The heart is a muscular bag which squeezes to pump blood around our bodies. Like all muscles it has its own blood supply and the coronary arteries are responsible for bringing blood to the heart muscle. These arteries can become damaged from a condition called atherosclerosis which involves the build up of plaques on the inner surface of the arteries. If a break occurs in one of these plaques, a blood clot forms at this site in the artery and blocks off the blood supply to some of the heart muscle. If this occurs, the muscle gets damaged and the condition is called a heart attack.
Heart attack symptoms:
The most common symptom of a heart attack is chest pain. This is usually a crushing or tight pain, which may move to your jaw or your arms, particularly on the left side. You may also feel short of breath, sweaty or sick. Some people may feel light-headed or lose consciousness. You may become anxious or very afraid. However 10 to 15 per cent of people who have a heart attack may not feel anything. This is more common in older people, especially women and those with diabetes. Sometimes these people just feel weak, tired or short of breath. Some elderly patients may simply become confused.
How is a heart attack diagnosed?
Your doctor will make a diagnosis of heart attack based on a number of factors. It is sometimes a very difficult diagnosis to make and it may take a few days to make sure the diagnosis is correct. First of all, the type of chest pain and how long it lasts is very important information to help make the diagnosis. Secondly your doctor will look at an image of the electricity going through your heart called an electrocardiogram (ECG). There are certain patterns on the ECG, which suggest a heart attack. Lastly, your doctor will carry out blood tests, which will help confirm the diagnosis.
Getting over a Heart Attack
How long is spent in bed?
After a heart attack it is important to rest your heart. This will allow the damaged part to heal. At this stage most people will be in a Coronary Care Unit or a step down/sub acute ward but will be on constant heart monitoring. Despite this, it is still possible to carry out some simple exercises in the bed. Taking deep breaths and moving your legs will help your circulation. You will be shown how to do these exercises.
Gradually your strength will return and you will be taken for short walks, first around the bed, then around the ward. In a few more days you will be able to walk by yourself and for longer distances. Usually by this stage you will be off the monitor and out of the Coronary Care Unit.
During this time the doctors will be trying to find out why you had a heart attack. They will have measured the level of cholesterol (blood fat), your weight and blood pressure, asked whether you smoke or not, how much exercise you take, and whether or not anyone else in your family had the same problem. You should try to use this time in hospital to think about your lifestyle and consider ways to improve it in the long term.
Sometimes a stress test will be carried out before you go home. This is a way of seeing how much your heart has recovered. By walking on a treadmill attached to a monitor the doctor can see how much you can "push" yourself. It’s also a good way of boosting your confidence! Other tests may be necessary and your doctor will explain why. An "Echo" or cardiac ultrasound may be needed to look at the heart valves and the pumping chamber of the heart. A coronary angiogram may be needed (see angiogram) but this will depend on the extent of the heart attack and whether future problems are considered likely.
This worries some patients so try to plan ahead. The simple day-to-day chores may be more tiring at the start, so it’s better to ask for help from family or friends. Try to get plenty of rest at night or even take a nap in the middle of the day. At the same time it’s important to take a fair amount of exercise but build up the distances slowly. Walk around the house first, try the stairs at your own pace and eventually, you will be able for longer walks outside. Your physiotherapist will give you guidelines before you go home.
How soon you return to work may depend on the type of work you do. Your doctor can advise on this. Here are a few guidelines. Lifting heavy weights is probably not a good idea for a few months and even then it may be best to avoid this kind of work. Driving is not wise for about 4 weeks. Some people who drive buses or trucks may not be allowed to drive again but others can return to commercial driving after 6 months after obtaining medical clearance. Please consult your cardiologist and the appropriate road safety authorities for guidelines.
Patients are often worried about having sex after a heart attack. Give yourself about 2 or 3 weeks to get over a heart attack. By this time you will be more or less back to normal. If you are at all worried tell your doctor. Finally, some people feel low in spirits after going home. This is to be expected especially after such a life altering experience. Being at home may seem like an anti-climax. You may also be worried about the future. This is normal. It may help to talk to your family, friends and to the nurses and doctors, but first of all you must get your strength back so that you are able to tackle these worries. The Cardiac Rehabilitation Team is also there to help you (see cardiac rehabilitation).It may be suggested that you see a psychologist in hospital or after discharge to help you through this difficult period period who can help you with ways to cope.