A heart attack is often announced

A heart attack comes - supposedly - out of the blue. Cold sweat, chest pain, fear of death. He meets you in the middle of life, and you're completely unprepared. At least that's how it is still described in books and films. According to new medical findings, this does not reflect reality. Firstly, the symptoms are often very different, and secondly, in the last six months before a heart attack, there are crucial signs.

If one were to recognize these and react correctly, this would save many people's lives.

Heart attack is when one of the coronary arteries that supply the heart muscle with blood is more or less completely closed by a plug. Thus, no or hardly any blood reaches the heart. Parts of the heart tissue then die. The cause: fatty, calcified deposits close the coronary arteries. According to new findings, vascular damage caused by an aggressive metabolic product, homocysteine, is also significantly involved and also leads to scarring and narrowing of the vessels.

However, the heart vessels do not close up overnight, but take decades to do so. Most of the time there are no symptoms, which is why patients at risk of myocardial infarction often do not know anything about the impending disaster. Up to now it was thought that this unsuspectingness would last until the unexpected heart attack. Recently, however, we have seen the following signs:

Respiratory distress: Those who suddenly become inexplicably short of breath should urgently have this examined by their doctor. Patients with shortness of breath are four times more likely to have a heart attack.

Persistent exhaustion and excessive fatigue: This may indicate both an imminent heart attack and an already experienced heart attack. This symptom is typical for women in particular. It has now been found that men also suffer from it in the weeks before the heart attack.

Sleep disorders, mental stress and depression: These feelings are also more frequent before a heart attack. It has long been known that negative stress and a hostile attitude to life increase the risk of a heart attack just as much as cigarette smoking, for example. According to new findings, there is also an inverse relationship, especially among men: probably because they are not as efficient in the last few months before a heart attack, they feel more stressed and depressed. And this is then an additional indication of a threatening heart event.

The main symptom, chest pain, which has been the main symptom to date, is still the highest alarm level, even after new findings. Especially if the chest pain shows up as follows:

Chest pain is diffuse, so it is not possible to say exactly where it is.

He radiates in shoulders and arms.

It is accompanied by nausea, vomiting and sweating.

However, we must not wait any longer for this sign to diagnose a heart attack. In women in particular, myocardial infarction is rarely manifested in chest pain, but mainly through shortness of breath and exhaustion.

But no matter what the signs look like, the events in the heart are always the same. The heart muscle is insufficiently or no longer supplied with blood at all, which means that the muscle cells lack vital oxygen and they die. And the longer a heart attack lasts without being treated, the more myocardial tissue is irretrievably lost!

In the hospital, doctors try to restore blood flow to the heart. If they find that a blood clot has formed in the narrowed coronary arteries that closes the vessel properly, a lysis is performed. The blood clot is dissolved by medication. It is likely that the doctors will then also decide on vascular dilatation, a vasodilatation. For this purpose, they use a thin hollow needle to penetrate the blood vessels to reach the closed area, stretch the vessel and place a stent. Because every second patient who survives a heart attack then suffers permanent cardiac insufficiency, there is help here too: a pacemaker system can be implanted - under local anesthesia - that starts automatically when the heartbeats become abnormal.

But in order not to let it come at all to the infarction, one should stop its risk factors completely at the latest with the threatening warnings described. This means concretely:

Stop smoking right now.

Remove any excess weight.

Eat regular and not too rich in fat to control blood lipid levels.

Take a tight walk of at least half an hour every day, which also has a positive effect on blood lipids and blood pressure.

As a diabetic, it is important that you pay close attention to your blood sugar levels.

In addition, your doctor will prescribe you tablets that you should take reliably. In order to reduce the risk of arteriosclerosis and thus the risk of heart attack in the long term, new findings have shown that the combined administration of vitamins B6, B12 and folic acid has also proven its worth, as this lowers the level of vasodilatory homocysteine in the blood.

Copyright: Landeszentrale fuer Gesundheitsfoerderung in Rheinland-Pfalz e.V. (LZG) Germany

Text: Dr. Beatrice Wagner, Editor: Birgit Kahl