We often hear the words heart attack, heart failure, cardiac arrest and stroke, and use them interchangeably. Clarity on these terms to common public is important because when they convey to a doctor about past history or any patient condition, the understanding is better.
Stroke is a neurological condition implying sudden onset of paralysis of parts of the body, loss or slurring of speech, and or visual disturbances. Stroke occurs due to blockage with clot or rupture of blood vessels that supply brain. FAST is used to detect and expedite responsiveness of medical teams: Facial drooping, Arm weakness, Speech difficulties and Time to call emergency services.
Stroke may be transient or cause permanent brain damage and therefore needs urgent medical attention.The other three terms are related to heart. Heart attack is the sudden onset of cut off of blood supply to heart muscle due to formation of blood clots in the heart arteries. Patients with heart attack may develop heart failure due to sudden weakening of more than 40% of heart pumping function.
When it happens suddenly, it is called acute heart failure and if it occurs slowly over a few months, it is called chronic heart failure. Heart failure may also arise due to many other causes such as long-standing high blood pressure, diabetes, infections, old heart attacks, after bypass surgery, valve diseases, pregnancy, anaemia, thyroid problems, cancer drugs, chronic lung problems, and hereditary causes.
Cardiac arrest is an ominous term denoting sudden stopping of heart contraction either due to stoppage of heart beat or due to extremely high heart rates. Cardiac arrest causes almost 50% of deaths in patients with heart attack in the first one hour and is the final mode of death in all other cardiac patients.The causes for heart attack and stroke are similar which include some modifiable and some non-modifiable factors. These include diabetes, high blood pressure, high cholesterol, smoking, obesity, sedentary habits, and family history of heart attack or blockages in immediate relatives. By identifying and controlling them, one can prevent or delay the progression of blockages.
What causes heart attacks and angina?
The heart is a pump that takes bad blood from the body, sends to lungs and purifies there and brings back to heart for circulation all over the body. It also needs blood for its energy which it derives through three arteries called coronary arteries. With time, within the wall of these coronary arteries, cholesterol starts accumulating and causes narrowing of the blood stream within the artery. Sometimes, the block may rupture into the blood vessel and cause blood clot leading to heart attack.
Manifestations of coronary disease
These narrowing called “stenosis” cause less blood flow to heart and manifest as chest pain on exertion or during emotional stress so called Angina. Angina has three characteristics:* It occurs during physical exertion or emotional stress* It is heaviness in the centre of the chest which spreads to left hand mostly, but can also spread to right hand, upper stomach, jaws or to the back. * It lasts 5-10 minutes and is relieved by rest or medication.(To be continued next week)