Prevention of heart failure after a heart attack

If you’ve ever had a myocardial infarction (MI), also informally called a heart attack, your heart muscle has been damaged. If enough damage occurs, a person may suffer a mild myocardial infarction and be at risk for developing heart failure, even if the damage is minimal or moderate. (For people who have had very large heart attacks, the risk of heart failure is serious and can occur within the first hours or days of an MI.)

Regardless of the degree of damage to the heart after a heart attack, appropriate medications and lifestyle changes can be effective in delaying or preventing the onset of heart failure.

how the heart heals

After a heart attack, the undamaged parts of the muscles stretch to take over the work of the damaged muscles. (The clinical term for enlargement of the heart is cardiomegaly.)

As a result of this process, called “cardiac remodeling,” the heart becomes larger. Enlargement of the heart allows the heart to pump out a more normal amount of blood despite some damage to the muscle, which contributes to the increased risk of heart failure after an MI.

To assess heart health after an MI, cardiologists typically use noninvasive imaging tests. This includes a multi-gate acquisition (MUGA) scan and echocardiogram to determine the so-called left ventricular ejection fraction (LVEF).

Prevention of cardiac remodeling

After a heart attack, people with signs of impending heart failure may be prescribed one or more of the drugs known to significantly reduce post-myocardial infarction remodeling. survival rate is improved. These drug classes include:

ACE inhibitors are thought to help prevent or slow remodeling after a heart attack, thereby lowering the risk of recurrent myocardial infarction, stroke, or sudden death. These are known to significantly improve long-term survival.

Side effects of ACE inhibitors include cough, low blood pressure, dizziness, rash, gastrointestinal disturbances, and decreased kidney function. People who should not take ACE inhibitors include pregnant women, people with severe kidney disease, people with high potassium levels, and people with allergic reactions that cause swelling.

ARNi therapy combines the benefits of ARBs (lowering blood pressure and dilating blood vessels) with a drug that limits the activity of an enzyme called neprilysin. It helps increase the effectiveness of ARBs while reducing the workload on the heart. Research suggests it can limit remodeling in people diagnosed with heart failure.

maintain heart health

The key to keeping your heart healthy and preventing new cardiac events is how you live your daily life. This may mean making significant changes to your diet, activity level, and certain habits that affect your heart health.

• Quit smoking. Smoking accelerates the progression of atherosclerosis by increasing bad cholesterol (LDL) levels and decreasing good cholesterol (HDL) levels in the blood. It also makes your heart beat faster, increases your blood pressure, and increases your blood’s tendency to form blood clots.
• Improve your eating habits. Focus on a heart-healthy diet and maximize your intake of vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, non-tropical vegetable oils, and nuts. Limit your intake of red meat, sweets, processed foods, and carbonated drinks.
• exercise. Research shows that at least 150 minutes of moderate-intensity physical activity per week can lower blood pressure and cholesterol and help maintain weight. If you have been diagnosed with heart failure, first discuss your exercise goals with your health care provider.
• Lose weight if you are overweight. Obesity puts you at risk for high cholesterol, high blood pressure, and insulin resistance, which are precursors to type 2 diabetes. These factors increase the likelihood of developing cardiovascular disease.
• Lower your blood pressure. The optimal blood pressure reading is less than 120/80 mmHg. You can reach your goals by taking your blood pressure medication as prescribed, exercising, and reducing salt intake.
• If you have diabetes, keep it under control. At least 68% of people with diabetes under the age of 65 die from some form of heart disease.
• stress management. Research has linked chronic stress to inflammation, which can contribute to coronary artery disease.
• Limit alcohol. Drinking too much can increase blood pressure, increase cardiomyopathy, increase triglycerides, and cause arrhythmia. Alcohol in moderation may have some benefits for your heart. The appropriate amount is one drink per day for women and up to two drinks for men. A drink is defined as 5 ounces of wine or 12 ounces of regular beer.
• Please take care of your teeth. Research shows that periodontal disease (gingivitis) can increase the risk of heart disease and stroke due to the presence of high levels of bacteria in infected areas in the mouth. Inflammation in the gums can also worsen inflammation in other parts of the body.
• Get enough sleep. Lack of sleep is a significant risk factor for heart disease. In the evening following sleep deprivation, sympathetic nervous system activity and blood pressure increase, and these increases are associated with an increased risk of coronary artery disease.

You can’t change the fact that you had a heart attack, but by paying attention to your medications, lifestyle, and diet, you may be able to prevent another heart attack and slow the progression of heart disease.