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Heart Attack

What is a heart attack?

A heart attack occurs when a coronary artery, an artery in a heart, becomes blocked or narrowed, causing inadequate blood flow to the heart muscle. This blockage is typically caused by furring up of the coronary arteries, buildup of fatty deposits along the inner walls of the arteries. When such a buildup ruptures, a blood clot may form, completely obstructing the artery and cutting off blood flow to the part of the heart muscle it supplies. This is the most dangerous type of heart, which is sometimes a life threating event, known as a STEMI (ST-segment elevation myocardial infarction) Partial blockage of a coronary artery, with still maintain flow is called a NSTEMI (Non-ST-segment elevation myocardial infarction). 

The symptoms of a heart attack can vary depending on the individual affected, and they may not always be sudden, severe or classical. Common signs and symptoms include: chest pain, pain or discomfort in one or both arms, the back, neck, jaw, or stomach, shortness of breath, nausea, indigestion, or vomiting, cold sweats or dizziness. 

Some individuals, particularly women, older adults, or those with diabetes, may have atypical symptoms or no symptoms at all, known as silent heart attacks. Atypical symptoms that can be seen in female patients have been described in our latest blog post here. The primary aim of treating a heart attack is to restore blood flow to the affected part of the heart, prevent further damage, and reduce the risk of long term complications.  Treatments for heart attacks include medications, invasive procedures and lifestyle modifications, which are often linked to cardiac rehabilitation. 
Medications involve starting antiplatelet agents, aspirin, clopidogrel, ticagrelor or prasugrel. These medications are necessary for a coronary stent to be implanted. They are usually used in combination with beta-blockers (bisoprolol, nebivolol or atenolol), ACE inhibitors (ramipril or enalapril) and statins (atorvastatin, rosuvastatin, pravastatin or simvastatin). Invasive procedures include performing a coronary angiogram , to confirm a diagnosis and angioplasty/coronary stents to restore the blood flow in the affected arteries. On occasion coronary artery bypass grafting may need to be considered too, especially if several of the arteries are furred up. 
Lifestyle modification following a heart attack involve managing the risk factors, which may include high cholesterol, high blood pressure and diabetes. Cardiac rehabilitation programs, which encompass exercise training, education, and counselling, can help individuals recover from a heart attack and prove very beneficial in a long term.  Dr Bart is an interventional cardiologist, which means that he is trained in coronary intervention, which includes angioplasty and coronary stents. . He is on a regular on call rota to treat acute heart attacks at our Heart Centre in Basingstoke.

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