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who, what, when and how of Heart attack
< b>Heart attack: The death of heart muscle due to the loss of blood supply.
The loss of blood supply is usually caused by a complete blockage of a coronary
artery, one of the arteries that supplies blood to the heart muscle. Death of the
heart muscle, in turn, causes chest pain and electrical instability of the heart
muscle tissue.
The electrical instability of the heart causes ventricular fibrillation (chaotic
electrical disturbances affecting the ventricles, the lower chambers of the heart).
Orderly transmission of electrical signals in the heart is important for the regular
beating (and the efficient pumping) of the heart. A heart undergoing ventricular
fibrillation simply quivers and can not pump or deliver oxygenated blood to the
brain. Permanent brain damage and death can occur unless oxygenated blood flow is
restored within five minutes.
Many heart attack deaths are due to ventricular fibrillation that occurs before
the victim can reach any medical assistance or the emergency room. These electrical
disturbances of the heart can often be successfully treated with medications or
other means by paramedics in the "field," or upon arrival to the hospital. Approximately
90-95% of heart attack victims who reach the hospital survive. The 5-10% who later
die are those who have suffered major heart muscle damage, or who suffer an "extension"
or enlargement of their heart attack.
Early heart attack deaths can be avoided if a bystander starts CPR (cardiopulmonary
resuscitation) within five minutes of the onset of ventricular fibrillation. CPR
involves breathing for the victim and applying external chest compression to make
the heart pump. When paramedics arrive, medications and/or electrical shock (cardioversion)
to the heart can be administered to convert ventricular fibrillation to a normal
heart rhythm. Therefore, prompt CPR and rapid paramedic response can improve the
survival chances from a heart attack.
The treatment of a heart attack may include the prompt administration of drugs
to dissolve and prevent blood clots; an angioplasty or intracoronary stenting to
open an obstructed artery; and medications that open (dilate) blood vessels. Early
reopening of a blocked coronary artery reduces the amount of heart muscle damage,
lessens the size of the heart attack, and improves prognosis. Patients suffering
a heart attack are usually hospitalized for several days to detect heart rhythm
disturbance, and observe for shortness of breath and chest pain.
A heart attack is also called a myocardial infarction or an MI. Myocardial refers
to the myocardium, the heart muscle. Infarction is tissue death due to a local lack
of oxygen.
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