Heart Attack, (Ischemic Heart Disease) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

Heart Attack (Ischemic Heart Disease) is a medical disorder that happens when the coronary arteries become blocked reducing blood flow to the heart muscles.
The blood supply to the part of the heart can not give sufficient oxygen and nutrients to the muscles of the heart.
The cells in that affected area of the heart died off and that area of the heart is not able to function.
This is called a heart attack.
Heart Attack (Ischemic Heart Disease) can result in sudden death.
It needs just four to six minutes after cardiac arrest before a person develops brain death and then complete death.
The survival rate before reaching a hospital is less than 1-2%.
A heart attack (myocardial infarction) happens when blood supply to the heart muscle stops and the heart muscle dies.
A sudden cardiac arrest (SCA) happens when the heart suddenly stops pumping due to an electrical disorder in the heart.
Heart Attack (Ischemic Heart Disease) happens when

1. There is an obstruction of an artery in the heart by a blood clot, piece of fat or air bubble traveling in the blood from another part of the body.
   This results in a lack of supply of oxygen and nutrients to the heart muscle.
   Consequently the heart cells died resulting in loss of function of the part of the heart.
2. The narrowing of the blood vessel because of fat deposit in the walls of the artery supplying blood to the heart.
   This decreases the blood supply of oxygen and nutrients to the heart muscles cells and decreases its function.
   The causative diseases are:
3. High Blood pressure-Hypertension narrows the arteries of the heart and provides blockage.
4. High cholesterol-Cholesterol deposit causes the walls of the arteries to be thicker, making them narrow and reducing the blood flow.
5. Diabetes mellitus
6. Obesity
7. Smoking and alcohol
   The main symptom of IHD is a crushing heaviness or pressure in the chest which may spread to the left jaw, neck, shoulder and down the inside of the left arm and hand.
8. Breathing difficulty is normally linked with the chest pain
9. Cold sweats
   Diagnosis of ischemic heart disease is normally confirmed by:
   ECG (electrocardiogram) reveals characteristic features of depression in Q wave, ST segment and raised RS segment.
   Angiogram (cardiac catheterization)
   Immediate treatment is required
   Give nitroglycerin under the tongue if nitroglycerin is available
10. Anticoagulants such as warfarin, aspirin
11. Vasodilators like isorbide
12. Any abnormal rhythm of the heart must be treated with medicines
    Surgical treatments include:
13. Balloon angioplasty
14. Stent
15. Bypass heart surgery

TABLE OF CONTENT
Introduction
Chapter 1 Heart Attack (Ischemic Heart Disease)
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Angina Pectoris
Chapter 8 Heart Failure
Epilogue

Ischemic Heart Disease is the third commonest cause of death in Singapore in 2014 having fallen from second place in 2009 to cancer and pneumonia.
I had several patients who died of heart attacks most of them peacefully.
Some of them had a successful coronary artery bypass operation done on them but later succumbed to other illness such as pneumonia.
Treatment has been quite successful in reducing the number of heart attack especially with the use of blood thinners such as aspirin, plavix and warfarin that prevent formation of blood clots in the coronary arteries.

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