Heart attack (MI) signs, prevention and action

Heart attack is referred to as ‘Myocardial Infarction’ in the medical world. It is the death of heart tissue due to lack of blood supply.

Fig 1. Clinical presentations of heart attack. (American Heart Association,2020)

It usually presents as:

  • Deep visceral, substernal pain (described as a pressure); it can radiate to the jaw, back, left arm, right arm, shoulders.
  • Dyspnea (difficulty breathing)
  • Diaphoresis (Excessive sweating)
  • Nausea and Vomiting

In approximately 20% of individuals, it would be a silent myocardial infarction meaning that the individual won’t experience the symptoms indicating a typical MI and may mistake their MI for indigestion.

It is extremely important to recognize the symptoms and get adequate care as soon as possible to avoid complications and death. Do not be ashamed or second guess the severity of your symptoms, it is always better to be safe than sorry.

In the Hospital, some investigations could be done to confirm if this is indeed a heart attack. Some of these investigations include:

  • Serial ECGs
  • Blood test to check for cardiac markers
  • When appropriate, Immediate Coronary angiography is done

While we have briefly touched on how to recognize if you or a loved one is having a heart attack, it is also important to know how to prevent the occurrence. The prevention of MI can be divided into primary and secondary prevention.

Primary Prevention –

This targets the 3 major risk factors of cardiovascular disease (Cigarette smoking, Serum cholesterol level and systolic blood pressure) in order to delay or prevent the onset of cardiovascular disease.

Lifestyle modifications:

  • Weight loss/management
  • Cigarette smoking cessation
  • Limited alcohol consumption
  • Heart healthy dietary plan(like DASH diet)
  • Sodium reduction (salt reduction/ processed food)
  • Dietary potassium supplementation
  • Increased physical activities – by just walking 30 minutes daily, the risk of MI is reduced by 50%
  • When systolic BP is above 130mmHg or diastolic BP is higher than 80mmHg, It is important to include BP lowering medications to aid maintain a normal BP range

DASH Diet stands for Dietary Approaches to Stop Hypertension. It is a diet that focuses on high vegetable, fruit, whole grains, low fat dairy products; poultry, fish, beand, nuts non tropical vegitable oil. The diet is also rich in potassium, magnesium, calcium, protein and fiber.This diet is low in sweets, sugar, sugar sweetened beverages, sodium, red meat, saturated fat, total fat. The total caloric target is 2000 calories.

Secondary Prevention:

This is the prevention of recurrence. The first line approach in secondary prevention is lifestyle modifications as we have discussed earlier.

Where lifestyle modification has failed, medication is the next stage like antiplatelet (Clopidogrel), Statins, Beta blockers, ACE-inhibitors, Angiotensin receptor blockers. This stage is best managed by your physician.

To learn more, visit AHA’s website: Heart.org/HeartAttack

Published by Gray Healthcare Foundation

A Non Governmental organisation with Headquarters in Africa ,dedicated to uplifting the health of the elderly population .Passionate about the elderly , we drive increased inclusivity ,availability of essential health care services, advocacy and research for those aged 60 years and above.

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