The heart, which is located in the thorax, a little to the left of the midline of the chest and is of vital importance, is a muscular organ. The weight of this organ, which pumps almost 8000 liters of blood into the circulation by contracting an average of 100 thousand times a day, is 340 grams in men, while it is about 300-320 grams in women. Due to any disorder in the heart structure, heart diseases such as heart valve diseases (valvular diseases), heart muscle (myocardial) diseases, heart attack related to the coronary vessels responsible for feeding the heart tissue, or various inflammatory disorders of the heart may occur.

Heart attack and stroke are the most common causes of death worldwide. The World Health Organization (WHO) predicts that by 2030, 23.6 million people will die every year due to cardiovascular diseases.

What is a Heart Attack?

Heart attack, also referred to as myocardial infarction; It is the condition of interruption of blood flow to the heart muscle due to obstruction or excessive narrowing of the coronary vessels responsible for the oxygen and nutritional support of the heart. There is an increase in the risk of permanent damage every second that the heart tissue cannot get enough blood.

Any sudden blockage in the arteries feeding the heart can cause the heart muscle to not receive enough oxygen, leading to damage to the heart tissue. On the walls of the vessels responsible for blood flow to the heart, substances such as fatty cholesterol accumulate and form structures called plaques. The plaques multiply over time, narrowing the vessel, and cracks form on them. Clots that form in these cracks or plaques that break off from the wall can clog the vessels and cause a heart attack. If the vessel is not opened in an early time and with the right intervention, heart tissue loss occurs. The loss reduces the heart’s pumping power and heart failure occurs. In Turkey, 200 thousand people die every year due to heart attacks. This rate is almost 30 times more than deaths due to traffic accidents.

12 signs of a heart attack

The most basic heart attack symptom seen in a heart attack is chest pain, which is called heart pain. This pain felt behind the chest wall is a blunt pain in the form of heaviness and pressure that feels as if someone is sitting in the rib cage. It can spread to the left arm, neck, shoulders, abdomen, chin and back. It generally takes about 10-15 minutes. Resting or using nitrate-containing drugs that dilate coronary vessels can relieve pain. Other symptoms of a heart attack may include feelings of distress, dizziness, nausea, shortness of breath, easy fatigue, and heart rhythm disturbances. Heart pain, sometimes occurring in narrowed areas, Heart attack symptoms may differ from person to person. This is especially true for heart attack symptoms in women.

Symptoms that may occur during a heart attack can be summarized as follows:

1.  Chest Pain, Pressure or Feeling of Discomfort:  Most people who have had a heart attack describe a feeling of pain or discomfort in the chest area, but this is not true for every heart attack. In some people, a tightness may occur in the chest area in a compressive manner. The discomfort is usually short-lived and disappears within a few minutes. In some people, this feeling can be felt again within a few hours or the next day. These symptoms are generally complaints that indicate that the heart muscle is not getting enough oxygen, and care should be taken as it may require urgent medical attention.
2. Reflected Pain: The feeling of tightness and pain in the chest can also be reflected to various other parts of the body during a heart attack. In most people who have a heart attack, chest pain tends to radiate to the left arm. Apart from this area, there are people who experience pain in areas such as shoulders, back, neck or jaw. Caution should be exercised during a heart attack in women, as the pain may be reflected in the lower abdomen and lower chest. Pain in the upper back is another symptom that is more common in women than in men.
3. Sweating: Excessive sweating that is not during activity or exercise is a symptom that may indicate various heart problems. Some people may also experience excessive cold sweating.
4. Fatigue:  The extreme stress that occurs during a heart attack can make a person feel tired and sluggish. Fatigue and shortness of breath are more common symptoms in women and may be present a few months before the crisis.
5.  Shortness of breath: The work of the heart and breathing are closely related events. Shortness of breath, which is defined as being aware of one’s breathing, is an important symptom that occurs due to the inability of the heart to pump enough blood during the crisis.
6. Dizziness: Dizziness and lightheadedness are among the heart attack symptoms that usually occur in female patients. These situations should not be accepted as normal by the living person and should not be neglected.
7. Palpitation: People are in a state of intense anxiety when they complain of palpitation due to a heart attack. Some people may describe this palpitation not only in the chest but also in the neck region.
8. Digestive Problems: Some people may experience various digestive complaints in the pre-crisis period with hidden heart attack symptoms. Digestive problems such as indigestion and burning in the chest can be similar to some heart attack symptoms, so care should be taken.
9. Swelling of the legs, feet and ankles: Swelling of the  feet and legs develops as a result of fluid accumulation in the body. This  may be a sign of worsening heart  failure.
10. Fast and irregular heartbeats:  It is stated that the irregularity of the rapid or irregular heartbeat should be taken seriously. In addition, it may not be late when fatigue, weakness and short breathing are added to the palpitation. 
11. Cough: Persistent and ongoing cough can be a sign of a heart attack. This is due to blood flow in the lungs. In some cases, the cough may be accompanied by blood. In such a situation, it is important not to waste time. 
12. Sudden change in body weight-weight gain or loss:  Sudden weight gain or loss increases the risk of heart attack. Sudden changes in the diet can cause fluctuations in the cholesterol profile. It has been observed that the risk of heart attack increases in the following years in middle-aged individuals who gain 10 percent or more weight in a short time. 

Heart Attack Symptom in Women

Male gender is considered a risk factor for susceptibility to heart disease. Men can also have a heart attack at an earlier age than women. Although heart attack symptoms can vary from person to person, heart attack symptoms in men usually consist of classic symptoms. For women, the situation is slightly different. Since some non-classical symptoms such as long-term weakness, sleep problems, anxiety and upper back pain are considered among the heart attack symptoms in women, it should be conscious.

What are the Types of Heart Attack?

Heart attack, also known as acute coronary syndrome (ACS), is divided into 3 subtypes. STEMI, NSTEMI, and coronary spasm (unstable angina) make up these three types of heart attacks. STEMI is a heart attack pattern in which an elevation occurs in the region expressed as the ST segment on the EKG study. In the NSTEMI type heart attack, there is no such segment elevation in the electrocardiography (ECG). Both STEMI and NSTEMI are considered major types of heart attacks that can be highly damaging to heart tissue.

STEMI is a type of heart attack that occurs when the nutrition of a large part of the heart tissue is impaired as a result of complete occlusion of the coronary arteries. In NSTEMI, however, the coronary arteries are partially occluded, and therefore, no change may occur in the region expressed as the ST segment in the ECG examination.

Coronary spasm is known as occult heart attack. Although the symptoms are similar to STEMI, they can be confused with muscle pain, digestive problems and various other complaints. This condition, which occurs due to contractions in the heart vessels, can cause hidden heart attack symptoms when it reaches a level that cuts off or greatly reduces blood flow. Although it is pleasing that there is no permanent damage to the heart tissue during this situation, it is a situation that should not be neglected because it causes an increase in the risk of having a heart attack in the future.

What are the Causes of Heart Attack?

The formation of fatty plaques in the vessels feeding the heart is among the most common causes of heart attack. Apart from this, clots or ruptures in the vessels can also result in a heart attack.

Due to various factors, the accumulation of fat deposits called atherosclerosis may occur in the inner wall of the vessels and these conditions are considered as risk factors for heart attack:

• Smoking is the most important reason that increases the risk of heart attack. The incidence of heart attack in men and women who smoke is almost 3 times higher.
• The higher the ratio of LDL, defined as bad cholesterol, in the blood, the higher the risk of having a heart attack. Avoiding foods with high cholesterol content such as offal, sausage, salami, sausage, red meat, fried meat, squid, mussels, shrimp, full-fat dairy products, mayonnaise, cream, cream and butter may have a reducing effect on the risk of heart attack.
• Diabetes is an important disease that increases the risk of heart attack. The vast majority of diabetics die due to a heart attack. In patients with diabetes, the flexibility of the vessel walls is impaired, the coagulation level in the blood may increase, and the damage to the endothelial cells on the inner surface of the vessel may be facilitated. Care should be taken as there may be an increased risk of heart attack in insulin resistance that develops due to unhealthy diet and lack of physical activity.
• Increased pressure in the blood vessels (high blood pressure) is another condition that can increase the risk of a heart attack.
• With age, deterioration in the structure of the vessels and an increase in damage may occur. This also increases the risk of heart attack.
• Estrogen hormone in women may have a protective effect against the risk of heart attack. For this reason, men and post-menopausal women are considered to be at higher risk of heart attack.
• Obesity increases the risk of heart attack by causing dysfunction of blood vessels, premature aging and hardening of the arteries. Other conditions such as high blood pressure, cholesterol and diabetes accompanying obesity, which cause disorders in carbohydrate and fat metabolism, are also important for the formation of heart attack.
• Having a history of heart attack in a person’s first-degree relatives such as mother, father, sibling increases the risk of having a heart attack.
• Care should be taken as elevated levels of substances such as C-reactive protein, homocysteine, fibrinogen and lipoprotein A produced in the liver may be associated with the risk of heart attack.

How is a Heart Attack Diagnosed?

ECG (electrocardiography), which provides documentation of the electrical activity of the heart, is one of the first tests applied to detect a possible heart attack. In this examination, which is performed by means of electrodes placed on the chest and extremities, electrical signals are reflected on the paper or monitor in various waves.

Apart from EKG, various biochemical analyzes may also be useful in the diagnosis of heart attack. Depending on the cellular damage at the time of the crisis, some proteins and enzymes, especially troponin, which are normally located in the heart cell, can pass into the blood circulation. By examining the level of these substances, an idea is obtained that the person may be experiencing a heart attack.

Apart from ECG and blood tests, radiological examinations such as chest X-ray, echocardiography (ECHO) or, rarely, computed tomography (CT) or magnetic resonance imaging (MRI) can also be used in the diagnosis of heart attack.

Angiography is an important diagnostic and therapeutic tool for heart attack. During this examination, the veins in the arm or thigh are entered through a thin wire, and the heart vessels are examined by means of a dark-colored contrast material on the screen. If obstruction is detected, the vessel can be opened with balloon applications called angioplasty. By using a wire tube called a stent outside the balloon, the patency of the vessel can be preserved after angioplasty.

What are Heart Attack Treatment Methods?

A heart attack is an emergency and when symptoms occur, a full-fledged hospital must be consulted. The vast majority of heart attack-related deaths occur within the first few hours after the onset of the attack. For this reason, it is vital that the diagnosis is made quickly and the intervention is done correctly. If you are having a heart attack, call the emergency numbers immediately and report your situation.

The patient who comes to the ED due to a heart attack is referred to a cardiologist after the necessary emergency treatments and blood thinners are administered. If the doctor deems it necessary, he can perform angiography in order to control the patient’s vessels. According to the angiography results, whether there will be drug treatment or surgical procedure is usually determined by a council that includes a cardiologist and a cardiovascular surgeon. Angioplasty, stenting and bypass surgery are among the main treatment options for heart attacks. In bypass surgery, the cardiovascular surgeon uses the vessels taken from another part of the body to repair damaged vessels in the heart.

Risk factors of heart attack, which is one of the leading causes of death all over the world, are examined in two groups as modifiable and non-modifiable. Lifestyle changes that can contribute positively to your heart health can be summarized as quitting tobacco use, eating a balanced and healthy diet, exercising, taking care to keep sugar within normal limits in the presence of diabetes, keeping blood pressure low and improving the ability to control the stress of life.

One of the most important steps to be taken in reducing the risk of heart disease is to quit tobacco use. Smoking is among the leading risk factors for coronary artery disease, heart attack and stroke. In the process leading to atherosclerosis, smoking may have a stimulating effect on the accumulation of fatty substances on the vessel wall. Apart from the heart, the normal functions of other organs are also adversely affected by tobacco use. Tobacco use can also reduce the amount of HDL, known as good cholesterol, and increase blood pressure. Due to these bad properties, an extra burden is placed on the veins after smoking and the person may become prone to various ailments. It is a proven fact that quitting tobacco use reduces the risk of heart disease, and the effects of quitting begin to manifest themselves directly. With a decrease in blood pressure, circulation improves and the oxygen support carried in the body increases. These changes also provide an improvement in the energy level of the person and it becomes easier to perform physical activities.

Exercise and having a healthy body weight are among the issues that are very important in controlling blood pressure and preventing various heart diseases. Exercising for 30 minutes a day and at least 5 days a week is sufficient practice to stay physically active. It is also not necessary for the activity to be of high intensity. With exercise, it becomes easier to reach the weight that is considered healthy. Physical activity supported by a balanced and healthy diet contributes to the prevention of complications that may occur due to excess weight by supporting the normal functions of the body, especially in the control of blood pressure.

It is very important that people who have experienced a heart attack or have been diagnosed with similar conditions strictly follow the medicines prescribed by the physicians. If you feel the symptoms of a heart attack, you should immediately contact the emergency number and seek medical help.