Myocardial infarction
Cardiovascular diseases are the most common cause of death worldwide and in Switzerland. Every year, around 30,000 people in Switzerland suffer a heart attack. The faster the diagnosis is made and targeted heart attack treatment can be initiated, the higher the patient's chances of survival.
A heart attack is an emergency situation. Act quickly and call the emergency number 144! Avoid driving yourself to hospital or having your relatives drive you.
Patients with a heart attack are hospitalized as an emergency at a central hospital. Once the diagnosis has been made, treatment is initiated in hospital with a cardiac catheter. The aim is to reopen the blocked coronary artery as quickly as possible, restore the function of the heart and prevent permanent damage to the heart.
The main task of the heart is to maintain blood circulation and thus the supply of oxygen to the body. The coronary vessels supply the heart muscle with blood. A heart attack is caused by a narrowing or even blockage of a coronary vessel. A sudden occlusion of such a vessel jeopardizes the blood flow and oxygen supply to the heart muscle.
A heart attack is usually the result of a disease of the coronary arteries, known as coronary heart disease. The most common cause of a heart attack is a blockage of a coronary artery.
In most cases, an atherosclerotic plaque in the vessel wall favors the formation of a blood clot. The deposition of blood lipids, inflammatory cells and connective tissue in the vessel wall leads to the formation of an atherosclerotic plaque over the years, which narrows the vessel. This can lead to a reduction in blood flow. If such a plaque ruptures, i.e. if it becomes unstable, the atherosclerotic material comes into contact with the blood and leads to the formation of a blood clot. A blood clot then causes a partial or complete blockage of the coronary artery. If a clot blocks a coronary artery, the blood flow to the heart muscle is interrupted and a heart attack occurs.
The development and progression of atherosclerosis is favored by risk factors over many years. In addition to increasing age and male gender, the risk factors for a heart attack include smoking, high blood pressure, diabetes, high cholesterol, lack of exercise and obesity. It is therefore important to optimally control these risk factors through lifestyle changes and medication. This reduces the risk of the development or progression of atherosclerosis. Some people also have a certain predisposition, a family history, to developing atherosclerosis.
However, a heart attack can also occur without previous atherosclerotic changes in the coronary arteries. Such a clinical picture can be due to various causes such as a tear in the vessel wall (coronary dissection), an embolism (coronary embolism), a spasm of the coronary vessels or a functional disorder of the small coronary vessels (microvascular dysfunction). Emergency diagnostics and targeted therapy are also important for these clinical pictures.
Preventing a heart attack requires a combination of a healthy lifestyle and medical care. A balanced diet with plenty of fruit, vegetables, wholegrain products and healthy fats can significantly reduce the risk. Regular physical activity, such as at least 150 minutes of moderate exercise per week, strengthens the cardiovascular system. Quitting smoking is essential, as smoking significantly increases the risk of a heart attack. In addition, risk factors such as high blood pressure, diabetes and high cholesterol levels should be controlled by regular medical examinations and, if necessary, drug therapy. A conscious approach to stress, sufficient sleep and avoiding excessive alcohol consumption also contribute to heart health. Regular check-ups and close cooperation with the family doctor are important components of prevention.
Many heart attacks come out of nowhere. Sudden severe chest pain occurs, typically of a pressing nature, sometimes radiating into the arm or neck. However, a heart attack does not always manifest itself with these typical symptoms. Atypical symptoms such as nausea, tiredness or abdominal pain are frequently observed, particularly in women, diabetics or older patients. As a result, those affected usually underestimate the symptoms and it is more difficult to recognize a heart attack quickly.
It is also possible for a heart attack to occur completely without symptoms, in which case it is referred to as a “silent heart attack”.
The following symptoms indicate a heart attack:
The symptoms of a heart attack in women can be more subtle and less obvious than in men, which can lead to a delayed diagnosis. Women often experience atypical symptoms such as nausea, vomiting, back pain, sore jaw or throat and severe fatigue. Chest pain or pressure can also occur, but is often less intense than in men. Shortness of breath, dizziness or a general feeling of discomfort and anxiety can also be signs of a heart attack in women. As these symptoms are not always an obvious indication of a heart attack, it is important that women take these unspecific signs seriously and seek medical help in good time.
Even if symptoms can be unspecific and unclear, emergency diagnosis and treatment of heart attack patients is important. So do not hesitate to call the emergency services or go to a central hospital if you experience sudden symptoms. The doctor can then initiate the necessary diagnostic and therapeutic steps.
We use various methods for diagnosis: an electrocardiogram (ECG) maps the heart’s current curve and enables signs of a circulatory disorder in the heart muscle or a heart attack to be identified immediately. A blood test makes it possible to measure heart markers that are released when heart muscle cells die. The diagnosis of a heart attack can be made quickly and reliably on the basis of these examinations.
A heart attack is a medical emergency that requires immediate attention and prompt treatment. It is important to act quickly to minimize the damage to the heart and increase the chances of survival.
Once a heart attack has been diagnosed, important medication is administered immediately to stop the formation of clots. Blood-thinning medications include aspirin and heparin. Pain medication such as morphine relieves the pain of a heart attack. Oxygen is also administered if necessary. If there are signs of a blockage or severe narrowing of a coronary vessel, an emergency cardiac catheterization, known as coronary angiography, is performed. During this examination, a catheter is inserted via the artery in the arm or groin to the heart. By injecting contrast medium into the coronary arteries, a blockage in a coronary vessel can then be identified, localized and treated immediately afterwards.
Depending on the location of the vessel, it is referred to as an anterior wall, posterior wall or lateral wall infarction.
To treat a vascular occlusion, the vessel is opened, dilated using a balloon catheter and then usually treated by inserting a fine metal tube, a so-called stent (coronary angioplasty). This can normalize the blood flow and keep the vessel open in the further course. Patients with a major heart attack sometimes require circulatory support in the form of medication or circulatory support systems, as well as treatment in the intensive care unit.
After immediate treatment with blood-thinning medication and opening of the coronary artery in the cardiac catheterization laboratory, long-term secondary prevention is important. This includes lifestyle changes and drug therapies to control the risk factors. The use of a blood-thinning medication is permanently recommended for patients who have suffered a heart attack. In the first year after implantation of a stent, another medication is also administered to inhibit the blood platelets. Taking a cholesterol-lowering agent is also central to the treatment of patients after a heart attack.
A healthy lifestyle with regular physical activity, a balanced, healthy diet and stopping smoking is essential in heart attack aftercare. These measures not only have a positive effect on the blood vessels, but also on the development of numerous other diseases. Structured rehabilitation is therefore usually carried out after a heart attack in order to restore physical performance.
The prognosis of a heart attack depends above all on how quickly the affected person is admitted to hospital and how much heart muscle is supplied by the affected coronary artery. In addition, the prognosis is strongly influenced by whether the patient has suffered a dangerous arrhythmia outside the hospital and has lost consciousness. Patients who survive the first few days after a heart attack often have a good prognosis, especially if typical risk factors such as tobacco consumption or obesity are reduced later on.
Prompt treatment is very important, as blood flow to the heart must be restored as quickly as possible. It is therefore crucial to call the 144 emergency services in good time. If too much time passes between the infarction and therapy, the affected heart tissue dies and is unable to recover.
During a heart attack, a life-threatening cardiac arrhythmia or cardiac arrest may occur. Cardiac arr hythmias can lead to cardiac arrest and require immediate resuscitation measures. Immediate cardiac massage and defibrillation can save people in cardiac arrest.
Rare complications of a heart attack include dysfunction of a heart valve or – particularly in the case of long-lasting heart attacks – a tear in the heart muscle.
A heart attack can be announced days or even weeks in advance by symptoms such as recurring chest pain (angina pectoris) or general malaise, but it often occurs suddenly without any prior warning signs.
In a heart attack, the blood flow to part of the heart muscle is blocked by a blood clot, which leads to the death of the heart tissue.
Although high blood pressure (hypertension) is a risk factor for a heart attack, it is not particularly significant for the diagnosis of a heart attack. In reality, blood pressure can be both low and normal before a heart attack, but it can also increase due to the stressful situation.
Yes, women often show more non-specific symptoms such as nausea, back pain and severe fatigue, while men typically experience intense chest pain and pressure.
