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Heart Attack, Part One: A Patient Guide

Introduction

The Heart Attack Patient Guide is a simple explanation of what a person is likely to experience when having a heart attack. The guide describes how a person is treated immediately during the attack, upon arrival at the hospital, to months and years later. The first part of the guide discusses the basics of heart function, heart attack symptoms, emergency care, medications, tests and treatments performed in the hospital. The second part is a comprehensive guide that covers short-term recovery in the cardiac care unit of the hospital, including details about bypass and angioplasty recovery, discharge from the hospital, cardiac rehabilitation, exercise, long-term recovery, medication, depression, and lifestyle modification.

Heart function

The heart works as a muscular pump with blood vessels leading in and out. The blood flows from your lungs, where it picks up oxygen, into the pump (your heart) and is pumped out to the rest of the body. Once the blood has delivered oxygen to the tissues, it returns to your heart and gets pumped back out to the lungs.

Blood flow during a heart attack

The heart muscle requires oxygen to function properly. The blood inside your heart does not supply oxygen to the heart muscle. Special blood vessels on the outside of the heart, called coronary arteries, feed the heart muscle. Three major vessels and many smaller vessels do this job. When one or more of the major vessels is obstructed (usually due to blood clot formation in the blood vessel lumen), blood cannot reach the heart muscle beneath the block, restricting the supply of oxygen. Within 20 minutes of not receiving blood and oxygen, some heart muscle cells begin to die. The death of heart muscle cells is called a heart attack.  A heart attack results in the loss of some of the function or contractility portion of the heart that has been damaged.

Symptoms of a heart attack

The symptoms of a heart attack may vary greatly. For some people, a heart attack is quite obvious, an intense, vice-like squeezing chest pressure or a feeling of a heavy weight having been placed on the chest. For others, a heart attack is more subtle, often felt as a mild chest discomfort or dull ache. Some individuals report a stabbing, knifelike, or burning sensation. The pain is usually prolonged and typically lasts for at least 30 minutes. The pain, however, may also greatly fluctuate in intensity during the period of a heart attack, and at times, appear to nearly completely dissipate. The intensity of heart attack-related chest pain does not usually alter with changes in body position. Even rest will not typically relieve this type of chest pain. Some people may not experience any pain in the chest but may experience it elsewhere. It is not at all unusual for people to describe pain radiating down the arms (either one, or both) with a tingling sensation in the wrist, hand, and fingers, or in the shoulders, neck, and jaw. The pain can also radiate to the teeth, the gums, or through to the back. Additional symptoms may include indigestion, nausea, vomiting, palpitations, cold perspiration, weakness, dizziness, cough, breathlessness, fainting, anxiety, or a sense of impending doom. In general, men and women experience similar symptoms of a heart attack. Although most heart attack victims report some form of chest pain, others may report none at all. While individuals who are elderly or have diabetes are generally at highest risk for an absence of chest pain during a heart attack (this is known as a silent heart attack), all persons should recognize this risk. In particular, individuals with unexplainable new onset indigestion, nausea, or shortness of breath should consider seeking prompt medical attention. Heart attacks can cause of sudden death in adults and may occur with absolutely no warning signs at all.

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