What are the signs of a heart attack. How does a heart attack differ from angina. What happens during a heart attack. Why is immediate medical attention crucial for heart attacks. How can you recognize different types of heart attacks.

Understanding Heart Attacks: A Comprehensive Overview

A heart attack, medically known as a myocardial infarction (MI), occurs when blood flow to the heart is blocked, depriving the muscle of oxygen and nutrients. This blockage can lead to tissue death and permanent damage to the heart muscle. Understanding the symptoms, causes, and types of heart attacks is crucial for early detection and prompt medical intervention.

Recognizing Heart Attack Symptoms: Key Warning Signs

Heart attack symptoms can vary from person to person and may differ between men and women. Common signs include:

• Chest discomfort (pressure, squeezing, fullness, or pain)
• Pain radiating to the arms, back, neck, jaw, or stomach
• Shortness of breath
• Cold sweats
• Nausea or vomiting
• Lightheadedness or dizziness

Women may experience additional or atypical symptoms such as:

• Unusual fatigue
• Indigestion or abdominal discomfort
• Pain in the neck, shoulder, or upper back

Silent Heart Attacks: A Hidden Danger

Some heart attacks occur without noticeable symptoms, known as “silent” myocardial infarctions. These are more common in people with diabetes and can be equally dangerous as symptomatic heart attacks.

Causes and Risk Factors of Heart Attacks

Heart attacks primarily result from coronary artery disease (CAD), where plaque buildup narrows the arteries supplying blood to the heart. Risk factors include:

• High blood pressure
• High levels of LDL (“bad”) cholesterol
• Diabetes
• Smoking
• Age (risk increases with age)
• Family history of heart disease
• Obesity
• Sedentary lifestyle

Can coronary artery spasms cause heart attacks? Yes, in rare cases, a spasm in the coronary artery can trigger a heart attack, even in individuals without severe coronary artery disease. These spasms can occur at rest and temporarily cut off blood supply to the heart muscle.

Types of Heart Attacks: Understanding the Differences

Heart attacks are classified into different types based on the extent and nature of the blockage:

1. STEMI (ST-Elevation Myocardial Infarction)

STEMI is a severe type of heart attack where a coronary artery is completely blocked. It requires immediate medical intervention to restore blood flow and minimize heart muscle damage.

2. NSTEMI (Non-ST-Elevation Myocardial Infarction)

In NSTEMI, a coronary artery is significantly narrowed but not completely blocked. While less severe than STEMI, it still requires prompt medical attention.

3. MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries)

MINOCA is a unique type of heart attack where no significant blockages are visible in the main coronary arteries. Its causes are still being studied, but it can be just as serious as other types of heart attacks.

Heart Attack vs. Sudden Cardiac Arrest: Important Distinctions

How does a heart attack differ from sudden cardiac arrest? While often confused, these are distinct cardiac events:

• Heart Attack: A circulation problem where blood flow to the heart is blocked
• Sudden Cardiac Arrest: An electrical problem causing the heart to stop pumping suddenly

Although different, a heart attack can sometimes lead to sudden cardiac arrest.

Angina and Heart Attacks: Recognizing the Difference

Angina is chest pain or discomfort caused by reduced blood flow to the heart. While it can be a symptom of a heart attack, it’s not always indicative of one. There are two main types of angina:

Stable Angina

Stable angina is predictable chest pain that typically occurs with specific triggers such as physical exertion, strong emotions, or extreme temperatures. It usually subsides with rest or nitroglycerin medication.

Unstable Angina

Unstable angina is more severe and unpredictable. It may occur at rest, last longer, or not respond to nitroglycerin. Unstable angina is considered a medical emergency as it may precede a heart attack.

What should you do if you experience angina symptoms? If you have stable angina and your symptoms worsen, last more than 5 minutes, or don’t improve with rest or nitroglycerin, call emergency services immediately. For unstable angina, seek medical attention right away.

The Pathophysiology of Heart Attacks: What Happens Inside Your Body

Understanding the process of a heart attack can help appreciate its severity and the importance of quick intervention:

1. Plaque Buildup: Over time, fat, calcium, proteins, and inflammatory cells accumulate in the coronary arteries, forming plaques.
2. Plaque Rupture: The hard outer shell of a plaque can crack, exposing the soft interior.
3. Blood Clot Formation: Platelets rush to the site of the rupture, forming a blood clot.
4. Artery Blockage: If the clot is large enough, it can block the artery, cutting off blood supply to part of the heart muscle.
5. Muscle Damage: Without oxygen, heart muscle cells begin to die, causing permanent damage.

How quickly does heart muscle damage occur during a heart attack? Heart muscle cells can start dying within 20-40 minutes of oxygen deprivation. The extent of damage depends on the size of the affected area and the time between onset of symptoms and treatment.

Immediate Response and Treatment for Heart Attacks

Quick action is crucial when a heart attack is suspected. Here’s what to do:

1. Call Emergency Services: Dial 911 or your local emergency number immediately.
2. Chew Aspirin: If available and not allergic, chew a regular-strength aspirin to help prevent blood clotting.
3. Stay Calm: Try to relax and wait for help to arrive.
4. CPR: If the person loses consciousness and stops breathing, begin CPR if trained.

What treatments are available for heart attacks? Once at the hospital, treatments may include:

• Thrombolytic therapy to dissolve blood clots
• Angioplasty to open blocked arteries
• Stent placement to keep arteries open
• Coronary artery bypass surgery for severe blockages
• Medications such as blood thinners, beta-blockers, and ACE inhibitors

Prevention Strategies: Reducing Your Risk of Heart Attacks

While some risk factors for heart attacks are beyond control, many can be managed or eliminated:

• Maintain a healthy diet rich in fruits, vegetables, whole grains, and lean proteins
• Exercise regularly, aiming for at least 150 minutes of moderate-intensity activity per week
• Quit smoking and avoid secondhand smoke
• Control blood pressure, cholesterol, and diabetes through medication and lifestyle changes
• Manage stress through relaxation techniques, meditation, or counseling
• Maintain a healthy weight
• Limit alcohol consumption

How effective are these preventive measures? Studies show that adopting a heart-healthy lifestyle can significantly reduce the risk of heart attacks, even in individuals with a genetic predisposition to heart disease.

Regular Health Check-ups: Your First Line of Defense

Regular medical check-ups are crucial for early detection and management of heart disease risk factors. These should include:

• Blood pressure measurements
• Cholesterol level tests
• Blood glucose tests
• Body Mass Index (BMI) calculations
• Discussions about lifestyle habits and family history

How often should you have a heart health check-up? For most adults, an annual check-up is recommended. However, individuals with existing risk factors may need more frequent assessments.

Recovery and Rehabilitation After a Heart Attack

Recovering from a heart attack is a gradual process that involves both physical and emotional healing. A comprehensive cardiac rehabilitation program typically includes:

1. Exercise training to improve cardiovascular fitness
2. Education on heart-healthy living
3. Counseling to reduce stress and improve mental health
4. Nutritional guidance
5. Smoking cessation support if needed

How long does cardiac rehabilitation usually last? Most programs run for about 12 weeks, but the duration can vary based on individual needs and progress.

Long-term Lifestyle Changes

Adopting and maintaining a heart-healthy lifestyle is crucial for preventing future cardiac events. This includes:

• Following a Mediterranean or DASH diet
• Engaging in regular physical activity
• Taking prescribed medications as directed
• Managing stress effectively
• Attending follow-up appointments with healthcare providers

Can you fully recover from a heart attack? While the damaged heart muscle cannot regenerate, many people can return to a normal life with proper treatment and lifestyle changes. The key is to follow medical advice and commit to a heart-healthy lifestyle.

Emerging Research and Future Directions in Heart Attack Prevention and Treatment

The field of cardiology is constantly evolving, with new research offering hope for improved prevention, detection, and treatment of heart attacks:

Genetic Testing and Personalized Medicine

Advances in genetic testing are allowing doctors to identify individuals at higher risk for heart disease and tailor prevention strategies accordingly. How might genetic testing change heart attack prevention? It could lead to more personalized risk assessments and earlier interventions for those at high genetic risk.

Novel Biomarkers for Early Detection

Researchers are investigating new blood biomarkers that could detect heart attacks earlier or even predict them before they occur. What potential impact could these biomarkers have? They could revolutionize early intervention strategies, potentially preventing heart attacks before they happen.

Stem Cell Therapy

Stem cell research shows promise in regenerating damaged heart tissue after a heart attack. While still experimental, this approach could potentially reverse some of the damage caused by heart attacks in the future.

Artificial Intelligence in Diagnosis

AI algorithms are being developed to analyze ECGs and other cardiac data more accurately than human experts. How might AI change heart attack diagnosis? It could lead to faster, more precise diagnoses, especially in complex cases or in areas with limited access to cardiac specialists.

Nanotechnology in Treatment

Nanoparticles are being explored as a way to deliver drugs directly to damaged heart tissue, potentially improving the effectiveness of treatments while reducing side effects.

What challenges remain in heart attack research? Despite these advancements, challenges persist in translating research findings into clinical practice, ensuring equitable access to new technologies, and addressing the rising global burden of heart disease in an aging population.

Global Impact and Public Health Initiatives

Heart attacks remain a leading cause of death worldwide, prompting various public health initiatives:

• Community education programs on heart attack symptoms and prevention
• Workplace wellness programs promoting heart health
• Policy measures to reduce risk factors (e.g., tobacco control, trans fat bans)
• Improved emergency response systems for faster treatment

How effective are these public health initiatives? Studies show that comprehensive public health approaches can significantly reduce heart attack rates and improve outcomes at a population level.

Disparities in Heart Attack Care and Outcomes

Significant disparities exist in heart attack incidence, treatment, and outcomes based on factors such as race, ethnicity, gender, and socioeconomic status. Addressing these disparities is crucial for improving overall heart health outcomes.

What strategies are being employed to address these disparities? Initiatives include culturally tailored education programs, efforts to increase diversity in the healthcare workforce, and policies aimed at improving healthcare access in underserved communities.

The Role of Technology in Heart Attack Prevention and Management

Technological advancements are playing an increasingly important role in heart health:

Wearable Devices

Smartwatches and other wearable devices can now monitor heart rate, detect irregular rhythms, and even perform basic ECGs. How accurate are these devices in detecting heart problems? While not a substitute for medical evaluation, many of these devices have shown promising accuracy in detecting certain heart rhythm abnormalities.

Telemedicine

Remote consultations and monitoring are making it easier for patients to receive regular cardiac care, especially in rural or underserved areas. What impact has telemedicine had on heart attack outcomes? Early studies suggest that telemedicine can improve medication adherence and risk factor management, potentially reducing heart attack rates.

Mobile Health Apps

Numerous apps are available to help users track their heart health, manage medications, and make lifestyle changes. How effective are these apps in improving heart health? When used consistently, many of these apps have been shown to help users better manage risk factors like high blood pressure and high cholesterol.

As we continue to advance our understanding of heart attacks and develop new strategies for prevention and treatment, the outlook for heart health continues to improve. However, the importance of individual awareness, prompt action in emergencies, and commitment to a heart-healthy lifestyle remains paramount in the fight against this prevalent and potentially deadly condition.

Symptoms, Causes, Treatment, and Prevention

A heart attack happens when something blocks the blood flow to your heart so it can’t get the oxygen it needs. It’s a medical emergency. Call 911 right away at the first sign of any symptoms. Don’t wait to see if the symptoms pass.

Heart attacks are also called myocardial infarctions (MIs). “Myo” means muscle, “cardial” refers to the heart, and “infarction” means death of tissue because of a lack of blood supply. This tissue death can cause lasting damage to your heart muscle..

Symptoms of a heart attack include:

• Discomfort, pressure, heaviness, tightness, squeezing, or pain in your chest or arm or below your breastbone
• Discomfort that goes into your back, jaw, throat, or arm
• Fullness, indigestion, or a choking feeling (it may feel like heartburn)
• Sweating, upset stomach, vomiting, or dizziness
• Severe weakness, anxiety, fatigue, or shortness of breath
• Fast or uneven heartbeat

Symptoms can be different from person to person or from one heart attack to another.  Women are more likely to have these heart attack symptoms:

• Unusual fatigue
• Shortness of breath
• Nausea or vomiting
• Dizziness or lightheadedness
• Discomfort in your gut. It may feel like indigestion.
• Discomfort in the neck, shoulder, or upper back

With some heart attacks, you won’t notice any symptoms (a “silent” myocardial infarction). This is more common in people who have diabetes.

More than a million Americans have heart attacks each year.  It happens every 40 seconds to someone in the U.S., according to the CDC. 

Heart attacks happen to both men and women. Although they are more likely as you get old, there are many risk factors – including high blood pressure, high levels of LDL (“bad”) cholesterol, diabetes, and whether you smoke – that you can change.

Types of heart attacks: When someone has a heart attack, you may hear some of these terms used:

• STEMI: A heart attack where a coronary artery is completely blocked 
• NSTEMI: A heart attack where a coronary artery is narrowed enough to greatly reduce blood flow but is not totally blocked
• MINOCA: A heart attack in which no blockages are seen in the main coronary arteries.  MINOCA stands for myocardial infarction with non-obstructive coronary arteries. 

A sudden cardiac arrest is actually not a heart attack. You can think of a heart attack as a problem within the heart’s arteries, and a sudden cardiac arrest as the heart’s electrical system suddenly not working right, causing the heart to stop pumping.

Angina also isn’t a heart attack. It’s a symptom, and sometimes it can signal a heart attack. It means chest pain. And while it can happen with a heart attack, it can also happen for other reasons. The sensations may occur with normal activities or exertion but then go away with rest or when you take nitroglycerin.

With angina, you may feel:

• Pressure, pain, squeezing, or a sense of fullness in the center of the chest
• Pain or discomfort in the shoulder, arm, back, neck, or jaw

Call 911 if it gets worse, lasts more than 5 minutes, or doesn’t improve after you’ve taken nitroglycerin. Doctors call that “unstable” angina, and it’s an emergency that could be related to a heart attack that is about to happen.

If you instead have “stable” angina, which is the most common kind, your symptoms usually happen with predictable triggers (such as a strong emotion, physical activity, extreme high or low temperatures, or even a heavy meal). The symptoms go away if you rest or take nitroglycerin that your doctor has prescribed. If not, call 911.

Your heart muscle needs a constant supply of oxygen-rich blood. Your coronary arteries give your heart this critical blood supply. If you have coronary artery disease, those arteries become narrow, and blood can’t flow as well as it should. When your blood supply is blocked, you have a heart attack.

Fat, calcium, proteins, and inflammatory cells build up in your arteries to form plaques. These plaque deposits are hard on the outside and soft and mushy on the inside.

When the plaque is hard, the outer shell cracks. This is called a rupture. Platelets (disc-shaped things in your blood that help it clot) come to the area, and blood clots form around the plaque. If a blood clot blocks your artery, your heart muscle becomes starved for oxygen. The muscle cells soon die, causing permanent damage.

Rarely, a spasm in your coronary artery can also cause a heart attack. During this coronary spasm, your arteries restrict or spasm on and off, cutting off the blood supply to your heart muscle (ischemia). It can happen while you’re at rest and even if you don’t have serious coronary artery disease.

Each coronary artery sends blood to a different part of your heart muscle. How much the muscle is damaged depends on the size of the area that the blocked artery supplies and the amount of time between the attack and treatment.

Your heart muscle starts to heal soon after a heart attack. This takes about 8 weeks. Just like a skin wound, a scar forms in the damaged area. But the new scar tissue doesn’t move the way it should. So your heart can’t pump as much after a heart attack. How much that ability to pump is affected depends on the size and location of the scar.

After a heart attack, you need quick treatment to open the blocked artery and lessen the damage. At the first signs of a heart attack, call 911. The best time to treat a heart attack is within 1 or 2 hours after symptoms begin. Waiting longer means more damage to your heart and a lower chance of survival.

If you’ve called emergency services and are waiting for them to arrive, chew an aspirin (325 milligrams). Aspirin is a potent inhibitor of blood clots and can lower the risk of death from a heart attack by 25%.

Call 911 and start CPR (cardiopulmonary resuscitation) if someone goes into cardiac arrest, which is when the heartbeat has stopped and the person isn’t responsive. CPR doesn’t restart the heart; but it keeps the person alive until medical help arrives.

An easy-to-use device called an AED (automated external defibrillator) is available in many public places and can be used by almost anyone to treat cardiac arrest. This device works by shocking the heart back into a normal rhythm.

Here’s how to use an AED:

1. Check responsiveness

• For an adult or older child, shout and shake the person to confirm whether they’re unconscious. Do not use AED on a conscious person.
• For an infant or young child, pinch their skin. Never shake a young child.
• Check breathing and pulse. If absent or uneven, prepare to use the AED as soon as possible.

2. Prepare to use the AED

• Make sure the person is in a dry area and away from puddles or water.
• Check for body piercings or outline of an implanted medical device, such as a pacemaker or implantable defibrillator.
• AED pads must be placed at least 1 inch away from piercings or implanted devices.

3. Use the AED

For newborns, infants, and children up to age 8, use a pediatric AED, if possible. If not, use an adult AED.

• Turn on the AED.
• Wipe the chest dry.
• Attach the pads.
• Plug in the connector, if necessary.
• Make sure no one is touching the person.
• Push the “Analyze” button.
• If a shock is advised, check again to make sure no one is touching the person.
• Push the “Shock” button.
• Start or resume compressions.
• Follow AED prompts.

4. Continue CPR

• After 2 minutes of CPR, check the person’s heart rhythm. If it’s still absent or uneven, give them another shock.
• If a shock isn’t needed, continue CPR until emergency help arrives or the person begins to move.
• Stay with the person until help arrives.

Emergency medical workers will ask you about your symptoms and do some tests.

Tests to diagnose a heart attack

Your doctor may order tests, including:

EKG: Also known as an electrocardiogram or ECG, this is a simple test that records the electrical activity of the heart. It can tell how much your heart muscle has been damaged and where. It can also monitor your heart rate and rhythm.

Blood tests: Several blood tests, often done every 4 to 8 hours, can help diagnose a heart attack and spot any ongoing heart damage. Different levels of cardiac enzymes in your blood can indicate heart muscle damage. These enzymes are usually inside the cells of your heart. When those cells are injured, their contents – including the enzymes – spill into your bloodstream. By measuring the levels of these enzymes, your doctor can find out the size of the heart attack and when it started. Tests can also measure troponin levels. Troponins are proteins inside heart cells that are released when the cells are damaged by the lack of blood supply to your heart.

Echocardiography: In this ultrasound test, sound waves are bounced off your heart to create images. It can be used during and after a heart attack to learn how your heart is pumping and what areas aren’t pumping the way they should. The “echo” can also tell whether any parts of your heart (valves, septum, etc.) have been injured in the heart attack.

Cardiac catheterization: You might need cardiac catheterization, also called cardiac cath, during the first hours of a heart attack if medications aren’t helping with the ischemia or symptoms. The cardiac cath can give an image of the blocked artery and help your doctor decide on a treatment.

In this procedure, a catheter (a thin, hollow tube) is inserted into a blood vessel in your groin or wrist and threaded up to your heart. Dye is used to highlight your heart’s arteries. Your doctor can then identify blockages, which are often treated with angioplasty or stents to open the artery and restore blood flow. Your doctor may do several tests to assess your heart. Intravenous blood thinner is an option to open the artery if cardiac catheterization is not available.

Stress testing: Your doctor can do a treadmill test or a radionuclide scan to check whether other areas of the heart are still at risk for another heart attack.

A heart attack is a medical emergency that needs care right away to prevent permanent heart damage or death. Treatment often begins in the ambulance if you called 911, or in the emergency room if someone else took you to the hospital.

What drugs are used to treat a heart attack?

At the emergency facility or hospital, you’ll quickly get drugs to prevent further blood clotting in the heart and ease the strain on the heart. Drug therapy aims to break up or prevent blood clots, stop platelets from collecting and sticking to the plaque, stabilize the plaque, and prevent more ischemia.

You should get these medications as soon as you can (within 1 or 2 hours from the start of your heart attack, if possible) to limit heart damage.

Drugs used during a heart attack may include:

• Aspirin to stop blood clotting that may make the heart attack worse
• Other antiplatelet drugs, such as clopidogrel (Plavix), prasugrel (Effient), or ticagrelor (Brilinta) to stop clotting
• Thrombolytic therapy (“clot busters”) to dissolve blood clots in your heart’s arteries
• Any combination of these

Other drugs given during or after a heart attack help your heart work better, widen your blood vessels, lower your pain, and help you avoid life-threatening heart rhythms.

Are there other treatments for a heart attack?

Treatment may also include a procedure to open the blocked arteries.

Cardiac catheterization: In addition to making a picture of your arteries, cardiac catheterization can be used for procedures (such as angiography or stent) to open narrowed or blocked arteries.

Balloon angioplasty: This treatment can be done, if needed, during cardiac catheterization. A balloon-tipped catheter (thin, hollow tube) is inserted into the blocked artery in the heart. The balloon is inflated gently to press plaque outward against the walls of the artery, to open the artery and improve blood flow. Most of the time, this is not done without putting in a stent.

Stent placement: In this procedure, a small tube is inserted through a catheter into a blocked artery to “prop” it open. The stent is usually made of metal and is permanent. It can also be made of a material that your body absorbs over time. Some stents have medicine that helps keep the artery from getting blocked again.

Bypass surgery: You might have bypass surgery in the days after a heart attack to restore the blood supply to your heart. Your surgeon will reroute blood flow around your blocked artery, usually using a blood vessel from your leg or chest. They can bypass multiple arteries.

What happens in the coronary care unit (CCU)?

If you’ve had a heart attack, you’ll usually stay in a CCU for at least 24 to 36 hours. Once past the critical phase, you’ll continue to get a variety of drugs, including:

• Beta-blockers to slow the heart
• Nitrates to increase heart blood flow
• Blood thinners such as aspirin, Brilinta, clopidogrel, Effient, heparin, or Plavix to prevent further clotting
• ACE inhibitors to help the heart muscle heal
• Statins – cholesterol-lowering drugs such as atorvastatin and simvastatin – to help the heart muscle heal and lower the risk of another heart attack

While you’re in the hospital, medical staff will constantly monitor your heart by EKG in case you get unusual heart rhythms.

Some people may need to be fitted with a pacemaker, a battery-powered device to help keep a steady heart rhythm. If you have a dangerous arrhythmia known as ventricular fibrillation, medical providers will give an electric shock to your chest.

Treatments don’t cure coronary artery disease. You can still have another heart attack. But you can take steps to make it less likely.

The goal after your heart attack is to keep your heart healthy and lower your risk of having another heart attack. Take your medications as directed, make healthy lifestyle changes, see your doctor for regular heart checkups, and consider a cardiac rehabilitation program.

Why do I need to take medications after a heart attack?

You might take certain drugs after a heart attack to:

• Prevent blood clots
• Help your heart work better
• Prevent plaques by lowering cholesterol

You might take medications that treat an uneven heartbeat, lower your blood pressure, control chest pain, and treat heart failure.

Know the names of your medications, what they’re used for, and when you need to take them. Go over your medications with your doctor or nurse. Keep a list of all your medications, and take it to each of your doctor visits. If you have questions about them, ask your doctor or pharmacist.

It sounds obvious, but don’t skip your medications. Many people don’t take their medications the way their doctor told them to. Figure out what keeps you from taking your medicine – it could be side effects, cost, or forgetfulness – and ask your doctor for help.

What lifestyle changes are needed after a heart attack?

To keep heart disease from getting worse and to head off another heart attack, follow your doctor’s advice. You might need to change your lifestyle. Here are some changes you can make that can cut your risk and put you on the path to a healthier life:

Stop smoking: Smoking dramatically raises your risk of both heart attacks and strokes. Talk to your doctor about how to quit. You’ll also be doing your friends and family a favor, since secondhand smoke can also lead to heart disease. You also can call the hotline 800-QUIT-NOW (800-784-8669) and visit the smokefree.gov website.

Keep a healthy body weight: If you’re overweight or obese, you don’t have to get thin to reduce your risk for a heart attack or stroke, but your doctor may recommend some weight loss. If you lose 5% to 10% of your weight, you’ll improve your cholesterol numbers and lower your blood pressure and blood sugar levels.

Follow an exercise plan: Moderate physical activity lowers your chances of a heart attack. It also can reduce your blood pressure and LDL or “bad” cholesterol, raise your HDL or “good” cholesterol, and help you stay at a healthy weight.

Aim for 30 minutes of exercise that gets your heart pumping at least 5 days a week. Brisk walking or swimming are some good choices. On the other 2 days, do strength training, like lifting weights. If you’ve got a tight schedule, break your exercise routine into small chunks.

Eat a heart-healthy diet: Fill your plate with different kinds of fruits, veggies, beans, and lean meats, such as poultry without the skin. Also up your intake of whole grains, like oatmeal, quinoa, and brown rice, and of fish, especially those with omega-3 fatty acids, such as salmon, trout, and herring.

Avocados, olive oil, and flaxseeds also have omega-3s, as do some nuts and seeds. Fat-free or low-fat dairy products such as milk, yogurt, and cheese also are better choices for your heart health than higher-fat versions. 

Cut back on unhealthy foods: Stay away from processed or prepared foods that often are high in salt and added sugar. They’re also filled with preservatives. Avoid fatty beef, butter, fried foods, and palm oil. All are high in saturated fats.

Skip sugary drinks like sodas and fruit punch, which can lead to weight gain. So can packaged baked goods such as cookies, cakes, and pies. They are high in trans fats and can raise your cholesterol levels.

Limit alcohol: If you don’t drink already, don’t start. If you do drink, limit how much you drink. The recommendation is no more than one drink a day if you are a woman and no more than two a day if you are a man. Drinking raises your heart rate and blood pressure. It also raises the level of fat in your blood and can cause weight gain.

Get regular checks of your cholesterol, blood pressure, and blood sugar (glucose) levels: If you have diabetes, make sure it’s controlled. Keeping a check on these numbers can help you be more aware of the changes you need to make to keep these levels within normal limits.

Control stress: You may feel anxious or frustrated at times. Open up to your family and friends about what’s going on. Support groups can help you learn how others adjusted to life after a heart attack or stroke.

You may want to talk to a mental health professional or ask your doctor about a stress management program. You can also reduce stress with plenty of physical activity and mind-body practices like meditation.

Pay attention to your symptoms: Don’t just hope they’ll go away. See your doctor if you feel anything unusual, like shortness of breath, changes in your heart rhythm, or extreme tiredness. Also, watch for pain in your jaw or back, nausea or vomiting, sweating, or flu-like symptoms.

Why should I take part in cardiac rehabilitation?

If you’ve had a heart attack or have been diagnosed with heart disease, your doctor may recommend cardiac rehabilitation. You’ll work with a team of experts to boost your health and avoid future problems.

Your team may include doctors and nurses, as well as specialists in exercise, nutrition, physical therapy, occupational therapy, and mental health. They’ll set up a program to fit your needs. They can also help you make changes in your daily life. If you stick with it, it can make a big difference in your recovery and overall well-being.

When will I see my doctor again after I leave the hospital?

Make a doctor’s appointment for 4 to 6 weeks after you leave the hospital following a heart attack. Your doctor will want to check your recovery. You might need an exercise stress test on a regular basis. These tests can help your doctor find or slow blockages in your coronary arteries and plan your treatment.

Call your doctor if you have symptoms, such as chest pain that happens more often, gets stronger, lasts longer, or spreads to other areas; shortness of breath, especially while you’re resting; dizziness; or uneven heartbeats.

Vomiting (for Parents) – Nemours KidsHealth

en español: Vómitos

Medically reviewed by: Mary L. Gavin, MD

What Is Vomiting?

Vomiting is the forceful throwing up of stomach contents. Most kids vomit from time to time, but it usually doesn’t last long and often gets better on its own.

What Causes Vomiting?

Many different things can make kids throw up. Most of the time, it’s due to gastroenteritis, an infection of the stomach and intestines. Gastroenteritis, often called the “stomach flu,” is usually caused by viruses. Other germs, like bacteria and parasites, can also cause gastroenteritis. Besides vomiting, people with gastroenteritis also may have nausea, belly pain, and diarrhea. Vomiting due to gastroenteritis usually lasts less than 24 hours and other symptoms get better in a few days.

What Else Can Cause Vomiting?

People can sometimes vomit from:

• food poisoning
• motion sickness
• migraine headaches
• pregnancy

Rarely, vomiting can be a sign of a serious problem, including:

• a blocked intestine, such as pyloric stenosis in infants
• other problems of the stomach and intestines, like gallstones, pancreatitis, or appendicitis
• increased pressure in the brain that can happen after a head injury or as a symptom of meningitis or a brain tumor

What Are the Signs & Symptoms of Vomiting?

Kids often feel nauseous and have belly pain before throwing up. Other symptoms may include:

• fever
• loss of appetite
• diarrhea

Frequent vomiting can lead to dehydration (not having enough water in the body). Signs of dehydration include peeing less often crying with few or no tears, having a dry mouth or cracked lips, feeling dizzy or lightheaded, acting very sleepy or less alert.

How Do Doctors Find the Cause of Vomiting?

Doctors usually can tell if vomiting if part of a stomach flu by hearing about the symptoms. Usually, no tests are needed. If a child is vomiting often or is very sick, the doctor may order a urine test, blood test, or other tests to check for dehydration and to find out what is causing the vomiting.

How Is Vomiting Treated?

Treatment for vomiting depends on the cause. Vomiting from gastroenteritis usually goes away on its own in less than 24 hours.

If your child has vomiting, help prevent dehydration by giving an oral rehydration solution (such as Pedialyte, Enfalyte, or a store brand). It has the right amounts of water, sugar, and salt to help with dehydration. You can buy it without a prescription at drugstores or supermarkets. If you can’t get oral rehydration solution, talk to your doctor.

If your child has mild dehydration and your doctor says it’s OK to start treatment at home:

• Start with small sips of the oral rehydration solution, about 1 or 2 teaspoons every few minutes.
• Babies can continue to breastfeed or take formula as long as they are not throwing up repeatedly.
• Don’t give babies plain water instead of oral rehydration solution. It doesn’t have the right nutrients for babies with dehydration.
• Older children can have frozen electrolyte popsicles.
• Don’t give medicines for vomiting unless your doctor recommends it.
• When your child stops vomiting, you can offer small amounts of solid foods, such as toast, crackers, rice, or mashed potatoes. Yogurt, fruits, vegetables, and lean meat, like chicken, are also OK.

Kids who continue to vomit or have more severe dehydration need treatment in the ER or hospital.  

When Should I Call the Doctor?

Call the doctor if your child:

• can’t drink for several hours
• has signs of dehydration, such as peeing less often, crying with few or no tears, having a dry mouth or cracked lips, feeling dizzy or lightheaded, acting very sleepy or less alert
• has a high fever
• is vomiting blood, or has green or brownish vomit
• has severe stomach or back pain
• has headache or stiff neck
• is vomiting after a head injury
• is vomiting for more than 24 hours 

Medically reviewed by: Mary L. Gavin, MD

Date reviewed: May 2021

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when is it really dangerous? What to do with bouts of vomiting? When should you see a doctor for vomiting?

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Vomiting is a reflex eruption through the mouth of the contents of the stomach, and sometimes the duodenum.

Vomiting

The gag reflex is quite complex – it involves various muscle groups. It is controlled by the vomiting center located in the brain stem. By its very nature, vomiting is a mechanism by which the body defends itself against poisoning. Normally, vomiting is a reaction to the ingestion of toxic substances into the gastrointestinal tract or simply something that cannot be digested – for example, too fatty foods. Therefore, after an attack of vomiting, a person often feels relieved: the body has cleansed itself.

However, the intoxication that caused vomiting may have an internal source, that is, be the result of any pathology or disease. It is also possible that the irritation of the nervous system, leading to vomiting spasms, is not related to the state of the stomach at all. This makes one perceive vomiting as a very serious, and even formidable symptom. An attack of vomiting is almost always a sufficient reason to see a doctor. In case of recurring attacks, you should definitely consult a doctor!

Causes of vomiting

In most cases, vomiting is due to irritation of the receptors of the stomach or, in medical terms, has a visceral origin. The cause is most often acute or chronic diseases of the stomach itself (acute food poisoning, gastritis, stomach ulcers, food allergies). Also, the receptors of the stomach can also respond to diseases of other organs – the gallbladder, uterus, heart (vomiting is included in the complex of possible symptoms of myocardial infarction).

Vomiting can also be of central origin, that is, caused by pathologies of the central nervous system (brain), such as meningitis, encephalitis, trauma, and brain tumors. Quite often, vomiting is observed with migraines. Problems in the inner ear can also lead to vomiting (in which case, vomiting may be accompanied by dizziness). With excessive irritation of the receptors of the inner ear (during motion sickness), even a healthy person can vomit, especially if the vestibular apparatus is not trained. Sometimes vomiting is caused by an emotional disorder (stress) or is a reaction to something that causes extreme disgust (conditioned reflex vomiting).

Irritation of the vomiting center can be caused by toxic substances carried by the blood stream ( hematogenous toxic vomiting). Toxic substances can enter the body from the outside (for example, chlorine or carbon monoxide – by inhalation), or can be produced in the body itself – as a result of impaired liver or kidney function.

Vomiting and other symptoms

Usually vomiting is preceded by nausea, because, in fact, vomiting is the resolution of nausea, its logical conclusion. The fact that nausea turned into vomiting indicates the severity of the pathological process. Vomiting spasms can be observed against the background of elevated temperature, accompanied by diarrhea. In the vomit, in addition to food debris, gastric juice and mucus, bile, blood, and pus may be present.

Repeated, periodically recurring and indomitable vomiting exhausts and dehydrates the body, leads to a violation of mineral metabolism and acid-base balance.

Diarrhea and vomiting

Vomiting and fever

When vomiting scares

Any bout of vomiting is a very unpleasant experience. Even if a person experiences relief with the resolution of an attack, vomiting itself is perceived as an extraordinary event, which should not normally be. The shock of the body, domestic and social inconvenience – all this makes vomiting a process of a different order compared to other reflex actions, such as coughing or sneezing. We always react sharply to vomiting (we do not leave it unattended), and rightly so.

However, in some cases, vomiting worries us especially strongly. Such is vomiting of bile , vomiting of blood . Parents are worried about cases of vomiting in a child . Quite often, vomiting is observed during pregnancy , attracting increased attention.

These cases should be mentioned separately:

Vomiting of bile

Vomiting blood

Vomiting during pregnancy

Child vomiting

What to do if you are vomiting

What to do if you are vomiting

Because anyone can experience vomiting, it is helpful to know how to prevent vomiting, what to do during and immediately after an attack, and when to see a doctor.

Nausea is a precursor to vomiting. If you feel sick, try opening a window (increase the oxygen supply), drinking some sweetened liquid (this will soothe the stomach), sitting or lying down (physical activity makes nausea and vomiting worse). You can dissolve a tablet of validol. If you get sick on the road, take candy with you and dissolve on the way. This will help prevent vomiting.

What to do when vomiting

During an attack, it is important to exclude the ingress of vomit into the respiratory tract. The patient during vomiting should never lie on his back. Do not leave young children unsupervised if they may vomit. An elderly or weakened person must be helped to turn on his side, head to the edge of the bed, put a pelvis in front of him.

What to do after vomiting

After an attack, rinse your mouth with cold water. If the patient himself cannot do this, it is necessary to moisten a piece of gauze in a soda solution and wipe his mouth.

Immediately after the attack, you can drink only a few sips of water, and then if there was no blood in the vomit. You can drink properly only after 2 hours, and eat only 6-8 hours after the attack. Food should be dietary, sparing; best of all – porridge on the water, rice, low-fat soup.

With repeated attacks of vomiting, dehydration of the body is possible. Therefore, it is necessary to drink a special solution that restores the water-electrolyte and acid-base balance.

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When should you see a doctor if you vomit?

Vomiting – in many cases, a sign that the body is experiencing serious problems and needs to be cleansed, and therefore, most likely, in treatment. If the disease is accompanied by vomiting, this usually indicates that the disease is quite severe.

If the attack of vomiting was one-time and there is reason to believe that it was caused by overeating, motion sickness, alcohol poisoning or stress, there is no direct need to see a doctor. In all other cases, a doctor’s consultation is necessary. Especially if the attacks are repeated for two days or more, as well as in the presence of diabetes or other chronic diseases.

Sometimes emergency care is required for vomiting. You need to call an ambulance if:

• vomiting accompanied by persistent or severe abdominal pain;
• there are repeated bouts of vomiting after a head injury;
• with vomiting observed dehydration, dry mouth, increased urination;
• with deterioration of mental and functional activity in the elderly;
• there is blood in the vomit (for example, impurities in the form of “coffee grounds”).

Which doctor should I contact if I vomit?

Complaints of nausea and vomiting are usually addressed to a gastroenterologist or general practitioner (general practitioner, family doctor or pediatrician). In case of nausea and vomiting during pregnancy, you should contact your gynecologist.

Do not self-medicate. Contact our specialists who will correctly diagnose and prescribe treatment.

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All answers from doctors

Nausea and vomiting in adults – causes, examination and treatment in Astrakhan | Symptoms

Appendicitis, intestinal perforation, inflammation of the gallbladder, pancreatitis
Signs: Significant abdominal pain. The abdomen is painful on palpation.

Bowel obstruction
Signs: Lack of bowel movements and flatulence. Spasmodic abdominal pain that comes and goes. Bloated belly. Usually in people with a hernia or previous abdominal surgery.

Gastroenteritis
Signs: Vomiting and diarrhea. No pain or minimal abdominal pain (except for vomiting). Rarely, fever or blood in the stool. Normal results of abdominal examination.

Hepatitis
Symptoms: Mild to moderate nausea for many days and sometimes vomiting. General malaise. Darkening of the urine, then yellowing of the skin and whites of the eyes (jaundice). Loss of appetite. Sensation of mild discomfort in the upper right side of the abdomen.

Ingestion of toxic substances (alcohol, aspirin, iron, lead, or insecticides)
Signs: Information about ingestion is usually obtained from the history. Various other symptoms, depending on the substance ingested.

Head injury (due to a recent accident, sports injury or fall)
Signs: Injury is evident from the person’s history. Often headache, confusion, and difficulty remembering recent events.

Brain bleeding
Symptoms: Sudden, often severe headache. Confusion of consciousness.

Meningitis (brain infection)
Signs: Increasing headache and disorientation. Often fever and pain when the head is tilted forward, a reddish-purple rash of tiny dots on the skin (petechiae) if caused by meningococcal meningitis.

Increased intracranial pressure (for example, due to a blood clot or tumor)
Signs: Headache, confusion, and sometimes problems with nerves, spinal cord, or brain function.

Labyrinthitis (inflammation of the inner ear)
Signs: False sensation of movement (systemic vertigo), rhythmic twitching eye movement (nystagmus), and worsening of symptoms with head movement. Sometimes ringing in the ears (tinnitus).

Migraine
Signs: Usually moderate to severe headache. Headache, before which people sometimes see flashes of light and blind spots (aura). Sometimes sensitivity to light (photophobia) or temporary disturbances in balance or muscle strength. Often there is a history of recurrence of such attacks.

Motion sickness
Signs: The cause is obvious from the person’s history.

Psychological disorders
Signs: No diarrhea or abdominal pain. Vomiting often associated with stress. The food is disgusting.

Diabetic ketoacidosis
Signs: Increased daily urine volume (polyuria), increased thirst (polydipsia), and often significant dehydration.

Side effects or drug toxicity
Signs: Taking a drug or substance, which is obvious from the history taking.

Liver or kidney failure
Signs: Often jaundice with advanced liver disease. The smell of ammonia from the mouth in renal failure. Often in people with a known disorder.

Pregnancy
Signs: Nausea and/or vomiting often in the morning or in response to meals.