A threat of heart attack it is a tightness in the chest and sudden pain in the heart area. It is a paroxysmal pain that occurs behind the breastbone, which is considered a symptom and not a disease. Symptoms usually start suddenly and usually last seconds to minutes.
When the heart muscle does not have a sufficient supply of oxygenated blood or the heart demands more oxygen due to an increase in work or intense physical activity, an imbalance occurs, which can lead to a heart attack. The reason for this is mainly a hardening of the arteries (atherosclerosis).
It is estimated that approximately 9.8 million Americans suffer from this condition annually, and that 500,000 new cases occur each year..
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There are three types of suspected heart attack or angina pectoris: stable, unstable and variant (Prinzmetal).
It lasts a few minutes and is triggered by physical or emotional stress. Sometimes even for a very cold or very large meal. The pain can radiate to the neck, jaw, teeth, shoulders, and arms. After resting a little, the pain usually fades.
This does not disappear with rest, moreover, it can occur even if you are calm or at rest. This attack is stronger and lasts longer. The risk of heart attacks in patients who have unstable angina is 20 percent, so an emergency doctor should be called immediately.
He is a rare type. The pain occurs at rest as well as during sleep. The spasm occurs in the coronary artery, which is why doctors speak of a coronary vasospasm.
Coronary heart disease is the most common cause of reduced blood flow to the heart. This disease is the accumulation of fat deposits inside the coronary arteries, causing it to narrow and restrict the amount of blood that flows to the heart muscle.
Certain risk factors make it more likely that you will develop coronary heart disease and have a heart attack. Some of these risk factors can be controlled.
The main risk factors that can be controlled are:
Some of these risk factors, such as hypertension, obesity, and high blood sugar, tend to occur together, known as metabolic syndrome. In general, a person with metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes.
Risk factors that cannot be controlled include:
Symptoms basically manifest as pain, burning, and a feeling of pressure or tightness behind the breastbone..
The pain often radiates to other areas of the body, such as the neck, throat, jaw, teeth, arms, or the upper abdomen. Also, pain between the shoulder blades can occur.
A feeling of heaviness and numbness is often described in the arm, shoulder, elbow or hand, and especially the left part of the body is affected.
In addition, symptoms such as sudden shortness of breath, nausea, vomiting, sweating, and a feeling of choking may appear..
In women, symptoms such as fatigue, shortness of breath, and an upset stomach are more common. The chest pain on the other hand is uncharacteristic.
The threat of heart attack or angina pectoris has a special characteristic in diabetics, because due to nerve damage related to diabetes (diabetic neuropathy), they often do not feel any pain. Therefore, it can occur silently, with almost no pain, or with little pain..
The diagnostic studies that can be used are:
General measures include smoking cessation as well as treatment of risk factors (eg, hypertension, high cholesterol, diabetes mellitus, obesity, hyperlipidemia).
Other drug therapies that may be considered include: aspirin, clopidogrel, hormone replacement therapy, sublingual nitroglycerin, beta blockers, calcium channel blockers, angiotensin converting enzyme (ACE) inhibitors, autologous cell injections, revascularization, among others.
Other procedures that may be considered include: intra-aortic balloon counterpulsation, enhanced external counterpulsation (in patients whose angina is refractory to medical therapy and who are not suitable candidates for percutaneous or surgical revascularization), transmyocardial laser revascularization (experimental), among others.
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