Heart Facts. Normal. (Cross-sectional view) Normal. coronary artery. Left coronary artery

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1 (Cross-sectional view) Left coronary coronary Heart Facts The heart beats continuously, resting for only a fraction of a second between beats. Of all the blood pumped by the heart, 5 7% is needed by the heart itself. Right coronary Enlarged view (opposite page) Heart Function The heart is an active muscle that pumps a continuous supply of oxygen-rich blood through arteries to all parts of your body. The coronary arteries surrounding the heart deliver oxygen-rich blood to the heart itself. Each coronary supplies a different part of the heart. active heart muscle Coronary Artery Function During exercise or periods of emotional stress, the heart beats faster and thus needs more oxygen. Healthy coronary arteries can easily deliver the extra blood needed for the heart s increased oxygen demand.

2 Atherosclerosis, or hardening of the arteries Carotid Coronary arteries (fatty deposits) Atherosclerosis is a common disease in which arteries (e.g. heart, brain, and legs) become narrowed due to the gradual formation of plaque inside the walls. formation may be caused by high levels of fat and cholesterol in the bloodstream. Over time, the buildup of plaque gradually reduces oxygen-rich blood flow in the arteries. A crack in the plaque can also cause small cells in the bloodstream called platelets to clump together on or near the plaque and form a blood clot. A blood clot may block the flow of oxygen-rich blood in the and causes serious health problems, including heart attack and stroke. Leg arteries A person with atherosclerosis is at increased risk for both heart attack and stroke. Area at risk buildup Narrowing of Ruptured Coronary Artery Disease Coronary disease is a condition in which plaque gradually builds up in the cells lining the wall of a coronary (i.e., atherosclerosis of the coronary arteries). Over time, plaque buildup can obstruct blood flow to the heart muscle itself, causing heart damage. Atherosclerosis

3 (Cross-sectional view) Blood clot Diagnostic Tests Common Emergency Signs and Symptoms of a Heart Attack If you experience one or more of the following complaints, seek medical assistance immediately: Intense, continuing chest pain ( heavy pressure or tightness ) Pain that extends to the left shoulder and arm, back, and even teeth and jaw Continuing pain in upper abdomen Shortness of breath Fainting spell Nausea, vomiting, fainting, and/or profuse sweating may also occur. Heart Attack If a blood clot or plaque suddenly and severely restricts or cuts off blood flow in any of the coronary arteries, the area of heart muscle supplied by that begins to die. This death of heart muscle is known as a myocardial infarction or heart attack. A heart attack is a medical emergency. A person who has had a heart attack is at three to four times greater risk of having a stroke. buildup Heart muscle begins to die These tests are performed to determine whether a heart attack occurred. Electrocardiogram (ECG) Echocardiogram Blood tests Damaged muscle begins to repair Scar tissue forms Heart Attack Recovery If doctors begin treatment soon after a heart attack, they may be able to limit the extent of tissue damage to the area around the affected heart muscle. If prompt treatment restores adequate blood flow soon after a heart attack, the damaged but viable heart muscle begins to heal. However, dead heart muscle is replaced with scar tissue, which does not function normally. Heart Attack

4 Cardiac Procedures Treatment for a heart attack may begin with medicines (thrombolytic agents) to help dissolve the blood clot that is blocking blood flow in the coronary. Coronary angioplasty or coronary bypass surgery may also be performed to help restore blood flow. Coronary Artery Bypass Surgery Coronary bypass surgery is performed to reroute, or bypass, blood flow around the clogged coronary. Obstructed area Coronary Angioplasty Balloon angioplasty is an intervention to widen the narrowed arteries of the heart. The interventional cardiologist threads a balloon-tipped catheter into the obstructed and inflates it, flattening the plaque against the arterial wall. Balloon catheter in coronary Balloon catheter inserted Balloon is inflated, compressing plaque Bypass Site of blockage Bypass Clogged bypassed Following balloon angioplasty, a coronary stent (expandable metal tube) is often delivered to the newly dilated site. The stent is expanded and left in place to hold the open. Stent positioned Stent expanded to keep open Stent in place The surgeon removes a section of blood vessel from another part of your body and attaches it between the aorta (the major from the heart) and the coronary below the blockage. An may also be detached from your chest wall and the open end attached to the coronary below the blockage. Intervention

5 Guidelines for Reducing Your Risk of Heart Attack You can help reduce your risk of heart attack and stroke by making healthy lifestyle changes. If you smoke, quit! Smoking increases your risk of atherosclerosis and heart attack. Have your blood pressure and cholesterol levels checked regularly by your doctor. Some Medicines that May Help Reduce the Risk of Heart Attack and Stroke Anti-platelet therapy Platelets are very small blood cells which clump together to help blood clot. Anti-platelet drugs work by stopping platelets from clumping together. This reduces the chance of blood clots forming inside hardened blood vessels (a process called thrombosis), which reduces the risk of stroke, heart attack or death. Anti-hypertensive therapy High blood pressure, if not treated, can damage blood vessels in several organs such as the heart, the kidneys, the brain and the eyes. This may lead to heart attacks, heart or kidney failure, strokes, or blindness. There are many types of anti-hypertensive therapy which work in different ways to reduce high blood pressure. Begin a program of regular exercise such as walking. Check with your doctor before beginning an exercise program. Eat a balanced diet high in fibre and low in cholesterol and fat. Add more fruits, vegetables, and whole-grain breads and cereals to your diet. Your doctor may prescribe medications to help reduce your risk of heart attack and stroke. Whether the medication is an antihypertensive to help control high blood pressure and/or cholesterol-lowering therapy to reduce your risk of heart attack and stroke, you should always take your medicine according to your doctor s instructions. Cholesterol lowering therapy Everyone has cholesterol and triglycerides in their blood. They are needed by the body for many normal functions, including building cell membranes, making bile acids (which help to digest food) and certain hormones. However, too much cholesterol of the wrong type and too little of the good type may be a problem. Statins: are used in people who have coronary heart disease (CHD) or who are at high risk of CHD (for example, if they have diabetes, a history of stroke, or other blood vessel disease). Statins work by reducing the amount of cholesterol made by the liver. Statins reduce the bad cholesterol, raise the good cholesterol and decrease triglycerides. Cholesterol absorption inhibitors: are often used in combination with statins to help with cholesterol reduction. Cholesterol absorption inhibitors work differently to statins by decreasing the absorption of cholesterol in the small intestine. Other medicines that may also be used to reduce the risk of heart attack and stroke include fibrates, resins, fatty acids and nicotinic acids. Your doctor will be able to advise you on these therapies. Prevention