Complications after a heart attack

Complications after a heart attack

There are two types of complications, those that occur pretty much straight away, and those that happen afterwards. 

Immediate complications

·         Arrhythmias - the heart beats irregularly, either too fast or too slowly. Patients may be given cardioversion - an electric current is passed through the heart. Most patients, with time, will return to regular rhythms. There are also medications for arrhythmias.

·         Cardiogenic shock - the patient's blood pressure suddenly drops dangerously. The heart cannot supply enough blood for the body to work adequately. The following drugs will raise blood pressure and heart functioning, Dopamine, Dobutamine, Epinephrine, and Norepinephrine.

·         Hypoxemia - levels of blood oxygen become too low.

·         Pulmonary edema - there is fluid accumulation in and around the lungs.

·         DVT (deep vein thrombosis) - the deep veins of the legs and pelvis develop blood clots which either block or interrupt the flow of blood in the vein.

·         Myocardial rupture - the heart attack damages the wall of the heart. This increases the risk of a heart wall rupture.

·         Ventricular aneurysm - one of the chambers (ventricles) of the heart forms a bulge.

Complications that can occur later:

·         Aneurysm - scar tissue builds up on the damaged heart wall. This leads to blood clots, low blood pressure, and abnormal heart rhythms.

·         Angina - Not enough oxygen is reaching the heart. Symptoms may be similar to those of a heart attack, especially the chest pain.

·         Congestive heart failure - the heart can only beat very weakly. The patient feels exhausted and breathless.

·         Edema - fluid accumulates in the ankles and legs (they swell).

·         Future heart attacks - a person who has had a heart attack runs a higher risk of having another one, compared to other people.

·         Loss of erectile function - erectile dysfunction is generally caused by a vascular problem. However, it can also be the result of depression.

·         Loss of libido - this is especially the case with men.

·         Pericarditis - the lining of the heart becomes inflamed, causing serious chest pain.

Patients who comply with their doctors instructions have a much better chance of recovery than those who don't. It is important that the doctor monitor a heart attack patient for several months afterwards.

Convalescing/recovering after a heart attack

Convalescing/recovering after a heart attack

Recovery from a heart attack can be a slow and gradual process. It may involve liaising with various types of health care professionals, including doctors, dieticians, nurses, physio therapists, pharmacists, and personal trainers. The patients' recovery will generally start in hospital, and then continue at home.

·         Physical activity

Experts say it is vital that a recovering heart attack patient try to stay active. Exercise is a crucial part of recovery, as it strengthens the heart muscles, and significantly lowers the risk of another heart attack. Most patients will be given some kind of exercise program while they are still in hospital. It is important that any exercise program is devised by an exercise specialist who is part of the patient's health professional team. Most initial exercise programs will be about 12 weeks long. 

Most heart attack patients are able to go back to their normal everyday domestic activities. Of course, this will depend on the patient's physical and mental state. Doctors advise most patients to take it easy at first.

·         Going back to work

When a heart attack patient can go back to work depends on various factors: The severity of the heart attack, the type of job, the physical status of the patient after the heart attack, the financial situation of the patient, etc. 

Some people are eager to get back to work for various reasons. It is vital that people do not rush back - a proper recovery period is needed to prevent recurrences. Patients should be guided by their doctors' advice.

·         Heart attack and depression

The patient should understand that it is common to feel depressed or anxious after a heart attack. The worry about being able to cope, losing one's job or work status, are contributory factors. 

The severity of the depression can influence the patient's rehabilitation - making recovery a slower process. 

Heart attack patients who feel depressed or anxious should tell their doctors immediately.

·         Driving
Patients who have other conditions should check with their car insurance company to make sure they are still covered before they start driving again. In the UK anybody who drives large goods vehicles has to tell the DVLA about their heart attack. In most cases they will not be allowed to drive for six weeks, and will only be able to do so after passing a basic health and fitness test.

Diseases caused by long-term smoking

Diseases caused by long-term smoking

1. A lifetime smoker is at high risk of developing a range of potentially lethal diseases, including:
2. Cancer of the lung, mouth, nose, voice box, tongue, nasal sinus, oesophagus, throat, pancreas, bone marrow (myeloid leukaemia), kidney, cervix, ovary, ureter, liver, bladder, bowel and stomach
3. Lung diseases such as chronic obstructive pulmonary disease, which includes chronic bronchitis and emphysema
4. Coronary artery disease, heart disease, heart attack and stroke
5. Ulcers of the digestive system
6. Osteoporosis and hip fracture
7. Poor blood circulation in feet and hands, which can lead to pain and, in severe cases, gangrene and amputation.

Tobacco Smoke

The most damaging compounds in tobacco smoke include:

Tar – this is the collective term for all the various particles suspended in tobacco smoke. The particles contain chemicals including several cancer-causing substances. Tar is sticky and brown, and stains teeth, fingernails and lung tissue. Tar contains the carcinogen benzo(a)pyrene that is known to trigger tumour development (cancer).

Carbon monoxide – this odourless gas is fatal in large doses because it takes the place of oxygen in the blood. Each red blood cell contains a protein called haemoglobin – oxygen molecules are transported around the body by binding to, or hanging onto, this protein. However, carbon monoxide binds to haemoglobin better than oxygen. This means that less oxygen reaches the brain, heart, muscles and other organs.

Hydrogen cyanide – the lungs contain tiny hairs (cilia) that help to clean the lungs by moving foreign substances out. Hydrogen cyanide stops this lung clearance system from working properly, which means the poisonous chemicals in tobacco smoke can build up inside the lungs. Other chemicals in smoke that damage the lungs include hydrocarbons, nitrous oxides, organic acids, phenols and oxidising agents.

Free radicals – these highly reactive chemicals can damage the heart muscles and blood vessels. They react with cholesterol, leading to the build-up of fatty material on artery walls. Their actions lead to heart disease, stroke and blood vessel disease.

Metals – tobacco smoke contains dangerous metals including arsenic, cadmium and lead. Several of these metals are carcinogenic.

Radioactive compounds – tobacco smoke contains radioactive compounds, which are known to be carcinogenic.

DNA

What is DNA?

The answer lies in a molecule called deoxyribonucleic acid (DNA), which contains the biological instructions that make each species unique. DNA, along with the instructions it contains, is passed from adult organisms to their offspring during reproduction.

Where is DNA found?

DNA is found inside a special area of the cell called the nucleus. Because the cell is very small, and because organisms have many DNA molecules per cell, each DNA molecule must be tightly packaged. This packaged form of the DNA is called a chromosome.
During DNA replication, DNA unwinds so it can be copied. At other times in the cell cycle, DNA also unwinds so that its instructions can be used to make proteins and for other biological processes. But during cell division, DNA is in its compact chromosome form to enable transfer to new cells.
Researchers refer to DNA found in the cell's nucleus as nuclear DNA. An organism's complete set of nuclear DNA is called its genome.
Besides the DNA located in the nucleus, humans and other complex organisms also have a small amount of DNA in cell structures known as mitochondria. Mitochondria generate the energy the cell needs to function properly.
In sexual reproduction, organisms inherit half of their nuclear DNA from the male parent and half from the female parent. However, organisms inherit all of their mitochondrial DNA from the female parent. This occurs because only egg cells, and not sperm cells, keep their mitochondria during fertilization.

What is DNA made of?

DNA is made of chemical building blocks called nucleotides. These building blocks are made of three parts: a phosphate group, a sugar group and one of four types of nitrogen bases. To form a strand of DNA, nucleotides are linked into chains, with the phosphate and sugar groups alternating.
The four types of nitrogen bases found in nucleotides are: adenine (A), , thymine (T), guanine (G) and cytosine (C). The order, or sequence, of these bases determines what biological instructions are contained in a strand of DNA. For example, the sequence ATCGTT might instruct for blue eyes, while ATCGCT might instruct for brown.
Each DNA sequence that contains instructions to make a protein is known as a gene. The size of a gene may vary greatly, ranging from about 1,000 bases to 1 million bases in humans.
The complete DNA instruction book, or genome, for a human contains about 3 billion bases and about 20,000 genes on 23 pairs of chromosomes.

What does DNA do?

DNA contains the instructions needed for an organism to develop, survive and reproduce. To carry out these functions, DNA sequences must be converted into messages that can be used to produce proteins, which are the complex molecules that do most of the work in our bodies.

How are DNA sequences used to make proteins?

DNA's instructions are used to make proteins in a two-step process. First, enzymes read the information in a DNA molecule and transcribe it into an intermediary molecule called messenger ribonucleic acid, or mRNA.
Next, the information contained in the mRNA molecule is translated into the "language" of amino acids, which are the building blocks of proteins. This language tells the cell's protein-making machinery the precise order in which to link the amino acids to produce a specific protein. This is a major task because there are 20 types of amino acids, which can be placed in many different orders to form a wide variety of proteins.

Who discovered DNA?

The German biochemist Frederich Miescher first observed DNA in the late 1800s. But nearly a century passed from that discovery until researchers unraveled the structure of the DNA molecule and realized its central importance to biology.
For many years, scientists debated which molecule carried life's biological instructions. Most thought that DNA was too simple a molecule to play such a critical role. Instead, they argued that proteins were more likely to carry out this vital function because of their greater complexity and wider variety of forms.
The importance of DNA became clear in 1953 thanks to the work of James Watson, Francis Crick, Maurice Wilkins and Rosalind Franklin. By studying X-ray diffraction patterns and building models, the scientists figured out the double helix structure of DNA - a structure that enables it to carry biological information from one generation to the next.

What is the DNA double helix?

Scientist use the term "double helix" to describe DNA's winding, two-stranded chemical structure. This shape - which looks much like a twisted ladder - gives DNA the power to pass along biological instructions with great precision.
To understand DNA's double helix from a chemical standpoint, picture the sides of the ladder as strands of alternating sugar and phosphate groups - strands that run in opposite directions. Each "rung" of the ladder is made up of two nitrogen bases, paired together by hydrogen bonds. Because of the highly specific nature of this type of chemical pairing, base A always pairs with base T, and likewise C with G. So, if you know the sequence of the bases on one strand of a DNA double helix, it is a simple matter to figure out the sequence of bases on the other strand.
DNA's unique structure enables the molecule to copy itself during cell division. When a cell prepares to divide, the DNA helix splits down the middle and becomes two single strands. These single strands serve as templates for building two new, double-stranded DNA molecules - each a replica of the original DNA molecule. In this process, an A base is added wherever there is a T, a C where there is a G, and so on until all of the bases once again have partners.
In addition, when proteins are being made, the double helix unwinds to allow a single strand of DNA to serve as a template. This template strand is then transcribed into mRNA, which is a molecule that conveys vital instructions to the cell's protein-making machinery.

Treatment during a heart attack

Treatment during a heart attack

·         CPR (cardio-pulmonary resuscitation) 

Some heart attack patients stop breathing; they do not move or respond when spoken to or touched, they may also be coughing. If this is the case CPR should be started straight away. This involves: 

Manual chest compressions and mouth-to-mouth
30 chest compressions to the heart followed by  two mouth-to-mouth resuscitation breaths.

Defibrillator
This is a CPS medical device. It sends electric shocks across the patient's chest - the aim is to use electricity to shock the heart back into proper activity.

·         300mg of Aspirin

A 300mg dose of aspirin is often given to patients during a heart attack. Aspirin will help stop the clot in the artery from growing.

·         Thrombolytics

These dissolve the blood clots. These include alteplase and streptokinase. They should be injected into the patient as soon as possible. If the blood supply to the muscle can be restored soon enough, much of the affected heart muscle will survive.

·         Painkillers

Morphine is sometimes injected into the patient to control the pain and discomfort.

Treatment during a heart attack

Treatment during a heart attack

·         CPR (cardio-pulmonary resuscitation) 

Some heart attack patients stop breathing; they do not move or respond when spoken to or touched, they may also be coughing. If this is the case CPR should be started straight away. This involves: 

Manual chest compressions and mouth-to-mouth
30 chest compressions to the heart followed by  two mouth-to-mouth resuscitation breaths.

Defibrillator
This is a CPS medical device. It sends electric shocks across the patient's chest - the aim is to use electricity to shock the heart back into proper activity.

·         300mg of Aspirin

A 300mg dose of aspirin is often given to patients during a heart attack. Aspirin will help stop the clot in the artery from growing.

·         Thrombolytics

These dissolve the blood clots. These include alteplase and streptokinase. They should be injected into the patient as soon as possible. If the blood supply to the muscle can be restored soon enough, much of the affected heart muscle will survive.

·         Painkillers

Morphine is sometimes injected into the patient to control the pain and discomfort.