is one of the leading causes of death in the world. In Singapore, it is the second killer disease after cancer. A
occurs when blood flow to a part of your heart is blocked for a long enough time and the heart muscle is damaged or dies.
Most
s are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. If the blood flow is blocked, oxygen is unable to travel to the heart, which will affect its function critically.
The most common cause of
is atherosclerosis (narrowing of the artery due to build-up of cholesterol). Plaque, a substance made up of cholesterol and other cells, can build up in the coronary artery, and causing it to be blocked or narrowed. A
can occur as a result of plaque buildup.
However, the trigger for a
is not predictable.
s may occur:
Symptoms
Chest pain is the most common symptom of a
. You may feel the pain in only one part of your body, or it may move from your chest to your arms, shoulder, neck, teeth, jaw, belly area, or the back. The pain can be severe or mild. It can feel like:
The pain usually lasts longer than 20 minutes. Other symptoms of a
include:
Some people (the elderly, people with diabetes, and women) may have little or no chest pain. Or, they may have unusual symptoms (shortness of breath, fatigue, and weakness). A “silent
” is a
with no symptoms.
Symptoms
A doctor or nurse will perform a physical exam and listen to your chest using a stethoscope. The doctor may hear abnormal sounds in your lungs (called crackles), a heart murmur, or other abnormal sounds.
A troponin blood test can show if you have heart tissue damage.
However, the diagnosis is often based on an electrocardiogram (ECG). Coronary angiography is often done right away once a
is confirmed on ECG.
This test uses a special dye and x-rays to see how blood flows through your heart. It can help your doctor decide which treatments you need next, such as angioplasty (see below). Other tests to look at your heart that may be done while you are in the hospital include Echocardiography and Exercise stress test.
Treatment
Emergency treatment is needed when a
occurs. You will be hooked up to a heart monitor so the health care team can look at how your heart is beating. The health care team will give you oxygen so that your heart does not have to work as hard and medicine including morphine to ease the pain. These are given via an intravenous line (IV) that will be placed into one of your veins.
Angioplasty is often the first choice of treatment for
s. It should be done within 90 minutes after you get to the hospital, and no later than 12 hours after a
. It is a procedure to open narrowed or blocked blood vessels that supply blood to the heart and is carried out immediately after coronary angiography. Usually a small, metal mesh tube called a coronary stent is placed at the same time This helps prevent the artery from closing up again.
Alternatively, you may be given drugs to break up the clot. It is best if these drugs are given within three hours of when you first felt the chest pain. This is called thrombolytic therapy.
