When to seek medical attention Act quickly. Some patients may experience delays due to an inability to recognize important signs and symptoms. Follow these steps: 1. Call for emergency medical assistance. If you suspect you are having a heart attack, do not hesitate. 911 or your local emergency number should be called immediately. If you do not have access to emergency medical care, have someone drive you to the nearest hospital. Do not drive yourself unless you absolutely have to. This is because your condition may worsen and driving could put your life and the lives of others at risk. Take the nitroglycerin prescribed by your doctor. Take the medicine as directed while waiting for emergency medical help. Take aspirin if medically advised. Aspirin can antagonize blood clotting, so taking aspirin during a heart attack may reduce heart damage. However, aspirin can interact with other medicines and should not be taken unless advised by your doctor or medical emergency personnel. Don’t let taking aspirin delay you from calling 911. SEEK EMERGENCY MEDICAL ASSISTANCE FIRST WHAT TO DO WHEN ANOTHER PERSON IS HAVING A HEART ATTACK When you encounter someone who is unconscious, call for emergency medical assistance first. Then start CPR to keep the blood flowing. Apply rapid, firm chest compressions – about 100 compressions per minute There is no need to check the patient’s airway or give him or her artificial respiration unless you have specialized training in CPR. A heart attack occurs when there is a blockage in one or more of the coronary arteries. Over time, the coronary arteries become narrower and narrower (atherosclerosis) due to a buildup of various substances, including cholesterol. This lesion is called coronary artery disease and is the cause of the vast majority of heart attacks. When a heart attack occurs, one of the plaques ruptures and releases the cholesterol and other substances in it into the bloodstream. A blood clot forms at the location where the plaque ruptured. If the clot is large enough, it can completely block blood flow to the coronary artery. Another cause of heart attacks is spasms of the coronary arteries, and the spasms can cause the blood supply to part of the heart to be completely blocked. Tobacco and drug use such as cocaine can cause fatal spasms. Tears in the blood vessels of the heart can also lead to a heart attack (concurrent coronary artery entrapment). Lipid buildup (atherosclerosis) that leads to adverse outcomes can lead to narrowing of arteries throughout the body, and this lipid buildup is caused by certain factors. By reducing or eliminating the effects of these risk factors, you can reduce the risk of a first and subsequent heart attack. Risk factors for heart attack include: 1. Age. Men age 45 or older and women age 55 or older are more likely to have a heart attack than younger people. 2. Tobacco. Smoking or prolonged inhalation of secondhand smoke increases the risk of heart attack. 3. High blood pressure. Over time, high blood pressure accelerates atherosclerosis, which damages the blood vessels supplying the heart. High blood pressure that is accompanied by obesity, smoking, hyperlipidemia or diabetes leads to a higher risk of heart attack. 4. Hypercholesterolemia or hypertriglyceridemia. High levels of low-density lipoprotein (LDL) cholesterol (“bad” cholesterol) are more likely to lead to narrowing of the arteries. Elevated levels of triglycerides, a diet-related blood lipid, can also lead to an increased risk of heart attack. However, high levels of high-density lipoprotein (HDL) cholesterol (“good” cholesterol) reduce the risk of heart attack. 5. Diabetes. Insulin is a hormone secreted by the pancreas that promotes the body’s use of glucose. Developing diabetes – i.e., not producing enough insulin or responding poorly to insulin – causes the body’s blood sugar levels to rise. Diabetes, especially poorly controlled diabetes, increases the risk of heart attack. 6. Family history of heart attack. If you have siblings, parents or grandparents with a history of early-onset heart attacks (male relatives ≤ 55 years old or female relatives ≤ 65 years old), you are at increased risk of having a heart attack. 7. Lack of exercise. An inactive lifestyle can lead to hyperlipidemia and obesity. People who engage in regular aerobic exercise have a stronger cardiovascular system and a lower overall risk of heart attack. Exercise is often beneficial in lowering blood pressure. 8, obesity. Obesity is associated with hypercholesterolemia, hypertriglyceridemia, hypertension and diabetes. However, lowering your weight by just 10 percent will reduce this risk. 9, Stress. The way you handle stress may increase the risk of heart attack. 10, Use of illegal drugs . The use of stimulants such as cocaine or amphetamines may induce spasms in the coronary arteries, which can lead to a heart attack. 11. History of pre-eclampsia . This condition can lead to high blood pressure during pregnancy and can increase the lifetime risk of heart disease. 12. History of autoimmune diseases such as rheumatoid arthritis or lupus. Rheumatoid arthritis, lupus, and other autoimmune diseases increase the risk of heart attack. Complications from a heart attack are usually related to the damage to the heart that it causes. This damage may lead to conditions such as: 1. Abnormal heart rhythms (arrhythmias). If the heart muscle is damaged during a heart attack, there may be “short circuits” in the electrical current, some of which may be serious or even fatal. 2. Heart failure. The damaged heart tissue may be so large that the remaining heart muscle is insufficient to fulfill the heart’s pumping function. Heart failure may be temporary, disappearing as the heart, which was severely affected by the heart attack, recovers. However heart failure can also be chronic due to the extensive and permanent damage that a heart attack may have caused to the heart. 3. Heart rupture. A heart attack can cause some of the heart muscle to be damaged, and this damaged heart muscle may break off, leading to a perforation of the heart. And a ruptured heart is usually fatal. 4. Valve lesions. Damage to the heart valves that occurs during a heart attack can lead to severe, life-threatening blood reflux. Heart attacks are usually diagnosed in emergency situations. However, if you are concerned about your risk of having a heart attack, then you should see your doctor to assess your risk factors and make recommendations on how to prevent them. If your risk is high, then you may be referred to a heart specialist (cardiologist).