Heart attack is a serious complication of atherosclerotic coronary artery disease. Atherosclerosis is formation of plaque in the coronary arteries which consists of fat and other substances. When blood clot forms on the top of a plaque, it occludes or blocks the flow of oxygenated rich blood destined to heart muscles. As a result, a section of cardiac muscle dies or gets damaged due to starvation of valuable nutrition (oxygen). Physicians refer this condition as myocardial infarction or heart attack.
In mild heart attack, the blood clot is not large enough to block the blood flow completely.However, with partial reduction in blood flow a small portion of heart muscles can damage or die. The damage may not be permanent if treated promptly. After a mild heart attack, there is always high risk of second heart attack which in some cases may be massive and life threatening.
Symptoms Of A Mild Heart Attack
The presenting symptoms vary from severe pain in the chest to minimal symptoms with the disease remaining unrecognized sometimes. In most patients, there is pain below the breast bone with varying intensity, radiating to left arm, left side of jaw, back and epigastric region.
In mild heart attack, the pain remains for more than few minutes and may recur again after some time. The discomfort may be felt as compression in the chest or burning sensation. Pain is accompanied with breathlessness and sweating. Giddiness, profound fatigue, abdominal pain, nausea and vomiting, blurred vision and feeling of light headedness.
Diagnosis Of Mild Heart Attack
The history suggests an accelerating tempo in forty eight hours. With the help of Electrocardiogram, it is possible to distinguish between mild heart attack and massive heart attack. The ST segments are the key distinguishing points that may help to determine the difference. In mild heart attack, the ST segments are not elevated. In a massive heart attack, the ST segments are distinctly raised.
Since in some cases, angina may also mimic like a heart attack. However, if it is a mild heart attack, the enzymes are raised which in case of angina are not altered. These enzymes are CKMB and Trophonin. They are proteins which are released as a result of cardiac muscle damage. Besides, the ECG and enzyme studies, other tests such as Echo-cardiogram, coronary angiography can indicate the exact area of blocked coronary artery and the function of heart.
Treatment Options For Mild Heart Attack
Patients with mild heart attack need close observation and aggressive approach to minimize the risk of massive heart attack. Usually these patients need ICCU care and monitoring. Medicine frequently used is nitroglycerine. It helps to widen the artery and allow oxygenated blood to reach the heart muscles.
Beta blockers and calcium channel blockers are used to lower hypertension and control the rhythm of heart. Drugs like aspirin are given daily to prevent the formation of new blood clots. Low molecular weight Heparin is given subcutaneously for 5 to 10 days as a blood thinner. It helps to lower the stickiness in blood and prevent future clots.
For patients who have high cholesterol level, Statins are the drug of choice. It helps to keep cholesterol level under control. Patients suffering from diabetes have to control blood sugar with appropriate medicines.
Patients who do not respond to medical treatment may need to undergo urgent coronary angiography and angioplasty or coronary bypass surgery.
Whereas those patients whose pains are controlled and ECG changes are normal with normal enzymes, long time medical therapy may be recommended along with lifestyle changes. If patient is smoking or chewing tobacco, he has quit it permanently. Patient should also ensure eating low fat diet and do regular exercise. Diabetic patients have to focus on controlling blood sugar.