HEART ATTACK - Quick on the Net Limited



HEART ATTACK

Key Points (drop down)

The UK has one of the highest levels of heart disease in the world, claiming around 150,000 lives each year.

What is a heart attack?

Your heart is a powerful muscular pump that drives blood around the body. To keep your heart healthy, the muscles of the heart need to be supplied with blood by the coronary arteries. If one of the coronary arteries becomes blocked part of the heart may be starved of oxygen and become permanently damaged.

A heart attack usually causes severe pain in the centre of the chest. The pain lasts for more than 15minutes, and may last for hours. The pain usually feels like a heaviness or tightness which may also spread to the arms, neck, jaw, face, back or stomach. In some cases the pain may be mistaken for indigestion. There may also be sweating, lightheadedness, nausea or shortness of breath. A heart attack may cause the rhythm of the heart to become disturbed.

However sometimes a heart attack is ‘silent’ and produces little discomfort. It may even remain undiscovered until you have had medical investigation for other symptoms or a routine medical examination.

A heart attack is sometimes called a coronary thrombosis or myocardial infarction.

What causes a heart attack?

A heart attack is a sudden and often dramatic event, but it is usually the result of a process that has been ongoing for many years. The walls of the coronary arteries may have become narrowed by a gradual build up of a fatty material. This condition is called atherosclerosis. The fatty material is called atheroma. The walls of these dieased arteries may crack and blood cells called platelets become attracted to the damaged area. A clot may form on top of this, which may then suddenly and completely block of your artery. If your artery is blocked for more than a few minutes, the muscle cells in the area of your heart supplied by that artery may become permanently damaged. This is a heart attack.

What brings on a heart attack?

Heart attacks often happen to people who seem to have been perfectly well. In other cases, a heart attack may follow weeks, months or years of angina.

A heart attack can start at any time of the day or night either when you are resting or being active. We do not know why heart attacks happen when they do, but we do know a lot about why people get coronary heart disease:

Cholesterol has been shown to be an important cause of coronary heart disease (CHD). But if treated, it can reduce the risk of developing the disease. You can lower your cholesterol by diet and although sometimes medication is necessary, your doctor will advise you if additional individual treatment is required.

Blood pressure -needs to be checked at least once every five years and more frequently as you grow older.

Weight -aim to achieve the right weight for your height.

Diet –enjoy a healthy diet, which can help to reduce weight and blood pressure and reduce cholesterol.

Smoking –avoid the habit.

Exercise – take regular exercise aiming for physical fitness.

Stress – learn to relax and manage the stresses of your everyday life.

Alcohol – drink with sense and in moderation

Commonly asked questions (drop down)

What is the difference between a heart attack and angina?

Angina occurs when the coronary arteries have become narrowed and the supply of blood and oxygen to the heart muscle is decreased. The supply of blood may be enough when you are resting but not when you are exercising or under emotional stress.

What happens to my heart after a heart attack?

After a heart attack, the area of the heart muscle that was damaged will be replaced by scar tissue. This takes from a few days to a few weeks. Within two or three months, the hearts of many heart attack patients are functioning just as well as they were before the attack. However, sometimes a heart attack can cause more severe damage to the heart, with the result that the pumping action of the heart is not as good as before. This can lead to breathlessness, tiredness and swelling of the ankles.

Will it happen again?

Many people wonder if they will have another heart attack. Once the first few days are over, the chances of having a second attack is not great and, as time goes by it becomes less and less. The risk still remains, but it can be greatly reduced by adopting healthy eating habits and taking suitable medicines. This is called Secondary prevention. A rehabilitation programme will help you and your family choose a healthier lifestyle.

General Advice Section

A heart attack can be a frightening experience, especially if you have until now enjoyed excellent health. While in hospital, many people react with fear and anxiety, possibly made worse by pain and the distress of being in unfamiliar, technical environment.

Most of the risk of life occurs within the first few hours after the heart attack. When the early hours of the attack are safely over, most patients usually feel less anxious.

Many people also feel anxious when the time comes to go home. Away from medical care you may worry about being left alone or what to do if the pain comes back. This early period at home is also difficult for partners. Make sure you have detailed talks with the hospital staff, the cardiac rehabilitation team and your GP about what you should be allowed and encouraged to do. In general though, a gradual return to activity, and doing regular exercise, will help your heart and circulation. A rehabilitation programme is very important at this stage for both you and your partner.

Preventing A Heart Attack

The key to prevention is generally in making lifestyle changes

✓ Eat a healthy diet

✓ Lose weight if necessary.

✓ Stop smoking.

✓ Exercise regularly

✓ Reduce alcohol consumption.

Also, regular checks of the blood pressure, especially if there is a family history of hypertension or heart disease, are important. Advice or treatment can be started before complications arise.

Treatment

A heart attack is treated as an emergency because of the severe pain and the risk to the patients’ life if the heart stops beating (cardiac arrest).

The first priority is treatment to relieve the pain. An aspirin is usually given to chew as this helps to improve the anti- clotting effect of the treatment you will get when you reach the hospital. If the pain is still severe the nurse or doctor will usually inject a powerful painkiller into your vein.

Drugs used to treat a Heart Attack:

The treatment of having had a heart attack involves both a change in lifestyle and, if necessary, the prescription of drugs. In many cases if you have had a heart attack you may be given drugs for three main reasons:

✓ To prevent a further heart attack (for example aspirin, beta-blockers, anti-coagulants - to prevent clotting - or anti-arrhythmic - to stabilise the heart rhythm - drugs)

✓ To relieve breathlessness and heart failure (for example diuretics - 'water tablets')

✓ To treat angina (for example 'nitrates' or beta-blockers)

In addition, if tests show that one or more coronary arteries are severely narrowed and that drug treatment is not likely to be successful, you may be advised to have the following:

✓ Coronary angioplasty

✓ Coronary Bypass Surgery

Manager Section.

Short Term Sickness Absence.

Individuals with heart problems following a heart attack, can suffer short term sickness problems which may be due to medications becoming less effective or arteries becoming more 'blocked'. Those with a positive attitude to illness and who enjoy their work are commonly found to remain in work when perhaps they have not fully recovered, with the result that on odd days they find they are not able to cope and so take time off - but are then very quickly back to work.

Unusually, this is where a manager would perhaps benefit more from encouraging the individual to take more time off to stabilise their condition and return only when they are fit again!

Certain occupations, for example LGV drivers, must meet certain criteria laid down prior to returning to their usual occupations.

Others of course may be 'using' their medical condition to justify frequent short term sickness absence and in this case, the manager may consider asking these questions:

✓ Are you taking mediation and if so at the correct time?

✓ Have you made the lifestyle adjustments that you were advised to do?

✓ Is there anything about your work or working pattern that you believe may be exacerbating any of your symptoms?

✓ Do you see your GP regularly, if not maybe you need a check up?

✓ Would you like to seek advice from our Occupational Health specialist?

Long Term Sickness Absence

Although the severity of heart attacks will vary according to the damage to the heart muscle, a minimum time off work will be about six weeks. This will of course very much depend on the level of physicality required as well as any health standards which may have to be met prior to returning to work.

All cases of long term sickness absence should be referred to the Occupational Health Consultant

Manager Options

✓ Ask employee to see his GP

✓ Use AskLine option to get further advice - click on icon

✓ Refer to Occupational Health Consultant - Link to referral paperwork

Further Information

British Heart Foundation .uk

National Health Service nhs..uk

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