Interview with Dr. Ajay Kumar, Consultant Cardiology & Cardio Thoracic Surgeon.
Heart attack What are the symptoms?
Feeling a bad pain in your chest is the most common sign that you’re having a heart attack.
If you have severe chest pain and you’re not sure what iscausing it, don’t waste time.Call your cardiac consultant. Acting quickly might save your life. Once you get to hospital, doctors can run tests and treat you straight away.
Warning signs of a heart attack
The pain of a heart attack can stop you in your tracks. It can feel as if someone has tied a belt around your chest and is pulling it tighter and tighter until your breath is gone. People have described the pain as crushing, tightening, constricting and pressing.
Your heart is a muscle and needs oxygen to keep working properly. During a heart attack, blood and oxygen can’t get through to your heart. Th is causes pain around it.
You may have warning signs a few days before you have a heart attack. You may have chest pain that is uncomfortable but not severe. You may have a pain that feels like your chest is being crushed and you can’t get enough air. If you have a type of chest pain called angina, the pain might keep getting worse. Angina is usually caused by hardening of the arteries (atherosclerosis). It happens because your heart isn’t getting enough blood.
During a heart attack, you’ll usually have pain in the centre of your chest. It often spreads down one arm, usually the left. Sometimes the pain is in both arms. Sometimes it spreads up into your jaw. Th e pain doesn’t go away if you rest. It doesn’t disappear if you take painkillers or medicine prescribed for a type of chest pain called angina. Th e pain usually lasts half an hour or more.
Doctors call this kind of chest pain typical or classic. But for many people, heart attack pain is mild. Some people have no pain at all. If you’re a woman, are older or have diabetes, you’re less likely to have typical chest pain.
Heart attack What treatments work?
A heart attack is serious. But if you get treatment quickly, you have a good chance of living through it.
The first treatments you’re likely to have will help clear the blockage that is stopping blood getting through to your heart. Th ey will also stop the pain and limit the damage caused by your heart attack.
There are other treatments that can help with the pain and help your heart pump blood more easily. And there are treatments that can lower your chances of having another heart attack.
By keeping healthy you can make it less likely that you’ll have another heart attack. You can ask your doctor about joining a cardiac rehabilitation programme to learn how to care for your heart and your health.
You may have to take medicine for a long time after your heart attack. Don’t stop taking your medicine without talking to your doctor fi rst. If side eff ects bother you, see your doctor as soon as you can. You may be able to take a diff erent medicine or a diff erent dose.
Treatments work best if you get them quickly. If you think you may be having a heart attack, call your doctor.
While you’re waiting for help, chew an aspirin. Aspirin can help you make it through your heart attack. But always call for help fi rst, before looking for an aspirin. In hospital, two treatments can increase your chances of a good recovery. Th ey are clot-busting (thrombolytic) drugs and an operation to open up blocked arteries. Both work well.
Drugs called beta-blockers can reduce your risk of dying after a heart attack. Th ey may also lower your chances of having another heart attack.
After a heart attack, drugs called ACE inhibitors can help you live longer and may prevent another heart attack.
You and your doctor can take steps to prevent another heart attack. For example, you will probably be given a drug called a statin before you leave hospital. Statins are drugs that are used to treat high cholesterol, but they can also help people who have had a heart attack.
We’ve weighed up the evidence about treating heart attacks and divided the treatments into categories. You can fi nd out more about each treatment by clicking on the links.
For help in deciding which treatment is best for you, see.
Aspirin: Th is is a drug that makes your blood less likely to clot.
Clot-busting (thrombolytic) drugs: Th ese break up the blood clot that is stopping blood reaching your heart. Common clot-busting drugs (and their brand names) include alteplase (Actilyse), reteplase (Rapilysin), streptokinase (Streptase), and tenecteplase (Metalyse).
Beta-blockers: These are drugs that slow down your heartbeat. Common beta-blockers (and their brand names) include atenolol (Tenormin), metoprolol (Lopresor), propranolol (Inderal), and timolol (Betim).
ACE inhibitors: Th ese are drugs that relieve the strain on your heart after a heart attack. Common ACE inhibitors (and their brand names) include captopril (Capoten), enalapril (Innovace), lisinopril (Zestril), and ramipril (Tritace).
An operation to widen blocked arteries: Th is is called coronary angioplasty. It widens a blocked artery in your heart.
(Preventive Cardiology & Rehabilitation)