This blood supply travels to the heart muscle by way of small coronary arteries. These are normally able to respond to varying demands which the heart muscle makes by dilating (opening wider) or constricting (narrowing). When the heart speeds up, it requires more energy to do the extra work; so the coronary arteries dilate and deliver more oxygen to the heart muscles.
As the heart returns to its resting mode, less oxygen is required and the coronary arteries constrict to their original size. However, things sometimes go wrong with the coronary arteries, and the outcome can be either angina or a heart attack.
Angina is a specific type of pain in the chest caused by inadequate blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium).
It is brought on by exercise or effort and eases at rest or by using medication .
Symptoms include :
A feeling of tightness, heavy pressure, or squeezing or crushing chest pain that is
• Under the breastbone or slightly to the left
• Not clearly focused in one spot
• May radiate to shoulder, arm, jaw, neck, back, or other areas
• May feel similar to gas or indigestion.
• Is precipitated by activity, stress, or exertion
• Lasts 1 to 15 minutes
• Usually relieved by rest or nitro-glycerine
The pain varies from a dull ache to a sensation often described as a tight band around the chest and it rarely lasts longer than fifteen minutes on complete rest.
What is a Heart Attack?
A heart attack (also called a coronary thrombosis or myocardial infarction), is caused by a complete blockage of one of the coronary arteries. As a result, one part of the heart muscle is permanently deprived of oxygen. The blockage is often caused by a blood clot formed inside a coronary artery.
Most heart attacks are caused by a clot blocking one of the coronary arteries (the blood vessels bringing blood and oxygen to the heart muscle). The clot usually forms in a coronary artery previously narrowed from changes related to a condition called atherosclerosis.
The atherosclerotic plaque (or build up) inside the arterial wall sometimes cracks, and triggers the formation of a clot, also called a thrombus.
A clot in the coronary artery interrupts the flow of blood and oxygen to the heart muscle, leading to the death of heart cells in that area. The damaged heart muscle loses its ability to contract, and the remaining heart muscle needs to compensate for that weakened area.
In the first few days after a heart attack, the heart can be rather irritable with an accompanying erratic heart rate. This is why continuous observation in a health care setting is vital in those first few days.
Permanent damage to the heart can follow persistent total blockage of the coronary artery as the affected area of heart muscle forms a scar. Depending on the scar's exact location, it may be left weaker in its pumping action or there may be no noticeable impairment at all.
As the scar becomes fully formed, the heart stabilises and this surveillance is no longer required. Active rehabilitation ensures most people with uncomplicated heart attacks are able to lead perfectly normal lives afterwards.
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