Obesity is related to hypertension, diabetes, abnormal cholesterol levels, and other conditions, all conditions contributing to heart attack risk. Abdominal obesity (the "beer belly") poses a particular risk. Obesity in children is a greater risk for future heart trouble than a family history of heart disease. People who are overweight in middle age may still not completely reduce their risk for coronary artery disease later in life, although losing weight can help reduce the risk.
What is a Heart Attack?
The heart is the human body's hardest working organ. Throughout life it continuously pumps blood enriched with oxygen and vital nutrients through a network of arteries to all parts of the body's tissues. It has its own network of arteries, known as coronary arteries, that carry oxygen-rich blood to the heart's muscular walls (the myocardium). If blood flow to the myocardium is interrupted, an injury known as an infarct occurs, in other words, a myocardial infarction, more commonly known as a heart attack.
In most cases of myocardial infarction, this restriction of blood flow to the heart results from atherosclerosis, a process in which atheromas, layers of yellowish plaque made up of cholesterol, fats, and other particles, are deposited on the walls of arteries. The cholesterol plaques slowly thicken, narrowing the arteries (a condition known as stenosis) until blood flow is reduced. When the body's demand for oxygen exceeds its supply, ischemia, the deficiency of oxygen in vital tissues, occurs. Prolonged periods of ischemia can lead to tissue injury, which may be severe enough to cause a heart attack. Although atherosclerosis is ultimately responsible for almost all heart attacks, the attack itself is triggered by a particular event.
Most often a blood clot, or thrombus, forms on the fatty plaque, completely blocking the already narrowed coronary artery.
In other cases, the plaque can rupture or the artery can go into spasm; both of these events may also block the coronary artery, depriving a portion of the heart muscle of its vital oxygen. The severity of a heart attack depends upon the amount of the heart mu
scle involved, how long the ischemia lasts, and the extent of the infarction.
What are the Symptoms of a Heart Attack?
Most people know that chest pain is a symptom of a heart attack but many are unfamiliar with other important symptoms and aspects of its presentation. Chest pain in men, for example, is more likely to signal a heart attack, while in women chest pain is more often caused by other problems.
Women are more likely than men to report extreme fatigue rather than chest pain after physical activity as their first symptom. Women are also more apt to be nauseous and experience pain high in the abdomen or chest or in the back, jaw, or neck. For these reasons, physicians might not be as alert to heart attacks in women based on their symptoms. Sometimes within the month before a heart attack, a patient may experience mild chest pain, unexplained fatigue and ill health, or depression.
Right before a heart attack, many patients experience chest pain, usually precipitated by exercise or stress that does not clear up when medications are taken or when resting. The degree of pain experienced varies greatly between individuals. It should be stressed that the pain does not have to be intense; it may only be a sense of fullness or pressure in the chest. Some people may feel severe pain; others might feel only a tingling sensation.
Many patients experience the pain of a heart attack as a crushing weight against their chest accompanied by profuse sweating. The pain may radiate to the left shoulder and arm, the neck or jaw, and even infrequently to the right arm. The arm may even be numb. A feeling of indigestion or heartburn is common, as are nausea and vomiting. Some people have shortness of breath and may report a great fear of impending death, a phenomenon known as angor animi.
Early warning symptoms for heart attacks may be overlooked or may not even occur. Checking for symptoms other than chest pain is particularly important in light of research that shows that the absence of pain with a heart attack is associated with increased life-threatening complications or death.
Some evidence exists, in fact, that onset of chest pain (angina) right before a heart attack actually offers some protection, possibly by conditioning the heart to resist the damage resulting from the attack.
Prevention, before its too late, is always the best way to avoid a heart attack.
