Internal Medicine

Causes heart attack

Stress is also a potential cause of a heart attack.

At the Heart attack, also as Myocardial infarction or heartbeat is part of the Heart muscle (Myocardium) due to a circulatory disorder (Ischemia) undersupplied. Due to this lack of oxygen, this part of the heart muscle cells dies. The circulatory disorder occurs because one of the den Clogged vessels supplying the heart muscle is. As a result, the blood can no longer flow to the cells.

Heart attack almost always has one Calcification of the vessels (arteriosclerosis). The Arteries (Arteries) are responsible for supplying the body with oxygen-rich blood. The arteries of the heart are called Coronary arteries (Coronary arteries), if they are calcified, one speaks of one Coronary artery disease (KHK). This arises because harmful influences on the inner wall of the vessels (Endothelium) act. This damage to the vessel wall leads to a chronic inflammation. In the previously damaged inner wall of the vessel, fatty substances (LDL cholesterol) deposit. These cause an ever increasing inflammation of the vascular wall. In the innermost layer of the vessel wall migrate through the blood Inflammatory cells called phagocytes (Macrophages). These absorb the LDL cholesterol (LDL cholesterol is a form of transport of cholesterol that is increasingly formed in a diet that is too high in fat) and try to break it down. However, this does not succeed completely, due to the oversupply of LDL, the phagocytes are oversaturated after a certain time. Then they transform into so-called foam cells around. These perish from the cholesterol. The foam cells remain in the vessel wall and make up a large proportion of the plaque. The inflammation causes scarring and fatty and calcareous plaques. This reduce the diameter of the vessel. However, the main danger posed by plaques is that they can tear at any time. This is the number one cause of a heart attack. The deposits are usually surrounded by a solid shell, if this tears, platelets are immediately deposited (Platelets) to the tear to close it. However, since the diameter of the vessel is very reduced, it can become completely occluded. This is the Blood supply interrupted and a heart attack occurs, the heart muscle cells begin to die after 15-30 minutes without an oxygen supply.

It is difficult to say why some plaques tear and others remain stable. A high number of fatty parts and little lime should increase the risk of tearing. Chronic inflammatory stimuli, such as from smoking, also increase the likelihood of plaque tearing. Certain habits and factors increase the likelihood that the blood vessels in general and the coronary arteries in particular will calcify. This atherosclerosis also increases the risk of having a heart attack.

With the woman

Heart attacks in women are becoming more and more common in Germany and are now one of the main causes of death. One reason for this seems to be that women are different because of their Hormonal balance and yours physical condition react differently to medication. This is how the frequently prescribed drug works Acetylsalicylic acid (ASA) to thin the blood and thus to prevent a heart attack apparently in women much weaker than with men. The different structures of the Heart vessels in women and men could be related to it.
Fundamental risk factors for cardiovascular diseases are also to be regarded as causes of heart attacks in women such as obesity, high blood pressure (Hypertension), sedentary lifestyle or diabetes (Diabetes mellitus).
In addition, the proportion of women who smoke is increasing. Substances from tobacco smoke promote processes that lead to vascular calcification, so smoking is one of the indirect causes of a heart attack. In addition, they narrow Blood vessels and especially the Coronary arteries when you smoke every cigarette, so that the heart has less oxygen and the risk of a heart attack increases. Also by taking female sex hormones (e.g. birth control pills, Contraceptive patches, vaginal ring) can be a cause of a heart attack, but the risk of taking it is considered to be very low and can be further reduced by taking precautionary measures (do not smoke at the same time, do not take pills if you are very overweight or have a known tendency to thrombosis).

With the man

Men between 45 and 55 are particularly often affected by a disease of the coronary arteries (smaller vessels shown in red).

Between the 45th and 50th. Heart attacks occur much more frequently in men than in women. This seems to be due to the fact that women are only susceptible to heart attacks after menopause increases sharply as the female sex hormone estrogen "protects" women from infarction up to menopause. The classic risk factors for a heart attack in men are still smoking, diabetes mellitus, high blood pressure (hypertension), too high Cholesterol levels, Sedentary lifestyle, obesity and stress.
These factors can be the cause of a Coronary heart disease (CHD), in which the heart does not receive enough oxygen and the risk of a heart attack increases. The more factors a person fulfills, the greater the risk of suffering a heart attack.

stress

A heart attack is often due emotional stress or physical exertion caused. Also overwhelming emotional events such as the unexpected death of a loved one, a great shock or great excitement (e.g. as a spectator in the stadium at the victory of a football World Cup final). In such cases, the heart attack occurs when one is after a stressful period just wanted to recover, for example often a few weeks after retirement for older people. Reasons for this are likely Stress hormones and changes in autonomic nervous system. The constant tension becomes the Blood pressure increases in the long run and thus increases the risk of a arteriosclerosis, the most important risk factor for a heart attack.
Over a third of all heart attacks occur in the early morning hours, in addition, a fifth of all heart attacks occur on Mondays at the beginning of the week. The reason for this is likely that the blood in the morning more viscous is higher than in the afternoon, the blood pressure is higher and the pulse faster. If the person who may already be at risk of a heart attack is also exposed to severe stress, a heart attack is more likely than at another time of day. A study has shown that anger can also be the cause of heart attacks. By reducing stress, for example with the help of anger management training, the risk of heart attack can be reduced.

Among young people

One of the major causes of a heart attack is the degree of Hardening of the arteries (Atherosclerosis, plaques are deposited in the arteries). A certain degree of hardening of the arteries is often detectable even in young people. The plaques restrict blood flow as the diameter and the elasticity of the vessel decreases through the deposits.
Investigations carried out on soldiers who died in the Korean War have shown that fat deposits were found on the arterial walls of a third of the young men. In every tenth person, the deposits were so pronounced that several blood vessels were almost blocked. In addition, young people also belong to the risk group for heart attacks if they are strong Smoker are overweight or are very stressed at work. Also congenital diseases like Lipid metabolism disorders (e.g. familial Hypercholesterolemia) can be a cause of a heart attack at a young age.
Read more about the topic here: Lipid metabolism disorder

Even extreme athletes who appear to be well-trained and in good health may, under certain circumstances, have a weak heart and therefore have an increased risk of suffering a heart attack. However, the risk of heart attack due to stress usually only increases in people with previous illnesses such as arteriosclerosis; a person with healthy blood vessels can also tolerate severe emotional stress in the short term.

alcohol

Moderate Drinking alcohol (e.g. a glass of wine per week) can lower the risk of heart attacks. In particular, moderate consumption of red wine is often said to have a positive effect on the risk of heart attack. Certain substances (antioxidants) in red wine slow down the breakdown of Nitric oxide in the blood, which reduces the risk of deposits in the vessels. Also the Blood lipid levels can be positively changed by red wine.
However, the protective effect of alcohol on the heart only applies to very moderate consumption, because alcohol consumption is generally considered to be harmful for the cardiovascular system to consider. In contrast, harms a higher alcohol consumption directly the heart muscle and increases the risk having a heart attack. It is estimated that up to 60 percent all dilated cardiomyopathies (abnormal enlargement of the heart muscle) caused by alcohol abuse.
Alcohol leads to one increased blood pressurebecause alcohol stimulating acts on the vegetative nervous system. The heartbeat accelerates and blood is pumped into the body more intensely, it comes to Racing heart after alcohol. Permanently high blood pressure can damage the vessel walls and build up deposits of fat, calcium and connective tissue (arteriosclerosis) form. In addition, the chronically high blood pressure leads to heart damage such as one pathological thickening heart muscle, irregular heartbeat, atrial fibrillation or heart failure. Especially if other risk factors for the development of a heart attack already exist (e.g. obesity, lack of exercise, diabetes, high blood pressure), the risk of a heart attack is extremely increased due to the consumption of alcohol. Also Obesity is a major risk factor for a heart attack. Since alcohol contains plenty of calories, alcohol consumption leads to increased weight gain and thus also increases the risk of heart attack. In addition, it should be noted that regular alcohol consumption damages the liver and promotes other diseases (e.g. cancer).

The most common causes

As the number of risk factors increases, so does the individual risk of having a heart attack.

Diet plays a decisive role in the development of a heart attack due to vascular calcification. Food rich in fat increases the cholesterol levels in the blood and causes plaque to form over the long term.
Obesity results from years of poor diet and increases the risk of various diseases such as high blood pressure.
High blood pressure: When the pressure in the vascular system is increased, the heart has to work with more force to supply the tissue. The increased pressure damages the sensitive inner wall of the vessel, it can lead to inflammation of the vessel wall and subsequent plaque formation.
Sedentary lifestyle: The body is designed for a certain amount of exercise, if this is permanently undershot, diseases such as high blood pressure and diabetes mellitus develop. Because sufficient exercise lowers blood pressure. In addition, the sugar consumption is increased, which prevents diabetes mellitus. Furthermore, energy is consumed during exercise and the cholesterol levels are lowered.
Diabetes: Diabetes (diabetes mellitus) arises from the fact that the blood sugar is increased due to the development of tolerance of the cells to insulin. If the diabetes is poorly treated or not treated at all with medication, the blood sugar level is increased, which in turn damages the inner wall of the blood vessels and increases blood pressure.
Smoking: Smoking nicotine-containing cigarettes carries significant risks. In addition to nicotine, many other toxins such as arsenic, tar and lead enter the body when smoking. Smoking is therefore very damaging to the whole body. In the vessels, the ingredients of cigarettes, cigars and pipes promote the formation of unstable plaques that can easily tear. The ingredients also cause blood pressure to rise and the risk of diabetes increases. After just 24 hours of not smoking, the risk of myocardial infarction decreases; after a few months, by giving up smoking, the risk of a non-smoker has a heart attack. Other circulatory disorders caused by smoking are also common.
Disturbances in lipid metabolism: High levels of LDL cholesterol in the blood caused by poor diet lead to hyperlipidemia. Hyperlipidemia increase the risk of heart attack because the LDL cholesterol is deposited in the inner wall of the blood vessels. At the same time, too low HDL levels also promote plaque formation. Disturbances in lipid metabolism can also be hereditary; these must then be treated with medication.
Read more about the topic here: Lipid metabolism disorder
Chronic inflammation: Chronic inflammation caused by irritation such as smoking increases the inflammation parameters (e.g. CRP), the inflammation damages the inner wall of the blood vessels and makes the plaques unstable. An example of a chronic inflammatory disease is periodontal disease.
Male sex: Men are at a higher risk of having a heart attack than women. This is probably due to the protective effect of the female sex hormones.
Family stress: If events such as heart attack or stroke occurred early in the family or with relatives (i.e. before the age of 60), the risk is increased. Since there are sometimes clusters of cardiovascular diseases within a family, the genes seem to be important here to a certain extent.
Age: A very important risk factor is age. The older a person is, the more calcified their vessels are. Logically, therefore, the risk of plaque rupturing and a coronary vessel becoming blocked is also increased.
Alcohol: The constant excessive consumption of alcohol increases the risk of suffering a heart attack, and the risks for many other diseases are also increased.
Stress: A heart attack can be triggered by stress. Stress can cause tremendous fluctuations in blood pressure, which can cause the plaque to rupture. For example, long-term psychologically stressful stress can increase blood pressure and thus make a heart attack more likely.
Propensity for thrombosis: Genetic diseases such as factor V disease increase the blood's tendency to clot, so there is a higher probability of vascular blockages, i.e. heart attacks or strokes.

The main risk groups for a myocardial infarction are therefore all persons for whom one or more risk factors are particularly pronounced. Patients with a condition after a heart attack or stroke are particularly at risk, and patients with arteriosclerosis (e.g. with peripheral arterial disease) have a particularly high risk of suffering a heart attack. Patients who have already had angina pectoris (chest tightness caused by coronary artery disease) and shortness of breath are also at great risk.

Other causes

In very rare cases a Heart attack triggered by other causes:

For example, a Inflammation of the blood vessels cause a heart attack.
Also can clotthat come from other vessel sections are washed into the heart and that Coronary arteries clog.
They still exist congenital malformationsthat increase the risk.
Between 6 a.m. and 10 a.m. the likelihood of having a heart attack is increased because im blood More clots form in the early morning hours.
Also plays the Composition of the blood a role, an increased level of Homocysteine in the blood is said to increase the risk of myocardial infarction, but there are no medicinal approaches here, as the risk of myocardial infarction does not decrease even after lowering homocysteine with drugs.
One continues to appear too low blood levels of vitamin D3 related to an increased risk of heart attack. Studies have shown that men with low vitamin D3 levels have one twice as high risk for having a heart attack compared to men with normal vitamin D3 levels.
It also seems migraine as a cause of a heart attack to play a role.
Also the Pollution with fine dust from car and industrial fumes seems to increase the risk of heart attack, so that would be place of residence another factor that contributes to the general risk.
Another immutable factor is that blood type, People with the Blood group AB have the highest risk of having a heart attack, blood group 0 carriers the lowest.
A self-explanatory risk factor is that Compliance, so the acceptance of the treatment. When patients independently prescribed them Medication stopping, logically increases the risk of CHD and thus the risk of heart attack. This is especially evident when medication for diseases such as high blood pressure, Diabetes mellitus or simply stop taking fat-lowering drugs.

Avoid causes

To one Heart attack To prevent this, consider your the Avoid the formation and progression of calcification of the vessels. This can be achieved by reducing the risk factors or avoiding them entirely.

So one should make sure to live healthy. Most important here are the following factors. One should stop smoking, this reduces the risk of heart attack from day one. In addition, one should eat healthy, that is lots of fresh fruits and vegetables eat and little animal fat. Fast food in particular should be avoided. You should also try to reduce your weight to a healthy level. It does affect however every kilo positive out. Also more permanent stress should be reduced as much as possible. In addition, you should exercise a little every day, already one half hour walk can be seen positively compared to no movement at all. Finally, you should make sure that you get it from the doctor prescribed medication takes regularly. Especially high blood pressure and diabetes mellitus must closely controlled become.

Also read: Prevent heart attack