Recognising a Heart Attack and Acting Early
The classic warning is pressure, tightness or heaviness in the centre of the chest that may spread to the left arm, jaw or back, often with sweating, nausea or breathlessness. In women, older adults and people with diabetes the signs can be subtle, such as unusual tiredness, upper abdominal discomfort or breathlessness alone. Many people dismiss these as acidity or gas and lose valuable time.
Symptoms lasting more than a few minutes call for an ambulance (108 or 112) and travel to a hospital with a cath lab, rather than waiting at home or driving alone. The emergency team may advise aspirin, but this should never delay the call. For families in JP Nagar, BTM Layout and Hulimavu, Bannerghatta Road is the natural route to a hospital equipped for primary angioplasty.
Emergency (Primary) Angioplasty
When the ECG shows ST-elevation, the artery is usually completely blocked, and primary angioplasty is the preferred treatment wherever a cath lab is available. Guidelines aim to open the artery within about ninety minutes of reaching medical care. If a hospital with these facilities cannot be reached in time, clot-dissolving medicines may be given first, followed by angiography.
What happens during the procedure
A thin catheter is passed, usually through the wrist artery, up to the blocked coronary. Contrast dye outlines the blockage, a fine wire crosses it and a balloon restores flow. A stent, a small mesh tube, is then placed to keep the artery open. The patient remains awake, and the procedure is often completed within an hour. Blood-thinning medicines, including dual antiplatelet therapy, begin at once and continue for months.
Circulatory Support: IABP, Impella and ECMO
Some heart attacks damage so much muscle that the heart can no longer pump enough blood, a condition called cardiogenic shock. Blood pressure falls, organs are starved of flow, and medicines alone may not be enough. Mechanical circulatory support acts as a bridge, sustaining circulation while the artery is opened and the heart recovers.
Intra-aortic balloon pump (IABP)
A balloon placed in the aorta inflates and deflates in rhythm with the heartbeat, improving blood flow to the coronary arteries and easing the load on the left ventricle. It is a widely available form of support and is also used during high-risk procedures.
Impella
This small pump is passed through an artery in the groin across the aortic valve. It draws blood from the left ventricle and delivers it into the aorta, taking over a substantial share of the heart’s work. It can protect patients with very weak hearts during complex angioplasty and support those in cardiogenic shock.
ECMO
Extracorporeal membrane oxygenation takes over both circulation and oxygenation outside the body. It is reserved for the sickest patients, such as those in refractory shock or after cardiac arrest, and depends on an intensive care team working around the clock.
The choice of device depends on the heart’s function, the lungs, blood pressure, the planned angioplasty and the risk of vascular complications. These are time-limited therapies, and the goal is recovery of the heart or a bridge to the next step of treatment.
Rehabilitation After a Heart Attack
Recovery does not end at discharge. The weeks and months that follow determine how well the heart heals and whether another event can be prevented.
Medicines
Antiplatelet drugs, statins, beta-blockers and medicines such as ACE inhibitors are usually prescribed. Stopping them early, even when the patient feels well, is a recognised cause of stent blockage and repeat heart attacks.
Supervised activity
Cardiac rehabilitation begins with short, monitored walks and builds gradually. Many patients return to desk work within a few weeks, while strenuous activity is resumed on medical advice once the heart’s function is known.
Diet, risk factors and emotional recovery
- Moving away from refined carbohydrates, fried food and excess salt towards vegetables, dal, whole grains and nuts
- Stopping tobacco completely and keeping alcohol low
- Keeping blood sugar, blood pressure and cholesterol within the targets set by the cardiologist
- Recognising that anxiety and low mood are common after a heart attack and can be addressed openly
Follow-up echocardiography and periodic review of cholesterol, sugar and stent medicines complete the plan. Patients from Whitefield or the Sarjapur Road corridor can arrange these reviews closer to home.
Frequently Asked Questions
How soon should treatment begin after a heart attack?
As early as possible. Guidelines aim to open the blocked artery within about ninety minutes of reaching medical care, and earlier treatment preserves more heart muscle.
Does every heart attack need a stent?
No. Most need angioplasty with a stent, but some patients are better served by medicines alone or by bypass surgery, depending on the extent of disease and the condition of the heart.
Why is a support device such as Impella or ECMO sometimes needed?
When the heart cannot pump enough blood after a large heart attack, these devices sustain circulation until the artery is opened and the heart recovers.
When can normal activity resume after a heart attack?
Light activity usually resumes within days. Return to work and exercise vary with the heart’s function and the treatment received, and the cardiologist advises on each step.
Can a second heart attack be prevented?
The risk can be reduced considerably with regular medicines, tobacco cessation, a heart-healthy diet, physical activity and control of diabetes, blood pressure and cholesterol.
Have Questions About Heart Health?
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Ask on WhatsAppIf you or someone near you has chest pain, sudden breathlessness, fainting or a racing heartbeat that does not settle, call an ambulance (108 or 112) and go to the nearest emergency department.