Heart attack develops when the supply of the blood to the heart is disrupted or blocked. The blockage is often caused by a buildup of fat, cholesterol and other substances, which form a plaque in the coronary arteries that feed the heart. The severity widely ranges and it might be present as either acute episode or chronic condition. In fact, heart attack symptoms vary, not all people who have heart attacks experience the same symptoms. Nevertheless, it remains important to seek immediate medical attention when any warning sign, regardless of severity, of heart attack exhibits, allowing a timely diagnosis and effective treatment that significantly saves lives. 

Causes of heart attack

• Coronary artery disease when the arteries that supply blood to heart muscle become hardened and narrowed. As one or more areas of the heart muscle do not receive sufficient blood and oxygen, it eventually results in myocardial infarction in which heart muscle begins to die due to the disruption of the blood circulation and prolonged lack of oxygen supply.
• Valvular heart diseases, e.g. severe aortic valve stenosis that abruptly cuts off the blood supply to the heart or acute valve regurgitation when the valve does not close tightly, allowing blood to flow backward in the heart.
• Thyroid disorders, e.g. thyrotoxicosis. 
• Pregnant women with eclampsia

Warning signs and symptoms of heart attack

These 3 signs and symptoms strongly indicate heart attack. If any of them exhibits, medical assistance must be sought right away.

1. Feeling weak, light-headed, or faint. Feeling weak can be an indicative symptom of impaired heart function. The severity is associated with the intensity of activities. The condition is most likely serious if the patients experience weakness while resting without any physical exertion.
2. Chest pain, discomfort or tightness in the chest. Chest pain or discomfort signifying heart attack is often characterized by sudden pain in the center of the chest which might radiate from the neck to the jaw. Pain or tightness described as crushing pain with pressure might spread to one or both arms or shoulders. If the symptom persists and lasts longer than 20 minutes without timely treatment, it can potentially lead to myocardial infarction which deteriorates the heart function. 
3. Shortness of breath or difficulty breathing when lying down (orthopnea). If shortness of breath or trouble breathing develops when lying flat, it is often a serious sign of heart attack when there is a buildup of excess fluid that creates pressure around the lungs that increases more workload to the heart. The severity of this symptom usually depends on how flat the patients are lying —the flatter they lie, the more they feel short of breath.

Cardiac screening is essential

People aged over 35 who pose certain risk factors might be prone to develop coronary artery disease which substantially affects their health in the future. To catch heart diseases at earliest stages, cardiac screening is highly recommended, enabling lifestyle modification and proactive healthcare intervention to promote a better and healthier heart. 

Coronary Artery Calcium Scan (CAC)

Coronary Artery Calcium Scan (CAC) is an imaging test used to detect the atherosclerotic plaque that forms on the artery walls of the heart. This plaque is made up of calcium, fats, cholesterol and other substances. Over time, plaque buildup hardens and narrows the arteries, resulting in limited blood flow to the heart and other parts of the body. This plaque can burst, triggering a blood clot and causing life-threatening events such as heart attack. Coronary Artery Calcium Scan by using computerized tomography (CT) has been used to detect an atherosclerotic plaque, especially in chronic cases. Nevertheless, this imaging test might not be applicable to identify plaque in acute cases in which lesions might be afresh developed. The measurement of calcified plaque derived from the test is firmly correlated to the risk of developing coronary artery disease in the future. As the amount of calcium detected increases, the risk of heart attack relatively increases.  Using 10-15 minutes, the interpretation of calcium scoring is principally made by using Agatston Score, a semi-automated tool to calculate a score based on the extent of coronary artery calcification detected by CT scan. Grading of coronary artery disease (based on total calcium score) ranges from calcium score 0 to over 400 which an extensive plaque burden is found and atherosclerosis might be strongly indicated with extremely high risk of developing heart attack or myocardial infarction and coronary artery disease with high degree of occlusion. With or without symptoms, additional tests, interventions and treatments are further required under close supervision of expert cardiologists.

Adhering to the international standard of care and safety precaution, at Bangkok Heart Hospital, treatments and services are provided 24/7 by highly specialized multidisciplinary team in cardiology supported by cutting-edge technology, ensuring the highest degree of effectiveness and safety. For emergencies, cardiac operations and interventions can be conducted without delay. 

More importantly, to maintain your heart’s health, eating healthy food and refraining from risk factors contributing to heart diseases are the key. For patients with heart diseases, please be advised to strictly take your medications as prescribed while completing all follow-up appointments.