Coronary arteries, which supply the heart with oxygenated blood, can slowly narrow due to a build-up of plaque leading to angina. In a heart attack, there is a sudden plaque rupture leading to blood clot formation, blocking the artery.
In spite of the treatment given, there is still a 10% mortality rate in patients with a heart attack. This is usually caused by abnormal heart rhythm (ventricular fibrillation) due to electrical instability of the heart or heart failure due to a massive heart attack. Occasionally, the heart muscle can rupture after a heart attack and this is usually fatal.
The diagnosis of heart attack is based on three findings:
An early diagnosis is crucial to the treatment of a heart attack as it allows interventional cardiologists to open up the blocked artery quickly and effectively to minimise the extent of damage to the heart muscle. Currently, there are two treatment options to remove the blockage in the artery. The fastest way to treat a heart attack is to give a powerful blood-thinning medication (thrombolytic agents) to dissolve the clot and therefore remove the blockage in the artery. Any qualified physician can administer this immediately upon diagnosis of a heart attack. However, it is only effective in slightly more than 50% of the patients and may cause serious bleeding complications in other areas, including the brain.
A more effective way to unblock the artery is by inserting a balloon or stent through a small puncture in the groin or wrist to open up the artery This procedure is known as coronary angioplasty and has been successful in more than 90% of the cases. However, this is a procedure needs to be performed in the procedure suite or catheterisation laboratory and requires experienced operators. At the National Heart Centre Singapore (NHCS), emergency angioplasty for patients who are admitted for heart attack is available round the clock.
A balloon is inserted into the narrowed or blocked artery through a stent and inflated
As a heart attack is serious and can be fatal, immediate medical attention should be sought when one experiences any sort of chest pain or discomfort which is not relieved by rest or medication.One should follow the following steps when encountering a heart attack episode: