Heart Attack (cont.)
What are the complications of a heart attack?
Heart failure
When a large amount of
heart muscle dies, the ability of the heart to pump blood to the rest of the body is diminished, and this can result
in heart failure. The body retains fluid, and organs, for example, the kidneys, begin to
fail.
Ventricular fibrillation
Injury to heart muscle also can lead to
ventricular fibrillation. Ventricular
fibrillation occurs when the normal, regular, electrical activation of heart
muscle contraction is replaced by chaotic electrical activity that causes the
heart to stop beating and pumping blood to the brain and other parts of the
body. Permanent brain damage and death can occur unless the flow of blood to the
brain is restored within five minutes.
Most of the deaths from heart attacks are caused by ventricular fibrillation
of the heart that occurs before the victim of the heart attack can reach an
emergency room. Those who reach the emergency room have an excellent prognosis;
survival from a heart attack with modern treatment should exceed 90%. The 1% to
10% of heart attack victims who later die frequently had suffered major
damage to the heart muscle initially or additional damage at a later
time.
Deaths from ventricular fibrillation can be avoided by
cardiopulmonary resuscitation (CPR) started within five minutes of the onset of
ventricular fibrillation. CPR requires breathing for the victim and applying
external compression to the chest to squeeze the heart and force it to pump blood.
In 2008, the American Heart Association modified the mouth-to-mouth instruction
of CPR, and recommends that
chest compressions alone are effective if a bystander is reluctant to do
mouth-to-mouth. When
paramedics arrive, medications and/or an electrical shock (cardioversion) can be
administered to convert ventricular fibrillation back to a normal heart rhythm
and allow the heart to pump blood normally. Therefore, prompt CPR and a rapid
response by paramedics can improve the chances of survival from a heart attack.
In addition, many public venues now have automatic
external defibrillators
(AEDs) that provide the
electrical shock needed to restore a normal heart rhythm even before the
paramedics arrive. This greatly improves the chances of survival.
Next: What are the risk factors for atherosclerosis and heart attack? »
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