http://www.nhlbi.nih.gov/actintime/index.htm

What Is A Heart Attack?
The heart works 24 hours a day, pumping oxygen- and nutrient-rich blood to the body. Blood is supplied to the heart through its coronary arteries. In coronary heart disease (CHD), plaques or fatty substances build up inside the walls of the arteries. The plaques also attract blood components, which stick to the artery wall lining. Called atherosclerosis, the process develops gradually, over many years. It often begins early in life, even in childhood.

The fatty buildup or plaque can break open and lead to the formation of a blood clot that seals the break. The clot reduces blood flow. The cycle of fatty buildup, plaque rupture, and blood clot formation causes the coronary arteries to narrow, reducing blood flow.

When too little blood reaches the heart, the condition is called ischemia. Chest pain, or angina, may occur. The pain can vary in occurrence and be mild and intermittent, or more pronounced and steady. It can be severe enough to make normal everyday activities difficult. The same inadequate blood supply also may cause no symptoms, a condition called silent ischemia.

If a blood clot suddenly cuts off most or all blood supply to the heart, a heart attack results. Cells in the heart muscle that do not receive enough oxygen-carrying blood begin to die. The more time that passes without treatment to restore blood flow, the greater the damage to the heart.

--------------------------------------------
http://www.nhlbi.nih.gov/actintime/taha/taha.htm

Testing For A Heart Attack
If you think youre having a heart attack, get help at once. Dont wait to be sure. Call 9-1-1 right away. Delay can be deadly.

Once you get help, you will undergo tests to see if a heart attack has actually occurred. Some tests are done at the hospital, while others can be done by emergency medical personnel who come in an ambulance. (Tests and treatments done by emergency medical personnel.)

Key heart attack tests are:

Electrocardiogram (ECG or EKG). This is a graphic record of the electrical activity of the heart as it contracts and relaxes. The ECG can detect abnormal heartbeats, some areas of damage, inadequate blood flow, and heart enlargement.

Blood test. A blood test will be done routinely to check for enzymes or other substances that are released when cells begin to die. These are "markers" of the amount of damage to your heart.
 
Nuclear scan. This test shows areas of the heart that lack blood flow and are damaged. It also can reveal problems with the hearts pumping action. A small amount of radioactive material is injected into a vein, usually in the arm. A scanning camera positioned over the heart records whether the nuclear material is taken up by the heart muscle (healthy areas) or not (damaged areas). The camera also can evaluate how well the heart muscle pumps blood. This test can be done during both rest and exercise, enhancing the usefulness of its results.
 
Coronary angiography (or arteriography). This test is used to check blockages and narrowed areas inside coronary arteries. A fine tube (catheter) is threaded through an artery of an arm or leg up into the heart. A dye that shows up on X ray is then injected into the blood vessel, and the vessels and heart are filmed as the heart pumps. The picture is called an angiogram or arteriogram.

-----------------------------------
++++++++++++++++++++++++++++++++++++
http://www.nhlbi.nih.gov/actintime/saha/saha.htm

Surviving a Heart Attack
How do you survive a heart attack? Fast action is your best weapon against a heart attack. Why? Because clot-busting drugs and other artery-opening treatments can stop a heart attack in its tracks. They can prevent or limit damage to the heartbut they need to be given immediately after symptoms begin. The sooner they are started, the more good they will doand the greater the chances are for survival and a full recovery. To be most effective, they need to be given ideally within 1 hour of the start of heart attack symptoms.

 Uncertainty is Normal
 
 Delay Can Be Deadly
 
 Call 9-1-1
 
 Emergency Medical Personnel
 
 Plan Ahead
 
++++++++++++++++++++++++++++++++++
00000000000000000000000000000000000
http://www.nhlbi.nih.gov/actintime/rhar/rhar.htm

Reducing Heart Attack Risk
You can reduce your risk of having a heart attackeven if you already have coronary heart disease (CHD) or have had a previous heart attack. The key is to take steps to prevent or control your heart disease risk factors. 

Six Key Steps To Reduce Heart Attack Risk

Taking these steps will reduce your risk of having a heart attack:

 Stop smoking
 
 Lower high blood pressure
 
 Reduce high blood cholesterol
 
 Aim for a healthy weight
 
 Be physically active each day
 
 Manage diabetes

000000000000000000000000000000000
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
http://www.nhlbi.nih.gov/actintime/hdm/hdm.htm

Heart Disease And Medications

Sometimes, medications may be needed to help prevent or control coronary heart disease (CHD) and so reduce the risk of a first or repeat heart attack. But, if medications are needed, lifestyle changes still must be undertaken.

If prescribed, take medications as directed by your health care provider.

Drugs used to treat CHD include:

Aspirin  Aspirin helps to lower the risk of a heart attack for those who have already had one. It also helps to keep arteries open in those who have had a previous heart bypass or other artery-opening procedure such as coronary angioplasty. (More on aspirin and heart attack)

Because of its risks, aspirin is not approved by the Food and Drug Administration for preventing heart attacks in healthy individuals. It may be harmful for some persons, especially those with no risk of heart disease. Patients must be assessed carefully to make sure the benefits of taking aspirin outweigh the risks. Talk to your doctor about whether taking aspirin is right for you. (For details on the use of aspirin to prevent heart attacks, please visit the FDA Web site.)
 
Digitalis  makes the heart contract harder and is used when the heart's pumping function has been weakened; it also slows some fast heart rhythms.
 
ACE (angiotensin converting enzyme) inhibitor  stops the production of a chemical that makes blood vessels narrow and is used to help control high blood pressure and for damaged heart muscle. It may be prescribed after a heart attack to help the heart pump blood better. It is also used for persons with heart failure, a condition in which the heart is unable to pump enough blood to supply the body's needs.
  
Beta blocker  slows the heart and makes it beat with less contracting force, so blood pressure drops and the heart works less hard. It is used for high blood pressure, chest pain, and to prevent a repeat heart attack.
 
Nitrates (including nitroglycerine)  relaxes blood vessels and stops chest pain. 
 
Calcium channel blocker  relaxes blood vessels and is used for high blood pressure and chest pain.
 
Diuretic  decreases fluid in the body and is used for high blood pressure. Diuretics are sometimes referred to as "water pills."
 
Blood cholesterol-lowering agents  decrease LDL cholesterol levels in the blood.
 
Thrombolytic agentsalso called "clot busting drugs," they are given during a heart attack to break up a blood clot in a coronary artery in order to restore blood flow. (More on these and heart attack)
 
Drugs can cause side effects. If side effects occur, report them to your doctor. Often, a change in the dose or type of a medication, or the use of a combination of drugs can stop the side effect.

To learn more about medications for CHD and its risk factors:

High blood pressure medications.
 
Drug section of "Your Guide to Lowering High Blood Pressure" Web page
 
High blood cholesterol medications.
 
Drug section of "Live Healthier, Live Longer" Web page
 
Medications Databases
 
MedlinePlus drug data basea National Library of Medicine Web site that let's you search for drug information. (This link opens a second browser window. Simply close that window to return to this page.)

%%%%%%%%%%%%%%%%%%%%%%%%%%%
http://www.nhlbi.nih.gov/actintime/faq/faq.htm

Frequently Asked Questions About Heart Attack
Heart Attack Warning Signs
Q: How would I know if I were having a heart attack?

Often, it is not easy to tell. But there are symptoms people may have. These are: an uncomfortable pressure, squeezing, fullness, or pain in the center of the chest that lasts more than a few minutes, or goes away and comes back; discomfort in other areas of the upper body, which may be felt in one or both arms, the back, neck, jaw, or stomach; shortness of breath, which often occurs with or before chest discomfort; and other symptoms such as breaking out in a cold sweat, nausea, or light-headedness. When in doubt, check it out! Call 9-1-1. Dont wait more than a few minutes5 at most. Call right away!

Q: What is angina and how is it different from a heart attack?

An episode of angina is NOT a heart attack. However, people with angina report having a hard time telling the difference between angina symptoms and heart attack symptoms. Angina is a recurring pain or discomfort in the chest that happens when some part of the heart does not receive enough blood temporarily. A person may notice it during exertion (such as in climbing stairs). It is usually relieved within a few minutes by resting or by taking prescribed angina medicine. People who have been diagnosed with angina have a greater risk of a heart attack than do other people.

Prehospital Delay Time
Q: Id rather wait until Im sure somethings really wrong. Whats the rush anyway?

Clot-busting drugs and other artery-opening treatments work best when given within the first hour after a heart attack starts. The first hour also is the most risky time during a heart attackits when your heart might stop suddenly. Responding fast to your symptoms really increases your chance of surviving.

Q: So how quickly should I act?

If you have any heart attack symptoms, call 9-1-1 immediately. Dont wait for more than a few minutes5 at mostto call 9-1-1.

Q: Why should I bother? If Im going to die, theres not much I can do about it anyway, is there?

Thats not true. There is something that can be done about a heart attack. Doctors have clot-busting drugs and other artery-opening procedures that can stop or reverse a heart attack, if given quickly. These drugs can limit the damage to the heart muscle by removing the blockage and restoring blood flow. Less heart damage means a better quality of life after a heart attack.

Given that these new therapies are available, its very sad to know that so many people cannot receive these treatments because they delay too long before seeking care. The greatest benefits of these therapies are gained when patients come in early (preferably within the first hour of the start of their symptoms).

The Role of Emergency Medical Personnel
Q: Emergency medical personnel cause such a commotion. Cant I just have my wife/husband/friend/coworker take me to the hospital?

Emergency medical personnelalso called EMS, for emergency medical servicesbring medical care to you. For example, they bring oxygen and medications. And they can actually restart someones heart if it stops after they arrive. Your wife/husband/friend/coworker cant do that, or help you at all if they are driving. In the ambulance, there are enough people to give you the help you need and get you to the hospital right away.

Steps to Survival
Q: Im not sure I can remember all this. What can I do to make it easier for me?

You can make a plan and discuss it in advance with your family, your friends, your coworkers and, of course, your doctor. Then you can rehearse this plan, just like a fire drill. Keep it simple. Know the warning signs. Keep informationsuch as what medications youre takingin one place. If you have any symptoms of a heart attack for a few minutes (no more than 5), call the EMS by dialing 9-1-1 right away.

Q: I carry nitroglycerin pills all the time for my heart condition. If I have heart attack symptoms, shouldnt I try them first?

Yes, if your doctor has prescribed nitroglycerin pills, you should follow your doctors orders. If you are not sure about how to take your nitroglycerin when you get chest pain, check with your doctor.

Q: What about taking an aspirin like we see on television?

You should not delay calling 9-1-1 to take an aspirin. Studies have shown that people sometimes delay seeking help if they take an aspirin (or other medicine). Emergency department personnel will give people experiencing a heart attack an aspirin as soon as they arrive. So, the best thing to do is to call 9-1-1 immediately and let the professionals give the aspirin.

222222222222222222222222222222222222
