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Health and Disease

Management for Heart Attacks: Angioplasty and Bypasses

An article to explore the causes and pathology of heart attacks and potential treatment options.

By Sophie Farr

Published 7:21 PM EST, Wed April 21, 2021

What Is A Heart Attack?

Throughout our lives, deposits of saturated fats called plaques can build up in the arteries of our hearts because of high cholesterol levels. Over time, this can lead to the restriction of blood flow due to vessel narrowing. These fatty deposits can lead to a complete blockage of an artery because of formed blood clots. If this occurs in the coronary artery, oxygenated blood may be prevented from reaching the heart muscle tissue. Without this vital oxygen, which is needed for aerobic respiration and normal cell function, the heart muscle can begin to die. The longer the blockage continues, the more damage can be done to the heart;this effect is known as a heart attack. In the worst case scenario, if the clot is dislodged and becomes mobile, it may travel to different areas of the body and, when it reaches the brain, could cause a stroke. 

What Are The Risk Factors For Heart Attacks?

Your risk of having a heart attack is increased by both hereditary and lifestyle factors. Firstly, a diet full of saturated fats, such as butter, cakes and bacon, increases the LDL (low-density lipoprotein) cholesterol in your blood, leading to more fat deposits. Furthermore, a sedentary lifestyle means that deposits build up more readily; smoking can also cause this effect. Another key risk factor is genetics. Men are more likely to suffer from a heart attack than women. Stress hormones, such as cortisol, can increase your heart rate which, in turn, causes more fat deposits in arteries. 

What Are The Symptoms Of A Heart Attack?

The main symptom of a heart attack is severe chest pain which may radiate across the left arm, shoulder or even abdomen. Sufferers describe this pain to be “crushing” and “vice-like”, which can cause patients to collapse and be unable to perform daily activities. Despite some cases having extreme and visible symptoms, women and the elderly are more likely to experience lesser symptoms such as mild discomfort, agitation, lethargy and weakness. 

What Is The Immediate Response In Case Of A Heart Attack?

Treating heart attacks is a key part of most first aid qualifications. If you encounter a suspected heart attack, the crucial thing is to call emergency services as soon as possible to ensure the patient receives required treatment quickly. While you wait for further assistance, the pain of a heart attack can be partially relieved by sitting the patient in the “W” position. This refers to sitting on the floor, against a wall, and bringing your knees upwards to create a “W” shape. If there is access to medication, the patient should chew a 325mg aspirin, which works to thin their blood. This would allow potential blood flow through a blockage. 

Coronary Angioplasty

Coronary angioplasty is a medical technique that attempts to relieve the blockage by expanding the artery. Not all hospitals have access to the resources required to undertake this complicated procedure. Therefore, ambulances always attempt to take patients with suspected heart attacks to advanced cardiology units such as the Royal Papworth. Coronary angioplasties are usually done through a large vessel in the groin (the femoral artery) or the arm. A catheter, with a deflated balloon attached, is threaded through to the potential site of the blockage. Once the afflicted area is reached, the balloon can be inflated which expands the artery and relieves the blockage, allowing oxygenated blood to reach the heart. Commonly, a stent is also placed in the affected artery to hold it open to prevent further damage from deposits. These are typically made of a flexible metal and aid disease management into the future. 

Coronary Bypass

A coronary bypass involves taking a blood vessel from either the arms (radial arteries), chest (internal mammary arteries), or legs (greater saphenous veins) and reattaching it to the heart. This redirects blood flow to ensure oxygenated blood reaches the heart. The blood vessel created is referred to as a graft, and the whole procedure is done in 3-6 hours under general anesthetic. If there is a risk of a patient experiencing further damage to the heart in the same area, or another heart attack, this graft can help to lower the risk.

Sophie Farr, Youth Medical Journal 2021

References

NHS England, “Treatments for Heart Attacks”, Accessed March 2021 from: https://www.nhs.uk/conditions/heart-attack/treatment/#:~:text=Primary%20percutaneous%20coronary%20intervention%20(PCI),-Primary%20percutaneous%20coronary&text=It’s%20a%20procedure%20to%20widen,such%20as%20low%2Ddose%20aspirin.

NHS England, “Coronary Artery Bypass”, Accessed March 2021 from:

https://www.nhs.uk/conditions/coronary-artery-bypass-graft-cabg/

Mayo Clinic, “Cardiac Catheterization” Accessed March 2021 from: 

https://www.mayoclinic.org/tests-procedures/cardiac-catheterization/about/pac-20384695

By Sophie Farr

I am a student from the UK and my ambition is to become a doctor.

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