Transcript Heart Attack

HEART ATTACK
Compiled By
R.Solainathan, CPF No. 36875
Mine-I, Planning.
NLC Phone No - 3054
Cardiovascular System - Heart Attack
I.
Definition of a heart attack
-Coronary (crown) Artery Disease
-Heart attack = loss of blood to heart due to
artery damage
-What causes artery damage?
Definition of a
Heart Attack
Sudden blockage of
blood flow to a portion
of the heart.
Medical term: MI
myocardial infarction
(heart muscle
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damage)
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http://www.ehealthmd.com/yms_images/exhr0001.jpg
Obstruction blood flow
-Blood clots can form in
Brain blood vessel: “thrombus” (60%) – atherosclerosis!
Body blood vessel, then travel to brain: “embolus” (20%)
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Taagepera, All rights reserved.
Key component of plaques:
cholesterol
What is cholesterol?
Cholesterol is a fatty
substance found in all parts
of the body
Used by the body to make:
Cell membranes
Steroid hormones
Vitamin D
Sources of cholesterol
Liver and diet
Bad v. Good Cholesterol!
Lipoprotiens
A lipoprotein is a biochemical assembly containing both proteins and lipids (fats).
Function of
LDL v. HDL?
LDL = carries
cholesterol to cells
HDL = carries
cholesterol away from
cells
Here the driver and truck would be the lipoprotien.
Lipoproteins in the blood, a water medium, carry fats around the body.
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This is an example
ofrights
a reserved.
fairly good artery.
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This one is not so good. Note the narrowing of the artery, which decreases the
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amount of blood flow.
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Good, or not so good?Copyright © 2006 Dr. Salme
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This is an example of an artery with 100% blockage.
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Taagepera, All rights reserved.
Copyright © 2006 Dr. Salme
Taagepera, All rights reserved.
Heart Attack
Unlike angina, heart muscle
dies during a heart attack, and
loss of the muscle is
permanent.
While heart attacks can occur
at any time, most heart attacks
occur between 4:00 A.M. and
10:00 A.M. because of the
higher blood levels of
adrenaline released from the
adrenal glands during the
morning hours. Increased
adrenaline may contribute to
rupture of cholesterol plaques.
http://www.medicinenet.com/heart_attack/article.htm
Warning signals of a heart attack
• Uncomfortable pressure, fullness, squeezing or pain in
the center of the chest lasting more than a few minutes.
• Pain spreading to the shoulders, neck or arms. The pain
may be mild to intense. It may feel like pressure,
tightness, burning, or heavy weight. It may be located in
the chest, upper abdomen, neck, jaw, or inside the arms
or shoulders.
• Chest discomfort with lightheadedness, fainting,
sweating, nausea or shortness of breath.
•
•
•
•
Anxiety, nervousness and/or cold, sweaty skin.
Paleness or pallor.
Increased or irregular heart rate.
Feeling of impending doom.
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Taagepera, All rights reserved.
American Heart Association
• Not all of these signs occur in every attack.
• Sometimes they go away and return. If some
occur, get help fast.
IF YOU NOTICE ONE OR MORE OF THESE
SIGNS IN YOURSELF OR OTHERS, DON'T
WAIT. CALL EMERGENCY MEDICAL
SERVICES (9-1-1) RIGHT AWAY!
http://www.heartinfo.org/hrtatkang.html
Cardiovascular System II - Heart Attack
I.
II.
Definition of a heart attack
How is a heart attack diagnosed?
- Coronary risk factors
–
–
–
–
–
Smoking
Lack of physical activity
Stress
Alcohol
Family history
- Blood test
–
–
Standard markers : cholesterol, tri glycerides
New: homocysteine, C-reactive protein, fibrinogen
How do doctors diagnose a heart attack?
1. Review the patient's complete medical
history.
2. Give a physical examination.
3. Use an electrocardiogram (or EKG) to
discover any abnormalities caused by
damage to the heart.
4. Use a blood test to detect abnormal
levels of certain proteins/enzymes in the
blood.
Medical history/physical exam reveals
risk factors
•
High blood pressure – promotes vessel damage
•
High blood cholesterol levels – promotes atherosclerosis
•
Smoking - increases vessel inflammation promoting increased
atherosclerosis, promotes excessive blood clotting
•
Lack physical activity – leads to high blood pressure and obesity
•
Stress – raises blood pressure
•
Alcohol – in moderation can increase HDL (“good” cholesterol),
excessive levels lead to increased blood pressure and triglyceride
levels
•
Family history of heart attack – genetic conditions may raise
cholesterol levels, blood pressure; poor health habits
What lasting damage can a stroke cause?
The effects of a stroke depend on the
extent and the location of damage in the
brain. Among the many types of
damage that can result from a stroke
are:
Inability to move part of the body
(paralysis)
Weakness in part of the body
Memory loss
Inability to speak or understand
words
Change in personality
Confusion or poor judgment
Difficulty swallowing
Question: Why does a stroke affect
different parts of the body?
Answer: ???
How to help a stroke victim:
Call 911
Have him lie down
Lift chin to clear airway
Check for breathing and pulse
If he is unconscious, roll him on his side
Do not give food or drink
Reassure and comfort
Heart Attack analysis - blood test
•
•
•
Cholesterol: LDL, HDL
Triglycerides
High levels of blood
1. Homocysteine
2. C-reactive protein
3. fibrinogen
http://www.coral-cure.com/images/Cholesterol-test.jpg
Cardiovascular System II - Heart Attack
I. Definition of a heart attack
II. How is a heart attack diagnosed?
III. Treatment
- medication
- intervention
- bypass surgery
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Taagepera, All rights reserved.
Heart attack - treatment
•
Medications for this purpose may include:
– aspirin
• anti-inflammatory
• prevents platelets from sticking together to form clots
– heparin
• blood-thinner
– thrombolytic therapy
• "clot busters" break apart fiberous tissue holding clot together
– Statins?
• typically used to lower cholesterol levels
• appears to lower inflammation of heart muscle after attack
•
Interventional procedures
– Angioplasty
– Stents
• open up the narrowed arteries
• break up any clots that are blocking them
•
Coronary artery bypass surgery
– If necessary, bypass surgery may be performed to restore the heart
muscle's supply of blood.
Heart attack – treatment: medication
•Clot buster drugs need to be administered within three hours heart attack
-Every minute of delay shaves 11 days off a heart attack patient’s life
Heart attack – treatment:
“Balloon” Angioplasty
•A catheter (fine, hollow tube)
passed into an artery in groin or
arm
•X-ray used to guide catheter to
blocked vessel
•Balloon inflated
•As balloon is inflated, stent (short
tube of stainless steel mesh)
expands
•Balloon removed, leaving stent in
place
http://images.google.com/imgres?imgurl=http://www.bhf.org.uk/heart
health/uploaded/coronary-angioplasty-withs.gif&imgrefurl=http://www.bhf.org.uk/hearthealth/index.asp%3FsecI
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w=87&hl=en&start=1&prev=/images%3Fq%3Dangioplasty%26svnu
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Heart attack – treatment: bypass surgery
•Bypass surgery creates new pathways of circulation around existing
blockages
•A healthy blood vessel from another part of the body becomes a "conduit"
to the coronary artery at a point beyond the narrowed artery.
•The blocked or narrowed portion of the artery is "bypassed" with this
vessel, allowing blood to flow to the heart muscle again.
http://www.well-net.com/cardiov/bypass1.jpg
Bill Clinton to Undergo Bypass Surgery
Sept. 3, 2004
Former President Bill
Clinton will undergo heart
bypass surgery as early as
Saturday, sources tell
CNN. Clinton was in New
York-Presbyterian Hospital
on Friday undergoing tests
for chest discomfort.
Cardiovascular System II - Heart Attack
I. Definition of a heart attack
II. How is a heart attack diagnosed?
III. Treatment
IV. What can you do to prevent a heart attack?
-Improve your diet!
vs.
What fats should you eat?
Saturated fats
Most animal fats
are saturated
Unsaturated fats
Most plant fats
are unsaturated
(canola, olive oil)
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Taagepera, All rights reserved.
Key points to remember
Dietary Habit
How it effects us
Healthy amounts of unsaturated
Too much of saturated
Any amount trans
fat
fat
fat
Reduces LDL and increases HDL
Increases LDL
Increases LDL and reduces HDL
Too much of any type of fat
Increases weight ** and increases
triglycerides
Diet rich with Essential Fatty Acids with
proper ratio of omega-3 and omega-6
fats
Lowers triglycerides, lowers blood
pressure, increases HDL
** could lead to increase in blood sugars, blood pressure as well as cholesterol.
Heart Attack - SUMMARY
1. Coronary artery disease (CAD): blockage of the arteries leading to
the heart muscle resulting in
- partial (heart attack) or
- full loss (heart failure) of heart muscle activity
2. Causes of CAD:
- poor diet (increases cholesterol levels)
- anything that increases inflammation of the blood vessels
3. Diagnosis of heart attack complex:
- cholesterol, homocysteine, C-RP, fibrinogen
4. Current treatment:
- intervention or bypass surgery recommended
- recent study shows medications are equally effective?
5. How avoid CAD?
- eat well:
=replace animal fats with plant fats (oils)
=avoid “partially hydrogenated” / trans fat products
=eat correct levels of ocean fish