Heart Attack is a lay man's term for a medical condition in which the blood supply to the heart is compromised due to which the heart is not able to pump blood.
2. Why is Heart so important ?
Heart along with the Brain is an organ which does not rest throughout life. The heart first starts beating in the first few weeks of life in the mother's womb. It only stops when the person dies. The reason that stoppage of the heart is not tolerated is because the brain cannot do without fresh oxygen carrying blood even for a second. In case the brain does not get blood supply for more than 4 mins it dies for ever resulting in the person's death.
Diabetes and Hypertension (blood pressure)
is one of the major caused of death in the modern world.
3. Is heart attack preventable ? If detected early heart attack is preventable ?
4. What exactly happens in heart attack ? Like other organs, even the heart gets its blood supply from arteries (Coronary artery). Narrowing of this artery or its branches due to a process of atherosclerosis (cholesterol plaque) restricts or totally blocks supply resulting in a heart attack ?
5. When the heart is full of blood why does it require coronary artery ?
The blood in the chambers of the heart can provide oxygen to very thin lining of the heart chamber. The rest of the heart muscle requires blood supply through the coronary artery.
6. Can the heart rebuild/regenerate after a heart attack ?
Unfortunately the heart muscle do not have the capability of cell division. So once they die they are dead for ever.
7. What is different about the coronary blood circulation ?
Coronary arteries have virtually no collateral. Only one branch of the artery will supply one part of the heart. In case of a block that part of the heart muscle will die.
8. What are the warning signs of heart attack ?
For a organ as important as the heart the warning signs are not enough. The complaints are not the same for all and also vary in their severity. To name a few :
Chest pain radiating to the arm
Chest pain on exercise like climbing of stairs or running.
Mild discomfort in the chest
Chest pain aggravated by exercise and relieved by rest.
9. What to do if there are warning signs ?
Following tests help in diagnosis
10. What is troponin ?
Troponin is a protein present in the cardiac muscle. Measurement of troponin level in the blood is being done since last several years. High levels are used to diagnose heart attack along with ECG and symptoms.
11. What is High sensitive Troponin (HsTroponin) ?
The older methods had a detection limit of 1 ng/ml. the new high sensitive methods are 1000 times more sensitive and can measure upto 1 pg/ml.
12. Is there a blood test that can tell if the coronary is blocked.
High sensitive Troponin is such a test. Several studies have shown that mild elevations in High Troponin signals a high risk of heart attack.
High Sensitive Troponin is a new test that can help to identify patients who look healthy but are at the risk of heart attack.
13. How Sure / Definite are these tests. Please note that only Angiography is 100% sensitive and specific. all other tests are indicative. However since we cannot do angiography in every patient, High Sensitive Troponin can help us select patients who require further investigations.
14. Why is early detection of a blocked coronary artery so important ? In case a person suffers from a heart attack in a public place or home where medical facility is not available he can die. However if detected early, the blockage can be removed and heart attack prevented.
15. How early can we predict that the coronaries are blocked ? High risk cases can be picked up many years before the actual attack. This prevents from the heart muscle from dying and preserves cardiac function.
16. What are the general risk factors for heart attack ? Family history : Most important risk factor Smoking Diabetes Untreated Blood pressure High LDL cholesterol High LPa Low HDL cholesterol Early menopause Male sex (Heart attack is more common in males)
17. Who should do High Sensitive Troponin test ? Males above 40 yrs and females above 50 yrs who have history of heart disease in the family or have risk factors mentioned above can do this test. This test should also be done if there are symptoms of heart attack.
19. When should the test be done ?
High Sensitive Troponin should ideally be done 2 times. First time immediately after symptoms and the second time 3 hrs afterwards. A rising concentration is more useful.
Take home message
Heart attack can be prevented in most cases by timely diagnosis. Act early especially if you have family history or if you are a diabetic, hypertensive or a smoker. A good functioning of the heart is essential for a healthy and enjoyable old age. Health is Wealth