Heart attack



Doctors usually refer to coronary thrombosis or heart attack as “myocardial infarction.” This is the result of blockage of blood flow in one of the branches of the two coronary arteries, through which the heart muscle is supplied with blood. Since the heart must beat (strain or contract) continuously, it needs a significant amount of oxygen and fuel (sugar). Any significant reduction in the supply of this fuel to any part of the muscle threatens not only its ability to work, but also its very survival as a living tissue. Clogging of arteries, atherosclerosis, is to some extent present in most adults in the Western world, and mainly coronary arteries are affected. This disease affects men more often than women who have not reached menopause, and increases with age in both sexes. That's why coronary thrombosis is responsible for almost half of deaths in Western countries and in medical circles is usually considered as a major problem in preventive medicine.


A blockage of the main branch of the coronary artery (coronary thrombosis) occurs,when blood coagulates in a clot upon contact with a coarsened plate of fatty, degenerate, cholesterol-containing substance called atherosclerotic plaque formed on the inner wall of the vessel (see below). Cholesterol (see Chapter 7) plays an important role in the body, but its excess in the blood can be deposited on the walls of blood vessels as part of these atherosclerotic plaques, which, until it comes to thrombosis, do not cause any symptoms, otherwise they do not indicate their the presence until the vessels are so narrow, reducing the lumen by more than half, that the blood flow is not enough to ensure full loads. At rest, the patient may feel completely normal, but a certain load causes pain in the heart — an angina pectoris.


When a complete blockage occurs, a portion of the heart muscle stops receiving blood and dies. Depending on the size of the blocked artery, this zone of necrosis may include the entire wall thickness of the heart, or only part of it. The heart cannot continue to work as a pump if it is destroyed over a certain amount of muscle.The blockage of a large branch, accompanied by necrosis of about half of the muscle in the main, left, swinging chamber, almost always leads to immediate death. Previous small strokes increase the chance of death.


Coronary thrombosis usually causes severe pain or pressure in the center of the chest. The pain often spreads to the back, neck and both hands. Often, this is experienced extreme anxiety and a terrible feeling of imminent death. Pulse is weak, hard to feel, and often irregular. Sometimes he slows down a lot. However, severe pain is not always present. In less severe cases, there may be no pain at all, and studies show that up to 20% of moderate heart attacks are not noticed by patients. This means that there are millions of people whose vulnerability is above average, since previous attacks have not been reported.


In half of those who die from myocardial infarction, death as a result of cardiac arrest occurs three to four hours after the onset of the attack, so there is always an urgent need to take the patient with coronary thrombosis to the hospital as soon as possible.Many of those who could be saved died because they did not understand or did not believe that they were suffering from a life-threatening disease. Factors that increase the risk of coronary thrombosis are well known or at least should be known. It:


  1. smoking;
  2. lack of exercise;
  3. fatty food;
  4. insufficient amount of antioxidant vitamins C and E;
  5. parents who died of arterial disease.


Only the latter factor does not lend itself to individual control, and there are many examples of how people who are able to listen to good advice reduce the likelihood of a heart attack by changing their lifestyle. Since these factors are widely known, the incidence of coronary thrombosis in some social groups has decreased significantly. Unfortunately, not everyone wants to understand this. A survey of 7,735 middle-aged men revealed that the level of coronary thrombosis among manual workers is 44% higher than that of more skilled workers. It is mainly associated with smoking, obesity and lack of exercise in your free time. A strategy to prevent coronary artery disease was published, based on consensus points of view of experts from 19 countries.The main points are aimed at combating smoking, reducing the consumption of cholesterol with an emphasis on unsaturated and high fiber foods and advertising physical exercises. The goal is to eliminate obesity, reduce blood cholesterol and reduce blood pressure. Particular emphasis is placed on strengthening the public response to smoking. In recent years, the importance of antioxidant vitamins has become apparent.