Heart attack

The main symptoms of a heart attack are:

• chest pain
• shortage of breath
• nausea

A heart attack often begins with sudden or gradually intensifying pain in the chest. It can be mild or very severe and doesn't go away when the person rests. It lasts more than five minutes and can radiate from the chest to an arm, the back, the neck or the upper abdomen.

Fear of dying, a pale to sallow face and sweating are also typical. Difficulty breathing, nausea and vomiting can also occur. The latter symptoms can also be the only signs of a heart attack in women. This is why it fails to be identified in women more often than in men.

Other signs of a heart attack include:

• a feeling of tightness and pressure in the chest
• pain or numbness in the upper body that spreads to the shoulder blades, the neck and the jaw
• sweating
• paleness and cold sweats
• lightheadedness or fainting
• dizziness

Further information, for instance on indications of a heart attack can be found at gesundheitsinformation.de

The same measures are recommended for prevention as for a healthy cardiovascular system:

• Stop smoking.
• Do regular physical exercise.
• Maintain a normal weight.
• Have a balanced diet.

The main test is an electrocardiogram (ECG). There are two types of heart attack based on the pattern shown on the recorded echocardiogram:

• ST-segment elevation myocardial infarction (STEMI)
• Non-ST-segment elevation myocardial infarction (NSTEMI)

With a STEMI, the ECG shows that a certain part of the curve is elevated – known as the ST segment. This indicates a more serious heart attack affecting larger parts of the heart muscle.

With a NSTEMI, no ST-segment elevation can be seen in the ECG. This is usually because a smaller area of the heart is damaged.

The most important thing to do first is to call the emergency number 112 as soon as possible and request an ambulance with an emergency doctor. This is because the blocked coronary artery has to be opened again as quickly as possible.

• Treatment of a STEMI (ST-segment elevation myocardial infarction): those affected usually have a cardiac catheter to widen the artery (angioplasty), providing the entire heart muscle with oxygen again.
• Treatment of a NSTEMI (non-ST-segment elevation myocardial infarction): the type of treatment depends on various factors: How are symptoms progressing? Are there other medical conditions? Age is also a factor in assessing the risk of complication with surgery. But, most of the time, a NSTEMI is also treated with a cardiac catheter.

After the acute phase, there are other treatments intended to reduce the risk of a further heart attack.

A heart attack occurs when a coronary artery becomes completely blocked. This means that part of the heart muscle no longer gets enough oxygen. If this state lasts too long, part of the heart muscle dies off. This means that there is a risk of the person dying and they need medical attention as soon as possible.

People who have heart attacks often have already had coronary heart disease (also called coronary artery disease) for years. This causes recurring chest pain (angina) or shortness of breath during exercise. Others have heart attacks who had no symptoms beforehand – they only find out about their heart problem when they have a heart attack.

Coronary heart disease occurs as a result of calcified coronary arteries (arteriosclerosis). The calcification begins with small areas of inflammation on the wall of a vein where cells, fats and other substances accumulate and gradually constrict the vein.

The danger of a heart attack exists when these plaques suddenly break open. A blood clot may form there. If it is so big that it blocks the blood vessel entirely, a heart attack occurs.

As with coronary heart disease, the risk factors for a heart attack are smoking, being very overweight, high cholesterol, high blood pressure and diabetes. The risk increases with age.

It affects both men and women. But, on average, women have heart attacks at a more advanced age than men do. Overall, more women die of a heart attack than of breast cancer, for example.