What you should know about heart attacks

Many people are dying from sudden heart attacks. But how many are aware of the warning signs? Here, we explore the causes, risk factors and how the condition can be managed.

Monday January 27 2014

Earnest Oloya lies at the Heart Institute, Mulago, where he is

Earnest Oloya lies at the Heart Institute, Mulago, where he is recovering after he suffered a heart attack. photo by Abubaker Lubowa 


Last week, news about the sudden death of celebrated BBC presenter Komla Dumor, aged 41 took the work by surprise. He had suffered a heart attack that killed him. Dr Emmy Okello, a cardiologist at the Uganda Heart Institute explains that heart attacks happen when coronary arteries that supply heart muscle with blood flow become narrow from a buildup of fat, cholesterol and other substances that together are called plaque.

“When a plaque in a heart artery breaks, a blood clot forms which then blocks blood flow through the heart muscle,” he explains, adding that when the heart muscle is starved for oxygen and nutrients, as a result, damage or death occurs.

Who is at risk?
Dr Okello says although there are several predisposing factors for heart attack, having high blood pressure is the most common. According to Dr Okello, diabetes, obesity, consuming foods in high cholesterol and lack of physical activity are also contributing factors top heart-related diseases.

Complications of heart attacks
During an attack, the heart is damaged due to lack of blood and oxygen. This damage can lead to several complications immediately following the attack or later in recovery.

Dr Okello says a person who suffers heart attack has high chances of survival if they seek treatment early.

Complications following a heart attack also depend on what part of the heart was damaged, the extent of the damage, and the duration from the time the symptoms appeared.

“The most common complication following a heart attack is heart arrhythmia. Because of damage to the muscle, the heart can start to beat erratically as it struggles to keep pumping,” he explains.

Repeat attacks
Unfortunately, recurrent heart attacks are common. Studies show that as many as 20 per cent of people who suffer from heart attack will experience an additional attack within a period of six weeks.

Heart failure
Sometimes a heart attack damages the heart muscle so much that the heart can no longer function properly. Heart failure is a condition in which the heart can no longer pump adequate supply of blood to your body, resulting in shortness of breath and fatigue. In some cases, the damage may be severe, resulting into chronic heart failure.

Heart valve damage
Dr Okello explains that the four valves in the heart which let blood in and out can be damaged when a person suffers a heart attack, causing blood to leak in the wrong direction.

Blood clots
These happen when blood is not being pumped to the heart. Clots can go in any part of the body, but for most heart attack patients, these clots go in the brain, causing excessive bleeding and subsequently leading to strokes.

Signs and symptoms
The most common symptom that come with heart attacks is chest pain or a feeling of discomfort. Dr Okello says that the pain is usually heavy and the patient will feel as if their heart is expanding within the chest.

“This is a signal that some parts of the heart have started dying and such a patient should be rushed to the hospital within 12 to 24 hours,” states Dr Okello.

He says that most heart attacks involve discomfort in the centre of the chest that lasts for a few minutes or keep recurring thereafter. The discomfort can be mild or severe, and sometimes the pain feels like an indigestion or heartburn.
However, not all heart attacks begin with a sudden, crushing pain.

According to Dr Muhoozi Rwakaryebe, a cardiothoracic surgeon at the Second Xiangya Hospital, Central South University in China, warning signs and symptoms of a heart attack are not the same for everyone.

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