be caused by pneumonia, a blood clot in the lung (pulmonary embolism), pericarditis, broken ribs, spasm of the esophagus, indigestion, or chest muscle tenderness after injury or exercise.
Diagnostics
A heart attack can be confirmed within hours of its occurrence. Diagnosis is made using electrocardiography (ECG) and blood tests to measure serum levels of markers. The presence of these markers indicates damage or death of the heart muscle. These markers are usually found in the heart muscle, but they are released into the blood when the heart is damaged.
An echocardiogram (ultrasound of the heart) may be done if the above tests do not provide enough information. In more rare cases, arteriography, radionuclide testing, or MRI is used.
Modern treatments
Half of the deaths from a heart attack in men occur in the first 3 to 4 hours after the onset of symptoms. Therefore, if you suspect a heart attack, it is important to seek emergency medical help as soon as possible. The sooner a heart attack is treated, the greater the chance of a favorable outcome.
While waiting for an ambulance, you can chew an aspirin tablet – it will help reduce the size of the blood clot. The emergency room doctors will likely administer a beta-blocker, which will slow the heart rate so that the heart isn’t overworking. Often, a person with a heart attack is given oxygen, which also helps reduce damage to heart tissue.
Patients with a heart attack are taken to a cardiac intensive care unit, where their heart rate, blood pressure, and oxygen levels are closely monitored so that damage to the heart can be assessed.
Intravenous drugs may be used to dissolve blood clots in the artery. But they are effective no later than 6 hours after the first symptoms of a heart attack. In the future, most of the damage is irreversible. However, not everyone can inject such drugs – people with bleeding or high blood pressure, as well as those who have recently had surgery or a stroke, they are contraindicated.
Instead of drug therapy, an emergency angioplasty may be performed to clear the arteries, in which case a stent is inserted through a vein in the arm or thigh and placed over the blockage. This is the most modern technique and I use it more often. If the blockage is extensive, coronary artery bypass surgery may be required.
Prevention of heart attack in men at home
The chances of surviving a heart attack can increase if a person recognizes the symptoms early and seeks medical help immediately. However, every tenth person who has a heart attack dies within a year – usually in the first 3 or 4 months. Typically, these people continue to experience chest pain, abnormal heart rhythms, or heart failure. After a heart attack, your doctor may order additional tests or treatments, including:
- wearing a Holter monitor for continuous monitoring of the electrical activity of the heart;
- exercise test;
- drug therapy, including daily aspirin, beta-blockers, or ACE inhibitors;
- ischemic angiography;
- angioplasty;
- bypass surgery;
- lower cholesterol.
Lifestyle changes can help prevent a second heart attack, as well as recover from a heart attack:
- quit smoking and avoid secondhand smoke;
- control high blood pressure and high blood cholesterol;
- Get regular medical check-ups and take your medicines as prescribed.
- regularly do individually selected physical exercises, especially for heart disease;
- maintain a healthy weight;
- follow a diet;
- control diabetes;
- avoid stress;
- Avoid drinking alcohol or drink in moderation.
Popular questions and answers
Answered questions about heart attacks in men Cardiologist Natalya Gavrilyuk.