Since the last few years, heart attacks have become a disease that is on the rise. It's not uncommon for us to hear news from acquaintances, or relatively young relatives who died suddenly and said it was due to a heart attack. Public attention to heart attacks is also increasingly widespread because the disease also attacks celebrities and is widely reported by the media. Meanwhile, ring burning is often the main treatment strategy and must be done immediately. Why is that? On this occasion, the author will try to explain what is meant by a heart attack, what happens in our body during a heart attack and its effects, and why placing rings is the main therapy that must be done immediately.
What is a heart attack?
Heart attack is one form of presentation of coronary heart disease. The heart is an organ consisting of muscles that works to pump blood throughout the body through blood vessels, so that the heart is responsible for the availability of nutrients and oxygen to the organs of the body, as well as the disposal of the remains of burning organs of the body. The heart muscle itself also needs access to nutrients, oxygen, and elimination pathways like other organs, and the heart muscle gets that access through the coronary arteries.
A person is said to suffer from coronary heart disease when the coronary arteries experience narrowing or blockage due to the process of atherosclerosis (fat accumulation and calcification in the blood vessel walls) which interferes with the availability of nutrients and oxygen for the heart muscle, as a result the heart muscle can experience decreased function, temporary, to permanent damage. .
Coronary heart disease has two main presentations. The first is stable coronary heart disease. This condition generally appears in the form of chest pain, heartburn, chest feeling heavy, or hot, triggered when the heart works harder than usual, such as when a person is physically active, or experiences emotional stress, but the symptoms are not prolonged, and disappear when resting. These symptoms are called stable angina pectoris. The second is a condition where chest pain is said to be unstable or angina pectoris is unstable, is a condition where the above complaints appear suddenly, or at minimal activity or rest, the duration is longer for more than 20 minutes, and does not subside with rest, can also be accompanied by cold sweat , nausea, vomiting, and shortness of breath. In the next evaluation at the emergency department, if it is proven that these symptoms are indeed due to coronary heart disease, then the individual is said to have suffered a heart attack, or hereinafter referred to as acute coronary syndrome (ACS).
In stable coronary heart disease, the process of narrowing or blockage is slow and chronic. New symptoms will appear when the narrowing is severe enough and interferes with the flow of the coronary arteries. In this condition, various evaluations can be carried out to assess the severity of the disturbance in blood supply to the heart, as well as to determine the initial treatment strategy, whether with medication or if further action is required. However, in ACS, there is erosion or rupture of the surface of the fat clot due to atherosclerosis, and is followed by the sudden formation of a blood clot (thrombosis) in a short time, so that the flow of the coronary arteries and the blood supply to the heart muscle stops suddenly. Heart muscle that does not get a blood supply will experience damage to its cells, which causes a sensation of chest pain in the form of unstable angina pectoris.
The effects of a heart attack on our bodies
Damage to heart muscle cells does not only give the sensation of chest pain alone. There are further complications in ACS, including:
- Disruption of the pumping function of the heart, so that blood is blocked in the lungs, causing shortness of breath and disrupting the blood supply throughout the body and vital organs such as the brain and kidneys, this condition is also called acute heart failure.
- Disruption of the electrical activity of the heart muscle, so that the heart rate can become too fast, too slow, or irregular, to stop beating suddenly and cause fainting or sudden death.
- Tear of the valves, septum or wall of the heart if the damage to the heart muscles is very extensive, this condition is also very fatal and the life expectancy is very low even though treatment has been carried out as soon as possible and as optimally as possible. These complications cause a heart attack to become a very dangerous and potentially fatal condition in a short time and suddenly.
Of course not all heart attacks will be fatal suddenly. Many people experience a heart attack and go through the treatment phase or even do not undergo treatment because they do not know that the symptoms they feel as a heart attack feel healthy again and continue their daily activities. However, permanent damage to the heart muscle over a period of time will gradually reduce the pumping function of the heart. Patients with a heart attack will feel more easily tired, have shortness of breath, and can be accompanied by swelling of the legs and stomach due to the gradual buildup of body fluids in the lungs, lower legs and stomach. This condition is also called chronic heart failure.
People with chronic heart failure will continue to worsen their symptoms if left untreated, and will depend on many drugs given throughout their lives to function daily with minimal symptoms, and are also at greater risk of having a recurrent heart attack and sudden cardiac death.
Ring placement in heart attacks as a solution
Ring placement in the coronary arteries or hereinafter referred to as Percutaneous Coronary Intervention (PCI), is a procedure to open narrowing/blockages due to atherosclerotic plaques or blood clots in the coronary arteries with the aim of restoring blood supply to the heart muscle, so that in addition to relieving symptoms of chest pain, can keep the heart muscle healthy and functioning as it should. In cases of stable coronary heart disease, the heart still gets blood supply even though it is inadequate so that the heart muscle is still alive even though its function is disrupted and PCI can be determined at the time according to the patient's wishes. However, in ACS, the blood supply to the heart muscle stops completely and the heart muscle cells will die permanently within minutes to hours with severe damage, so that in ACS, return of blood supply to the heart muscle with PCI must be done as soon as possible to stop it. process of damage and death of cardiac muscle cells as quickly as possible.
If PCI is carried out in a long period of time since the occurrence of a heart attack, the damage to the heart muscles may already be more severe, so that sufferers have a greater chance of experiencing more extensive heart muscle damage. This has several negative impacts including: 1) longer treatment time with more drugs and more expensive costs. 2) More severe heart failure occurs, so that heart attack sufferers will depend on more drugs, potential for repeated hospitalizations, higher medical costs, and quality of daily life and productivity is disrupted due to symptoms of heart failure. Meanwhile, if it is done as early as possible, it is hoped that the damage to the heart muscle cells will still be minimal, and the patient will not fall into a condition of heart failure either immediately or in the distant future, so that after treatment for a heart attack, the quality of life is relatively better with minimal symptoms and lower routine medical expenses. low.
Therefore, it is very important for the community to know the factors that put a person at risk of having a heart attack, quickly recognize the symptoms and signs of a heart attack, ask for help as soon as possible to an adequate health facility, and make the right and quick decisions on steps. heart attack management such as intensive care and PCI action. Handling a heart attack quickly and precisely will allow sufferers to go through the treatment period with more preserved heart function, continue daily life with minimal symptoms, better quality of life, and lower routine medical costs.
Article written by dr. Aron Husink, Sp.JP (K) FIHA , Cardiologist and Blood Vessel Specialist at EMC Tangerang Hospital . For Dr. Aron's practice hours, Monday and Wednesday at 19.00 – 20.00.
Education & Training dr. Aron Husink, Sp.JP (K) FIHA :
2006 - Faculty of Medicine, University of Indonesia (Bachelor of Medicine/B.med)
2008 - Faculty of Medicine, University of Indonesia (Medical Doctor/MD)
2015 - Faculty of Medicine, University of Indonesia, Resident in Cardiology and Vascular Medicine (Fellowship of Indonesian Heart Association/FIHA)
2016 - 1st Winner of Young Investigator Award at 25th ASMIHA, Jakarta. Title of Paper: Harapan Kita Score as Predictor of In-Hospital Mortality and Morbidity after Heart Valve Surgery
2017 - 1st Winner of Oral Case Presentation of the 9th ISICAM-InaLIVE. “When the Savior Becomes the Devil: Trapped and Fractured Side Branch Wire”
2018 - One Belt and One Road Interventional Cardiology Training Program. Collaboration between Indonesian Society of Interventional Cardiology and China Cardiovascular Association
Practice schedule :
Monday, 19.00 – 20.00 WIB.
Wednesday, 19.00 – 20.00 WIB.