Kalp Krizi Nedir ? (Bölüm 1) (What is a Heart Attack. Part I)
The heart is mainly made of special muscle. The heart muscle pumps blood into arteries (blood vessels) which take the blood to every part of the body. Like any other muscle, the heart muscle needs a good blood supply.
The coronary arteries take blood to the heart muscle. The main coronary arteries branch off from the aorta. (The aorta is the large artery which takes oxygen-rich blood from the heart chambers to the body.) The main coronary arteries divide into smaller branches which take blood to all parts of the heart muscle
If you have an MI, a coronary artery or one of it’s smaller branches is suddenly blocked. The part of the heart muscle supplied by this artery loses it’s blood (and oxygen) supply. This part of the heart muscle is then at risk of damage unless the blockage is quickly undone. (Strictly speaking, ‘infarction’ means death of some tissue due to a blocked artery which stops blood from getting past.)
The usual reason is that a blood clot (thrombosis) forms inside a coronary artery, or one of its branches. This blocks the blood flow to a section of the heart. Blood clots do not usually form in normal arteries. However, a clot may form if the artery has some atheroma on its inside lining. Atheroma is like fatty patches or ‘plaques’ which develop on the inside lining of arteries. (This is similar to water pipes which get ‘furred up’.) Plaques of atheroma may gradually form over a number of years in one or more places in the coronary arteries.
A ‘crack’ in a patch of atheroma can trigger the clotting mechanism in the blood to form a blood clot. Therefore, a build up of atheroma is the root problem that leads to most cases of MI.
Modern treatment with ‘clot busting’ drugs (see below) can undo the blockage quickly to prevent, or limit the extent of, damage to the heart muscle.
An MI usually occurs after the age of 50 and becomes more common with increasing age. Sometimes it occurs in younger people. It is 3 times more common in men than women. Sometimes an MI occurs in people who are known to have heart disease such as angina. It can also happen ‘out of the blue’ in people with no previous symptoms of heart disease.
Severe chest pain is the usual symptom. The pain may also travel up into your jaw, and down your left, or both, arms. You may also sweat, feel sick, and feel faint. Uncomfortable pressure, fullness, squeezing or pain in the center of the chest lasting more than a few minutes. Pain spreading to the shoulders, neck or arms. The pain may be mild to intense. It may feel like pressure, tightness, burning, or heavy weight. It may be located in the chest, upper abdomen, neck, jaw, or inside the arms or shoulders. Chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath. Anxiety, nervousness and/or cold, sweaty skin. Increased or irregular heart rate. Feeling of impending doom.
MI pain usually lasts more than 15 minutes – sometimes several hours.) A small MI occasionally happens without causing pain (‘silent MI’). It may be truly pain-free, or sometimes the pain is mild and you may think it is heartburn or ‘wind’. Collapse and sudden death may occur with a large or severe MI. The earlier the treatment, the better the chance of a good .
Many people recover well from an MI and have no complications. Before discharge from hospital it is common for a doctor or nurse to advise you how to reduce any ‘risk factors’ . This advise is to reduce your risk of a future MI as much as possible. An ‘exercise test’ may also be done. Briefly, this helps to tell how badly the coronary arteries are narrowed with atheroma, and whether more complex tests of the heart need to be done.
After recovering from an MI, it is natural to wonder if there are any ‘dos and don’ts’. In the past, well-meaning but bad advice to ‘rest and take it easy from now on’ caused some people to become over-anxious about their hearts. Some people gave up their jobs, hobbies, and any activity that caused exertion for fear of ‘straining the heart’. But, quite the opposite is true for most people who recover from an MI. Regular exercise and getting back to normal is usually advised.