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DESCRIPTIONWhen the supply of blood to the heart is sharply reduced or cut off, the heart is deprived of needed oxygen. If blood flow is not restored within minutes, portions of the heart muscle begin to die, permanently damaging the heart muscle. This process is referred to as myocardial infarction (MI), more commonly known as a heart attack. Because this happens when the coronary arteries cannot provide the heart with sufficient oxygen, health care providers also commonly refer to a heart attack as a "coronary."
A heart attack is not the same thing as heart failure. In heart failure, the heart does not supply enough blood to the body; in a heart attack, the heart does not receive enough blood to meet its needs. However, the damage produced by a heart attack can lead to heart failure.
SIGNS & SYMPTOMS
With the onset of a heart attack, the primary symptom is a consistent deep, often severe, pain in the chest that can spread (radiate) to the left arm, neck, jaw, or the area between the shoulder blades. The pain may be present for up to 12 hours. Many people who have had heart attacks describe it as a heavy, substernal pressure that makes it feel as if the chest is being squeezed. Other possible symptoms include:
- Shortness of breath.
- Sweating.
- Nausea and vomiting.
- Dizziness.
- Extreme weakness, anxiety or shortness of breath.
- Rapid or irregular heartbeats.
- Symptoms last 30 minutes or longer and are not relieved by rest or oral medications (medications taken by mouth).
In addition, a heart attack can cause abnormal heartbeat rhythms called arrhythmias. Arrhythmias result in over 500,000 sudden deaths in the United States each year and the incidence is rising, despite much-improved cardiac resuscitative techniques.
Most people who have heart attacks experience the characteristic chest pain (above). However, not all do. Some people have a sensation that feels like indigestion; others have no noticeable symptoms at all. This phenomenon is often referred to as a "silent" heart attack. Elderly people and people with diabetes are probably more likely than others to have this type of heart attack.
CAUSES
There are three basic scenarios that can produce a heart attack.
The first, and by far the most common, is partial or complete blockage of one of the arteries that supply the heart with oxygen, most often by a blood clot. Usually the arteries have been narrowed by years of coronary artery disease in which plaque, which is composed of cholesterol-rich fatty deposits, proteins, calcium, and excess smooth muscle cells, builds up on the arterial walls. The arterial walls thicken, inhibiting the flow of blood to the heart muscle. The roughening of arterial walls by deposits of plaque not only narrows the arteries, but also makes it easier for blood clots to form along their inner surfaces. When the clot grows, or detaches from its place of origin and travels through the blood vessels, it may block a coronary artery completely, resulting in a heart attack.
In the second heart attack scenario, an arrhythmia may set in, so that the heart is no longer pumping enough blood to ensure its own supply.
In the third, a weak spot in a blood vessel, called an aneurysm, may rupture, causing internal bleeding and disrupting normal blood flow.
Anything that puts extra strain on the heart and/or blood vessels, such as exercise or heavy lifting, may act as a trigger for a heart attack, but such factors are not the underlying cause.
In some cases, heart attacks are caused by spasms of the arteries that suddenly shut off the flow of blood to the heart.
RISK FACTORS
Risk factors for heart attack include:
- Smoking.
- A family history of the disease.
- Hypertension (high blood pressure).
- Diabetes.
- Abnormal/high cholesterol levels and/or triglyceride levels.
- Drug Abuse.
- Sedentary lifestyles.
- Stress and/or are "type A" personalities.
One third of all heart attacks occur without warning. The remainder are preceded by months or even years of symptoms, most commonly angina pectoris (chest pain that is typically aggravated by stress or physical exertion and relieved by rest). Like a heart attack, angina is caused by a lack of oxygen in the heart muscle, but the extent of oxygen deprivation is not sufficient to actually damage heart tissue. Many people complain of intermittent angina, shortness of breath, and/or unusual fatigue in the days or weeks leading up to a heart attack. A constant sensation of heartburn that persists for days and from which antacids provide no relief can be a sign of an impending heart attack.
TREATMENT GENERAL MEASURES
DIAGNOSIS
Once the emergency care team arrives, they will ask you about your symptoms and begin to evaluate you. The diagnosis of the heart attack is based on your symptoms, ECG and the results of your blood tests. The goal of treatment is to treat you quickly and limit heart muscle damage.
DIAGNOSTIC TESTS
ECG. The ECG (also known as EKG or electrocardiogram) can tell how much damage has occurred to your heart muscle and where it has occurred. In addition, your heart rate and rhythm can be monitored.
Blood tests. Blood may be drawn to measure levels of cardiac enzymes in the blood that indicate heart muscle damage. These enzymes are normally found inside the cells of your heart and are needed for their function. When your heart muscle cells are injured, their contents -- including the enzymes -- are released into your bloodstream. By measuring the levels of these enzymes, the health care provider can determine the size of the heart attack and approximately when the heart attack started. Troponin levels will also be measured. Troponins are proteins found inside of heart cells that are released when they are damaged by ischemia. Troponins can detect very small heart attacks as well as those that occurred more than a day after symptoms ensued.
Echocardiography. Echocardiography is an imaging test that can be used during and after a heart attack to learn how the heart is pumping and what areas are not pumping normally. The "echo" can also tell if any structures of the heart (valves, septum, etc.) have been injured during the heart attack.
Cardiac catheterization. Cardiac catheterization, also called cardiac cath, may be used during the first hours of a heart attack if medications are not relieving the ischemia or symptoms. The cardiac cath can be used to directly visualize the blocked artery and help your health care provider determine which procedure is needed to treat the blockage.
CONVENTIONAL MEDICAL TREATMENT
Once heart attack is diagnosed, treatment begins immediately -- possibly in the ambulance or emergency room. Medications and surgical procedures are used to treat a heart attack.
MEDICATION
The goals of medication therapy are to break up or prevent blood clots, prevent platelets from gathering and sticking to the plaque, stabilize the plaque and prevent further ischemia. These medications must be given as soon as possible (within one to two hours from the start of your heart attack) to decrease the amount of heart damage. The longer the delay in starting these drugs, the more damage can occur and the less benefit they can provide. Medications for this purpose may include:
- Aspirin to prevent blood clotting that may worsen the heart attack.
- Antiplatelets to prevent blood clotting.
- Thrombolytic therapy ("clot busters") to dissolve any blood clots that are present in the heart's arteries.
- Any combination of the above.
Other drugs, given during or after a heart attack, lessen your heart's work, improve the functioning of the heart, widen or dilate your blood vessels, decrease your pain and guard against any life-threatening heart rhythms.
OTHER MEDICAL & SURGICAL TREATMENT
During or shortly after a heart attack, you may go to the cardiac catheterization laboratory for direct evaluation of the status of your heart, arteries and the amount of heart damage. In some cases, procedures (such as angioplasty or stents) are used to open up your narrowed or blocked arteries. These procedures may be combined with thrombolytic therapy (drug treatments) to open up the narrowed arteries, as well as to break up any clots that are blocking them.
If necessary, bypass surgery may be performed to restore the heart muscle's supply of blood.
Treatments (medications, open heart surgery and interventional procedures, like angioplasty) do not cure coronary artery disease. Having had a heart attack or treatment does not mean you will never have another heart attack; it can happen again. But, there are several steps you can take to prevent further attacks.
MEDICAL RECOMMENDATION FOR HEART ATTACK PREVENTION
The goal after your heart attack is to keep your heart healthy and reduce your risks of having another heart attack. Your best bet to ward off future attacks are to take your medications, change your lifestyle, and see your health care provider for regular heart checkups.
You need to continue taking medications that have been prescribed after a heart attack to:
- Prevent future blood clots.
- Lessen the work of your heart and improve your heart's performance and recovery.
- Lower cholesterol.
- Other medications may be prescribed if needed. These include medications to treat irregular heartbeats, lower blood pressure, control angina and treat heart failure.
It is important to know the names of your medications, what they are used for and how often and at what times you need to take them. Your health care provider should review your medications with you. Keep a list of your medications and bring them to each of your health care visits. If you have questions about your medications, ask your health care provider or pharmacist.
You will need to review what lifestyle changes you will need to make with your health care provider. There is no cure for coronary artery disease. In order to prevent the progression of this disease, you must follow your health care provider's advice and make necessary lifestyle changes. You can stop smoking, lower your blood cholesterol, control your diabetes and high blood pressure, follow an exercise plan, lose weight, and control stress.
After you leave the hospital you will need to make a health care provider's appointment for four to six weeks after hospital release. Your health care provider will want to check the progress of your recovery. Your health care provider may ask you to undergo diagnostic tests (such as an exercise stress test at regular intervals. These tests can help your health care provider diagnose the presence or progression of blockages in your coronary arteries and plan treatment.
Call your health care provider sooner if you have symptoms such as chest pain that becomes more frequent, increases in intensity, lasts longer, or spreads to other areas; shortness of breath, especially at rest; dizziness, or irregular heartbeats.
HOME & HOLISTIC TREATMENT
Before taking any nutritional supplement or home treatment, consult with your health care provider. Some supplements may interfere or adversely react with prescribed medications. Know what you are taking and know all contraindications.
In a study involving people who adopted a vegetarian diet that restricted fat intake to 10 percent of total calories, these people showed a significant regression of advanced coronary artery disease after one year. The diet also limited dietary cholesterol to no more than 5 milligrams (mg) per day. In contrast, most Americans consume 37 percent of their total calories as fats, and 300 to 500 mg of dietary cholesterol each day.
Kombucha tea may help prevent and treat arteriosclerosis. See Kombucha Tea for more information.
Dehydroepiandrosterone (DHEA) is a natural hormone that has been shown to help prevent hardening of the arteries.
MoonDragon's Health Therapies: DHEA Therapy
Chelation therapy can break up arterial plaque and improve circulation.
Hyperbaric oxygen therapy (HBOT) is used in some countries to treat and improve circulation.
Many health care providers recommend angioplasty or bypass surgery for people with hardening of the arteries, particularly for those with disabling angina. Angioplasty is a procedure in which blocked vessels are reopened by flattening cholesterol and debris against artery walls. Bypass surgery involves taking healthy blood vessels from elsewhere in the body (usually the leg) and inserting them to detour around a diseased coronary artery. Unless people undergoing these procedures make significant nutritional and lifestyle changes, however, the disease process (arteriosclerosis) will continue, and it is only a matter of time before the fatty deposits begin to build up again.
Anticoagulants such as aspirin are often prescribed to make the blood less prone to clotting. For this to be effective, supplemental vitamin K and foods rich in vitamin K must be avoided.
Impotence can result from arterial disease.
DIET, HERBAL SUPPLEMENTS & NUTRIENTS
Eat high-fiber foods that are low in fat and cholesterol. Fruits, vegetables, and grains should be your main foods.
Include in your diet almonds, brewer's yeast, and sesame seeds.
Researcher have found that eating just an ounce of walnuts a day (about 7 nuts) may reduce the risk of a heart attack by 8 to 10 percent.
Add kelp and sea vegetables to your diet for necessary minerals. Drink plenty of fresh vegetable juices. See Nutrition Therapy: Juicing for more information.
Eat plenty of foods rich in vitamin E to improve circulation. Good choices include dark green leafy vegetables, legumes, nuts, seeds, soybeans, wheat germ, and whole grains.
Use only pure cold-pressed olive oil or unrefined canola oil (in moderate amounts) as fats in the diet. These may aid in lowering cholesterol. Do not heat these oils.
Sip barley water throughout the day for its healing and fortifying properties. See Barley Water and Therapeutic Liquids for more information.
Drink steam-distilled water only.
Do not eat any candies, chips, fried foods, gravies, high cholesterol foods, junk foods, pies, processed foods, red meat, or saturated fats. Avoid egg yolks, ice cream, salt, and all foods containing white flour and/or sugar. Refined sugars produce adverse reaction in all cells by causing wide variations in blood sugar. The high surges are followed by hypoglycemic drops, causing dangerous instability in vital intracellular sugar levels. Do not use stimulants such as coffee, black tea, colas, and tobacco; also eliminate alcohol and highly spiced foods. Alcohol has a direct toxic effect on the heart. If you do occasionally drink, avoid cod liver oil.
Minimize your intake of vitamin D, and do not obtain it from whole milk or any dairy product that is high in fat. Consumption of these contributes to clogged arteries. Moderate consumption of skim milk and low-fat yogurt is acceptable.
Studies have shown that people who take supplemental coenzyme Q10 following a heart attack are less likely than those who did not to have a second heart attack within five years.
Maintain a healthy weight for your height. Obesity causes unfavorable changes in serum lipoprotein levels.
Reduce stress and learn techniques to help you handle stress that cannot be avoided. To relieve stress and promote relaxation, add a few drops of lavender, sandalwood, or ylang ylang essential oil to a bath, or simply place a few drops on a tissue and inhale the aroma from time to time throughout the day.
Get sensible, regular moderate exercise. A daily walk is good. When combined with a proper diet with nutritional supplements can prevent arteriosclerosis of the coronary arteries and myocardial infarction. Caution: If you are over 35 and/or have been sedentary from some time, consult with your health care provider before beginning any type of exercise program.
Periodically monitor your blood pressure, and take steps to lower it if necessary. Control of high blood pressure is important.
Do not smoke. Avoid exposure to secondhand smoke. Cigarette smoke contains large quantities of free radicals, many of which are known to oxidize low-density lipoproteins (LDL, the so-called "bad cholesterol"), making them more likely to be deposited on the walls of blood vessels. The free radical is one of the primary factors in the development of atherosclerosis. The effect of cigarette smoke may be due to the direct oxidation of lipids and proteins, and it may also have indirect effects, such as the depletion of various antioxidant defenses, which then allows other cellular processes (inflammation, for example) to modify LDL. In addition, smoking increases levels of LDL, lowers levels of high density lipoproteins (HDL, or "good cholesterol"), and increases the blood's tendency to form clots.
Do not take any preparation containing shark cartilage unless specifically directed to do so by your health care provider. Shark cartilage may inhibit the formation of new blood vessels, the mechanism by which the body can increase circulatory capacity.
Fast three days a month to cleanse and detoxify the body. See Fasting for more information.
NUTRIENTS Supplement Suggested Dosage Comments Essential Choline
And
InositolAs directed on label, to supply up to 1,000 mg choline daily. These substances aid in the removal of fat from the liver and bloodstream. Coenzyme Q10 100 mg daily. Improves heart muscle and tissue oxygenation and may help prevent a second heart attack. Vitamin E Start with 200 IU daily and increase slowly to 800 IU daily. If you are taking an anticoagulant drug, do not exceed 400 IU daily except under a health care provider's supervision. A powerful antioxidant that improves circulation and thins the blood, reducing the risk of clots. Selenium 300 mcg daily. Deficiency has been implicated in heart disease. Grape seed extract 150-300 mg daily. A powerful antioxidant. Best used in combination with phosphatidyl choline, a natural component of lecithin. Very Important L-cysteine
And
L-Methionine
Plus
L-carnitine or Acetyl-L-Carnitine500 mg daily, on an empty stomach. Take with water or juice. Do not take with milk. Take with 50 mg vitamin B6 and 100 mg vitamin C for better absorption. To reduce blood lipid levels, increase cellular glutathione and coenzyme Q 10, protect against lipid peroxidation, and assist in the breakdown of fats, preventing fatty buildup in the arteries, which helps restore blood flow to the heart. Calcium
And
Magnesium1,500 mg daily, taken at bedtime.
1,000 mg daily, in divided doses, between meals and taken at bedtime.Important for maintaining proper heart rhythm and blood pressure. Use chelate forms.. Chromium 100 mcg daily. Helps raise levels of HDL ("good" cholesterol). Essential fatty acids (primrose oil and salmon oil are good sources) As directed on label. Protects heart muscle cells. Garlic (Kyolic) 2 capsules 3 times daily. Beneficial for the heart, promotes circulation, and aids in reducing high blood pressure. Glucosamine Plus
from FoodScience LabsAs directed on label. Plays an important role in the formation of heart valves. Heart Science
from Source NaturalsAs directed on label. Contains antioxidants, cholesterol-fighters, herbs, and vitamins that work together to promote cardiovascular function. Multienzyme complex As directed on label. Take with meals. Important for proper digestion and to prevent heartburn. Proteolytic enzymes As directed on label. Take between meals. Anti-inflammatory agents that prevent free radical damage to the arteries. Aids in destroying free radicals. Essential for assimilation of protein, aids digestion and rebuilding of tissue. Sea mussel As directed on label. Aids in the functioning of the cardiovascular system, the lymphatic system, and the endocrine system. Vitamin A As directed on label. If you are pregnant, do not exceed 10,000 IU daily. A potent antioxidant and free radical scavenger, helps to prevent free radical damage to the arteries. Use emulsion form for easier assimilation. Plus
Natural beta-carotene10,000 IU daily. An antioxidant and precursor of vitamin A. Zinc 50 mg daily. Do not exceed a total of 100 mg daily from all supplements. Necessary for proper balance with copper and for thiamine utilization. Use chelate forms. Plus
Copper3 mg daily. Deficiency has been linked to heart disease. Used to balance with zinc. Important Dimethylglycine (DMG)
(Aangamik DMG from FoodScience Labs)As directed on label. Improves heart tissue oxygenation. Vitamin B complex
plus extra
Vitamin B1 (thiamine)
And
Vitamin B12
And
Folic acid50 mg 3 times daily.
500 mg 3 times daily, with meals.
2,000 mcg daily.
400 mcg daily.The B vitamins work together as a complex taken together. Thiamine deficiency in the heart muscle leads to heart disease. Deficiencies of vitamin B12 and folic acid have been linked to heart disease. Pycnogenol As directed on label. Neutralizes free radicals, enhances the action of vitamin C, and strengthens connective tissue, including that of the cardiovascular system. Vitamin C
With
Bioflavonoids3,000-6,000 mg daily, in divided doses. Antioxidant that acts as a free radical scavenger. Aids in thinning the blood. Prevents blood clots and free radical damage. HERBS
Alfalfa, borage seed, horsetail, nettle, and pau d'arco are rich in minerals necessary for proper regulation of heart rhythm.
Black cohosh, oat straw, passion flower, valerian root, skullcap, and wood betony are calming herbs that may help to regulate arrhythmias.
Butcher's broom, hawthorn berries and leaf, motherwort, and red sage strengthen the heart muscle.
Cayenne (capsicum), ginger root, and ginkgo biloba strengthen the heart and are helpful for chest pain.
Green tea has superb antioxidant properties. Drinking 10 to 20 cups a day can provide protection against heart disease and many other illnesses.
The following herbs are helpful if you suffer from arteriosclerosis: Cayenne (capsicum), chickweed, ginkgo biloba extract, and hawthorn berries.
Citrin is an herbal extract that inhibits the synthesis of potentially dangerous fats in the body.
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NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You have symptoms of arteriosclerosis or atherosclerosis or observe them in a family member.
Life-threatening symptoms occur, including rapid, irregular heartbeat; chest pain; or loss of consciousness. Call for assistance immediately (usually 911)... THIS IS AN EMERGENCY!! Quick treatment to open the blocked artery is essential to lessen the amount of damage. At the first signs of a heart attack, call for emergency treatment. The best time to treat a heart attack is within one to two hours of the first onset of symptoms. Waiting longer than that increases the damage to your heart and reduces your chance of survival. Keep in mind that chest discomfort can be described in many ways. It can occur in the chest or the arms, back, or jaw. If you have symptoms, take notice. These are your heart disease warning signs. Seek medical care immediately.
If any unexpected or unusual symptoms appear. Therapies, supplements, medications or other treatments may produce side effects in some individuals.
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch
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