Tips for Heart Month: Cause and Treatment of Heart Attacks
"Knowledge...should sharpen our ability to scrutinize more
steadily." - Margaret Mead
Like the other organs of the body, the hardworking heart
requires oxygen and nutrients to function. This need is met by
the coronary arteries, two small vessels on the outer surface of
the heart muscle. The right coronary artery supplies the
undersurface of the heart. The left artery runs for about an
inch at the top of the heart before dividing into two main
branches called the "left anterior descending," traveling to the
front of the heart, and "circumflex" supplying the back of the
heart. These three arteries (right, left anterior descending and
circumflex) and their branches send smaller tributaries into the
substance of the hart muscle to supply it with the oxygen and
nutrients needed to contract and pump normally. The coronary
arteries are more susceptible than most other arteries to
athererosclerosis (also known as arteriosclerosis), a buildup of
cholesterol with the walls of the vessels. When severe, this
buildup may obstruct the artery. Under resting conditions, the
blood flowing through the diseased coronary artery may be
sufficient to supply a specific area of heart muscle, but under
more demanding conditions, such as exercise, when the heart is
working harder and requires oxygen and nutrients, the
obstruction may not allow sufficient blood through to meet the
needs of the heart area it supplies. An imbalance of oxygen
supply and demand (called "ischemia") is created. When this
occurs, the afflicted individual often experiences symptoms of
chest discomfort called "angina pectoris."
A diseased coronary artery can also become unstable, resulting
in ulceration or total disruption of a cholesterol deposit. This
often leads to major problems. An ulcerated or disrupted
coronary artery is susceptible to blood clots forming on its
exposed surface. When this occurs, the vessel can become
completely occluded. As a result, the portion of heart muscle
supplied by that artery becomes starved for vital oxygen and
nutrients. If the occlusion persists for more than an hour, the
affected muscle begins to die. This is usually accompanied by
severe, persistent crushing pain over the center of the chest,
the prime symptom of a heart attack.
When this symptom strikes, it is urgent to get to the nearest
hospital emergency room-- immediately! Cardiologists can now
thread a balloon catheter from the groin into the blocked area
and open it up, salvaging precious heart muscle, which can
substantially improve long-term prognosis. Remember: your heart
is a remarkably resilient organ. It can suffer significant
damage before impairment in function occurs. The outlook for
patients with coronary atherosclerosis depends on the extent of
heart muscle damage from a heart attack and on the extent of
blockage in the coronary arteries. Reducing the initial damage,
as well as taking the vital steps to reduce your risk factors
for a second attack (i.e. lowering your cholesterol, normalizing
blood pressure, supervised exercise, diet and weight reduction,
reducing stress, etc.) are the keys to living a long and healthy
life after suffering a heart attack.