Every day at work, I talk with people who have heart problems. My job is to a) explain the problem, and b) explain how to avoid more problems in the future. As a cardiac rehab nurse, I get to “translate” the big words and concepts from doctors and other healthcare professionals into everyday English.
Heart problems, or heart disease, kill more people in America than anything else.
About 1 out of every 4 deaths in America is caused by heart problems. That tallies up to around 630,000 people dying, every year. That’s a lot of people. And every 40 seconds, someone in the US has a heart attack. Every 40 seconds!
(https://www.cdc.gov/heartdisease/facts.htm)
Heart problems don’t just exist in the US. Actually, heart problems are responsible for more deaths worldwide than anything else.
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819990/)
Heart disease, therefore, is a very big deal. And one of the scariest consequences of heart problems is something called a myocardial infarction, or heart attack. In order to understand heart attacks, we first need to understand the underlying cause, called heart disease.
Heart Disease
So what is heart disease, exactly?
Your heart is actually a pump. It’s a muscle that pushes blood throughout your body. This is a very important job, because every cell in your body needs blood in order to survive.
Your entire body is made up of cells. In order for you to be healthy, you must have healthy cells. Each cell needs 3 main things in order to be healthy: 1) oxygen, 2) nutrients, and 3) waste removal. Those are the 3 things all bodies (and the cells that make up bodies) require. That’s why you must 1) breathe, 2) eat, and 3) eliminate waste (bladder and bowel emptying) in order to be healthy and survive.
So where does blood come in?
Blood is the way your cells receive oxygen and nutrients, and it is also the way your cells “take out the trash.” Blood is vital. It travels through blood vessels, or pipes, located all throughout your body. As it travels, it carries those 3 important things: oxygen, nutrients, and wastes.
(Image by LadyofHats)
What makes blood move?
Your heart generates the force that pushes blood all through your body, delivering it to each and every cell in need. Your heart works 24 hours a day, 7 days a week, 365 days a year. Your heart can’t take a vacation! Its job is much too important.
https://www.nhlbi.nih.gov/health/health-topics/topics/chd/heartworks
Heart disease happens when something is wrong with your pump.
Coronary Artery Disease
https://www.cdc.gov/heartdisease/coronary_ad.htm
The most common type of heart disease is called coronary artery disease. When this happens, “roadblocks” develop in some of your blood vessels, or pipes. These blockages cause big problems for all the cells “downstream” of the roadblock, because those cells don’t receive adequate blood.
Coronary artery disease, or CAD, occurs when the arteries (pipes) that provide blood to the heart muscle itself develop “roadblocks.”
Your heart pumps blood, but it also needs blood itself in order to have healthy heart cells and continue to pump well. Coronary artery disease is dangerous because it eventually causes heart cells to die, which prevents your heart from pumping well. If your heart doesn’t pump well, other cells throughout your body don’t receive adequate blood (carrying vital oxygen and nutrients), and then those cells die, too.
Heart Attack
https://www.nhlbi.nih.gov/health/health-topics/topics/heartattack
A heart attack occurs when an artery on your heart (called a coronary artery) develops a severe blockage. That “roadblock” prevents blood from reaching your heart cells “downstream” of the blockage, and if the blockage isn’t fixed in time (within a few hours), those heart muscle cells die. Dead cells can’t come back to life, so now you have a pump that won’t be able to work as well.
This interactive link from the American Heart Assoctagon depics the process with illustrations:
Interactive Heart Attack from AHA
There are 2 main types of heart attacks. One involves a blockage that isn’t quite complete, or the blockage is removed in time. This first kind is called a non-STEMI, and it causes damage but not death to your heart cells. If you’re going to have a heart attack, this is the kind to have.
The second kind of heart attack involves a complete blockage that is not removed in time, called a STEMI, and it causes cell death. This type of MI, or heart attack, will negatively affect your heart’s ability to pump blood. It’s the most dangerous kind.
In both types of heart attacks, the location of the blockage will determine which part of your heart is damaged or killed. Also, the higher up the blockage, the worse off you are, because higher blockages affect a larger portion of your heart cells.
The actual pathophysiology (disease process) behind the formation of a blockage begins with the narrowing of an artery. This narrowing occurs because of plaque building up in the artery walls. As more plaque forms, the artery gets progressively more narrow, “sick,” and unstable. It’s similar to a pothole forming on a road. Eventually, the pothole gets big enough that you have to bring in the tools and people to fix it. Similarly, that unstable, narrowed spot on the artery wall eventually ruptures (breaks open), and your body rushes in to fix it and form a clot. Unfortunately, it’s already a very narrowed area, and the clot meant to “fix” actually worsens the situation by creating a “roadblock.”
Another helpful link from the American Heart Association, showing this process:
Interactive Atherosclerosis/Artery Hardening from AHA
When this happens, severe pain usually occurs, warning the individual that something is very wrong with their heart. The classic symptoms of a heart attack are crushing chest pain or pressure; shortness of breath; and fatigue. The pain may radiate to their arm, neck, jaw, or back. Some people also feel nauseous.
https://www.cdc.gov/heartdisease/signs_symptoms.htm
Several options exist for removing or fixing the blockages. Some blockages can be removed with certain “clot-busting” medications. Others can be removed by a cardiologist in the cath lab, and the cardiologist will often then place a stent into the affected artery. Other blockages are too severe/hardened or are unable to be fixed by other means, and these severe blockages require a surgery called a CABG (Coronary Artery Bypass Graft), which actually creates an alternate pathway for blood that goes around, or bypasses, the blockage.
But honestly, prevention of blockages is a much better and safer option than attempting to fix a blockage that has formed.
Heart attacks, which are caused by heart disease, are a widespread (and preventable) cause of disability and death all over the world.
In my next post, I’ll discuss the reasons that coronary artery disease (a blockage in a heart artery) develops. If you know what is causing those deadly blockages to form, you have a much better chance of preventing them from happening in the first place.
Copyright 2017 by Laura Richie. All rights reserved.