Your heart muscle (myocardium) needs oxygen to survive, and this oxygen comes via blood. When the blood flow to the heart muscle decreases or is completely cut off as a result of the narrowing or complete blockage of the coronary vessels, through which blood carries oxygen to your heart muscle, a heart attack or, as doctors call it, myocardial infarction occurs. Atherosclerosis is defined as the thickening and hardening of the coronary vessels, which carry oxygen to the heart, with structures called plaques, formed by the accumulation of cholesterol and other substances. When the plaque inside the coronary vessels breaks down, the substances released form a blood clot around the plaque. When this clot blocks the vessel and blood cannot reach the heart muscle, that is, the heart muscle is deprived of oxygen, a condition we call ischemia occurs. A heart attack (myocardial infarction) occurs when irreversible damage or cell death occurs in a part of the heart muscle as a result of ischemia.
To Prevent a Heart Attack
There are 3 basic points to protect against heart attack and stroke:
Stop smoking.
Move more.
Pay attention to your diet.
It seems very simple, but why are heart attacks and strokes still the number 1 and 3 deaths in the world? What continues to be the reasons? Because unfortunately, the following heart-healthy suggestions are not always taken into account.
Quit smoking.
Be active every day.
Have a healthy body weight. Use BMI (body mass index) charts for this.
Reduce your blood cholesterol: Do not consume saturated (fats that are solid at room temperature, such as butter) and trans fats (solid margarines), keep total cholesterol below 200 mg/dL. pull. Depending on your risk level, reduce LDL cholesterol to below 160 mg/dL if your risk of heart disease is low, 130 if it is moderate, and 100 mg/dL if it is high.
HDL (good) cholesterol – 40 mg/dL in men and 50 in women. It should be mg/dL or above.
Triglycerides should be less than 150 mg/dL.
Lower blood pressure: Target <120/80 mmHg
If you have diabetes Be sure to get it checked. Because high cholesterol, which is often present in diabetics, The risk of cardiovascular disease has increased 2-4 times due to risk factors such as blood pressure, smoking, obesity and inactivity.
Reduce stress.Stress can cause you to smoke or overeat. may cause.
Limit alcohol. Excess alcohol increases blood pressure and triglyceride levels and may cause heart rhythm disturbance
Diagnostic Methods in Heart Attack
It is not recommended for patients suffering from heart attack. You may have heard that many diagnostic tests or procedures are performed. We think that if you know, even at a basic level, what these tests are and why doctors use them, you will feel safer and you will be able to understand your doctor's explanations more easily about the procedures performed on you, so we deemed it appropriate to explain and convey this information to you. Thanks to tests and other diagnostic methods, your doctor:
Whether you really had a heart attack,
If so, how much damage this attack has caused to your heart,
The damage to the coronary arteries that feed your heart. the degree of the disease (CAD),
If you have not been diagnosed with CAD before, in other words, if this heart attack is the first symptom of the disease in your cardiovascular vessels, what treatment methods and lifestyle changes will be used from now on? It determines that it will protect your heart and prevent you from encountering serious medical problems in the future.
These diagnostic methods are divided intoinvasiveandnon-invasive methods. In medical terms, interventional methods are also known as invasive methods. If a method is invasive, it means that no external tools, liquids, etc. are placed into the patient's body during the application of the method. It means giving.
Interventional methods are very diverse and are used for both diagnosis and treatment purposes. For example, taking blood from a vein for a simple blood test or placing a tube or device into a cavity in the body is an interventional method, while major surgical procedures such as open heart surgeries are also among the interventional methods.
Interventional Diagnosis. Methods:
Blood tests and other invasive diagnostic methods
Blood tests:They confirm that the patient has had a heart attack and determine the extent of the damage caused by the crisis in the heart muscle, what the patient will do in the future. These are some tests that show how much risk you are at, the degree of coronary artery disease, and help determine the most appropriate form of treatment.
Enzymes:In the early stage of a heart attack, the person usually goes to the emergency room first with chest pain. What is requested when you apply are tests that confirm whether the event is a heart attack at an early stage, these are called heart damage indicators or heart enzymes. These enzymes are normally found predominantly in the heart muscle cells. If a person is having a heart attack, they pass into the blood from the damaged heart muscle cells that cannot be fed due to lack of oxygen. Creatine kinase is one of the most commonly used enzyme tests in the diagnosis of heart muscle damage. It is known as CK because of the first letters of the enzyme's English name. A part of this enzyme that is specific to the heart muscle, known asCK-MB, is found in the blood of a person having a heart attack within the first 6 hours after the onset of chest pain (ischemic pain due to lack of oxygen), which is the most important symptom of a heart attack. It increases significantly in the person's blood compared to normal, reaches its highest level in the 18th hour of the event, and decreases again to the level of a normal person within 24-36 hours. However, if the person has had a major crisis or if the crisis is not noticed at an early stage and treatment is not initiated, it may take more than 36 hours for the enzyme to return to normal.
Troponins:Among other blood tests used to confirm a heart attack, Troponins, proteins found in heart muscle cells, are very important. There are different types of troponins, especially troponin T (cTnT) and troponin I (cTnI), which are found at very low levels in the blood of a normal person, but increase significantly in the person's blood compared to normal in the first 4-6 hours after the onset of chest pain. 10-24 of the incident. It reaches its highest level on time and its height lasts for 10-14 days. They are verysensitiveblood tests that allow the detection of damage to the heart muscle that is too small to be detected by the CK-MB test (these are called microinfarcts). .
Triglycerides:They are body fats made in the body or taken externally through food. Obesity, excessive inactivity, smoking, especially excessive alcohol consumption, and excessive consumption of carbohydrate foods such as rice, pasta, bread, pastries, and desserts (60% or more of the total daily calories are carbohydrates) cause triglyceride levels in the blood to be higher than normal. This creates a risk factor for atherosclerosis. This is often accompanied by high blood cholesterol. Many people with heart disease, especially diabetics, have high blood triglyceride levels as a result of excessive triglyceride production in the body.
Other Interventional Diagnostic Methods Other than Blood Tests
Transesophageal (Through the Esophagus) Echocardiography:
Echocardiography is the detailed imaging of the internal structure and functions of the heart, main artery (aorta) and coronary vessels through high-frequency sound waves (ultrasound). is to be examined. In some cases where the commonly used superficial echocardiography (transthoracic) method is insufficient, echocardiography is performed through the esophagus. These situations can be listed as follows: Investigating the presence of clot or infection in the heart, evaluating artificial valve functions, searching for main artery-aortic ruptures, examining heart holes, determining the severity of heart valve insufficiencies, evaluating the success of the procedure during and after heart valve repair or heart hole closure surgeries. .
The procedure takes 10-30 minutes.
Myocardial Perfusion Scintigraphy (Thallium test):
By evaluating the amount of blood reaching the heart muscle, the person is diagnosed with coronary artery disease (CAD). It is an imaging method that helps to understand whether ) is present or not. At the end of the stress test, a radioactive drug (thallium) containing a low amount of radiation is injected intravenously for the film. Thallium reaches the coronary arteries through the blood flow and from there to the heart muscle. Then, with the help of a special camera, images are obtained showing how the administered radioactive substance is distributed in the heart muscle. The images are edited and evaluated with the help of a computer. It is downloaded. The amount of thallium increases or decreases in direct proportion to the amount of blood flowing to the heart muscle. Thus, by imaging the heart muscle fed by the coronary arteries, information is obtained about the degree of stenosis or blockage in the coronary arteries and the extent of damage caused to the heart by a heart attack. It also helps determine the highest level of exercise that a person can perform.
Thallium Test with Exercise Stress
In some people, coronary artery disease occurs only when the heart is under stress and needs more blood. can be detected in some cases. For this reason, thallium testing is usually performed in two studies: at rest and after stress. Exercise to create stress on the heart can be done with the help of a treadmill or bicycle. Exercise helps detect the presence of blockages and narrowings by making the heart work harder and increasing the need for blood. While the person is at the highest level of exercise, thallium is injected into the blood and pictures of the heart muscle are taken via a gamma camera.
Cardiac Catheterizationand Angiography
Heart cavities It is based on the principle of imaging the coronary arteries and coronary arteries while injecting contrast material (a type of medical dye) into the blood from the veins through a tube called a catheter and taking moving movies using "X" rays. It is one of the methods that provides the most useful and accurate information in the diagnosis of cardiovascular diseases. It shows where the arteries are narrowed or blocked, how well the heart muscle is working, and the blood pressure and oxygen level inside the heart. The data obtained are very valuable in directing the treatment and are the main determinant in the choice of treatment strategy in most patients. Thanks to today's technological conditions and knowledge, the success rate of the mentioned procedures is over 99%. The procedure takes 2-3 hours.
Electrophysiological Tests
The heart has a specialized electrical conduction system that enables it to contract. In this system, the signals coming from the main center (sinus node) located in the right atrium pass through an intermediate station (atrioventricular node) located between the atria and ventricles after a short delay.
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