Heart Attack

(Myocardial infarction)

The heart is a muscle that pumps blood throughout the body. Arteries carry oxygen-rich blood from the heart to our organs and muscles, making it possible for them to function properly. The arteries that nourish and supply oxygen-rich blood to the heart muscle are called the coronary arteries. A heart attack occurs when the flow of oxygen-rich blood to a section of the heart muscle is cut off. It is often caused by an obstruction of the coronary arteries, usually by a blood clot. If the heart is not getting enough blood and oxygen, the section of heart muscle begins to die. The longer the artery remains blocked, the greater the damage. A blocked artery must therefore be reopened as quickly as possible. A heart attack is a medical emergency that requires immediate transport to the nearest hospital.

Symptoms

Symptoms can include any of the following:

• Pain, pressure or discomfort in the chest
• Pain or discomfort in the arms, back, neck, jaw or abdomen
• Irregular or rapid heartbeat
• Shortness of breath
• Nausea, vomiting or heartburn
• Sweating
• Light-headedness

What should I do?

If you experience one or more of the above symptoms, you should:

• Dial 911 immediately or ask someone to call for you. Do not try to get to the hospital on your own.
• Follow the instructions given to you by the 911 operator.

Treatment

Upon arrival at the hospital, the goal will be to clear the blocked artery and restore normal blood flow as quickly as possible. There are a few ways to do this. You may be given medication, you may undergo a procedure that involves inserting a thin tube through the groin or wrist to access the artery, or you may require bypass surgery, which is a type of open-heart surgery where a blood vessel is taken and used as a detour around the blocked coronary artery.

Once you leave the hospital, you will be prescribed several medications. The goal here is to lower your risk of having another heart attack. You will be prescribed medications to lower the risk of clots forming in your arteries, medications to reduce the workload of your heart, and medications to lower cholesterol.

Other medications may also be needed to manage additional risk factors that could cause another heart attack.

What can I do to reduce my risk for another heart attack?

After a heart attack, preventing another heart attack is your first priority. As a result, you will likely have to make some lifestyle changes.

Certain factors can increase your risk of having a heart attack. These risk factors include:

• Hypertension
• High cholesterol
• Diabetes
• Smoking
• Obesity
• Poor dietary habits
• Lack of exercise
• Stress

These risk factors are modifiable, meaning that you can change them. Hence, it will be important to normalize your blood pressure as well as manage your diabetes and your cholesterol.

You will also be advised to stop smoking, to eat a healthier diet and to lose weight, if applicable. You will be encouraged to be more active and appropriate activities will be recommended (e.g., walking, swimming and stretching). You may also want to consider enrolling in a cardiac rehabilitation program; for more information, speak to your healthcare provider.

Other risk factors are non-modifiable, meaning that you cannot change them. These include age, gender and family history (genetics).

Life after a heart attack

You will likely be able to gradually ease back into the activities you enjoyed before your heart attack. Your doctor will determine when you can start driving again and when you can go back to work. It is also advised that you discuss with your doctor when you can safely return to sexual activity.

Do not forget that you can lower your risk of having another heart attack by changing certain behaviours. Do not hesitate to ask for help when you need it. There are many resources available to you. Ask about the programs available in your area.

For more information or for support:

• The Heart and Stroke Foundation of Canada