Heart attacks which are medically known as a myocardial infarction (MI) is one of the leading causes of death in the elderly, particularly in developed nations. It is to a large extent preventable with a combination of lifestyle changes, medication and surgical procedures that can reduce the risk of a heart attack. However, there is still significant ignorance about how the condition develops and the nature of the disease itself.
The heart is a muscular pump that keeps blood circulating throughout the body. In this way blood laden with oxygen and nutrients can reach all the cells in the body. Similarly blood carrying waste and carbon dioxide can be routed to the different organs for disposal. In order to keep the heart muscle working throughout life it needs a very good supply of blood. The oxygen rich blood to heart is carried by the coronary arteries.
A heart attack occurs when one or more of these coronary arteries is blocked to an extent that the heart muscle gets very little or almost no oxygen-rich blood. Initially this causes injury to the heart muscle known as ischemia and eventually a portion of the heart muscle dies (infarct). This compromises the heart’s ability to pump blood. If a sufficient amount of heart muscle dies then the heart fails to perform it function to a sufficient degree to maintain life.
The most common cause of a heart attack is blockage of the coronary arteries by a build up of plaques in the artery walls. These plaques are a result of several factors including :
These plaques develop over months and even years and this condition is known as atherosclerosis. A blood clot can suddenly block an already narrowed artery causing almost total occlusion of the artery within minutes or hours. Gradual narrowing of the artery that eventually compromises heart function is known as coronary artery disease (CAD).
Sometimes a heart attack can occur with the intake of certain substances, particularly narcotics like cocaine, where the coronary artery goes into spasm thereby cutting of the blood supply. Less commonly small tumors or blood clots from elsewhere in the body can block the coronary artery or the artery may even tear thereby leading to a heart attack. However, the most common cause of a heart attack is coronary artery disease as a result of atherosclerosis.
Not all heart attacks are fatal but even what is termed as minor heart attack can drastically compromise a person’s quality of life and reduce their lifespan in the long run. The elderly are at the greatest risk as heart attacks more commonly occurs in people over the age of 60 years. Even though a heart attack is more likely to occur in seniors, the processes like atherosclerosis that leads to a heart attack often starts earlier in life usually within the late 40s or early 50s onwards.
Death is more likely in heart attack patients over 75 years of age even if it is not immediately fatal. Men are at a greater risk of a heart attack but after 70 years of age, a heart attack is likely to affect both men and women equally. Despite the higher risk in the elderly, any man over 45 years of age and women over 55 years of age is still considered to be at risk.