Heart attacks are more common in the morning and are also the most dangerous at this time of day, according to a study by Spanish specialists published in the latest issue of the British magazine Heart.
Dr Borja Ibanez from the National Center for Cardiovascular Diseases in Madrid warns that heart attacks that occur from 6 a.m. to 12 noon are particularly dangerous. At this time, they are the most extensive – they account for 21 percent. more damage to the heart muscle than between XNUMX p.m. and XNUMX p.m.
This is indicated by the studies conducted by Spanish cardiologists in a group of 811 patients with myocardial infarction (with the so-called elevated ST segment on the ECG). The extent of the infarction was evidenced by the increased levels of troponin and creatine kinase – enzymes informing about the severity of cardiac necrosis caused by heart ischemia.
A heart attack is caused by plaque rupturing in the arteries of the heart, which significantly restricts or completely blocks the blood supply to a fragment of the heart muscle. The wider the vessel is, the larger the area of damage to the heart can be. But the latest research shows that it also depends on the time of day. It is not known yet what the reason is. Dr. Ibanez suspects that in the morning the body produces substances which promote heart attacks and increase damage to the heart muscle. One of them may be cortisol, the so-called stress hormone. However, these are only speculations, not yet supported by any research.
Out of 811 heart attacks, three-quarters were men aged 62 on average. 269 of them had a heart attack between 6.00 a.m. and 12.00 p.m. The second largest group (240 patients) were those who had a heart attack in the afternoon. 161 people suffered a heart attack in the evening (between 18.00 and 24.00). The smallest number of respondents had a heart attack at night – between 24.00 and 6.00. People with ischemia of the back wall of the heart muscle had the greatest damage to the heart.
Dr. Ibanez believes that people who experience a heart attack in the morning require more invasive treatment, mainly using angiolplasty (called heart ballooning) to unblock a clogged artery. However, no matter at what time the heart attack occurs, it is crucial to call an ambulance as soon as possible. The first three hours after the myocardial ischemia are decisive are decisive.
Therefore, do not hesitate to call for help as soon as any symptoms suggesting a heart attack appear. This can be a severe, pressing or distressing pain in the chest that lasts at least 20-30 minutes and is not related to exercise. It is particularly disturbing when it covers a large part of the chest and does not go away with painkillers or under the tongue (nitroglycerin, sorbonite). Pain may radiate to the neck, jaw, arms and hands (more often to the left hand), less often it is accompanied by nausea, abdominal pain, vomiting and increased sweating. Often there is also strong anxiety.
According to prof. Waldemar Banasiak, president of the Polish Cardiac Society, 140 people are registered in Poland every year. cases of the so-called acute coronary syndrome, which is a heart attack or condition that is at risk of having a heart attack. 50 thousand of these cases are ST-elevation myocardial infarctions. The ascertainment of this segment elevation in the ECG record and typical ailments require immediate transfer of the patient to the hemodynamic laboratory, where we are able to quickly open the closed coronary artery – said Prof. Banasiak.
According to the president of PTK, 90 thousand. patients are patients who experience a myocardial infarction without ST segment elevation. There are also a good number of people in this group who also need to be treated quickly. But for some of them, the procedure can be postponed for a few or several hours. The rest can be successfully treated pharmacologically.
Zbigniew Wojtasiński