The phrase ‘heart attack’ is used a lot in common vernacular. People use the phrase often to mean a sudden death, if someone dies suddenly it is often quoted as a suspected heart attack until known otherwise. The term ‘attack’ to me, sounds like either heart is attacking something, or it is being attacked by something else, which kind of brings forward thoughts of a fight or struggle. I find it a strange term, although it does describe the symptoms that are often shown, the person looking like they are under attack internally and struggling to survive.
But what actually is a heart attack?
From what I have seen firsthand, there is nothing particularly simple in that explanation. I think the key two medical terms to understand, however, are ‘myocardial infarction’ and ‘coronary thrombosis’. A myocardial infarction, or MI, is a term used for when there is blood loss to a part of the heart which causes it to die or ‘infarct’. Infarction is also a term that can be used to any other area in the body where blood flow is lost and the cells die, for example can be in bowel tissue if there is a twist or strangulated hernia. Another common term for this is ischaemic or ischaemia. In effect, an MI is where one of the coronary arteries that supplies the heart with blood has become blocked and therefore the blood cannot flow. The tissues that need the blood are prevented from gaining oxygen and therefore die which causes the heart to struggle to function and sometimes stop.
The reason for this loss of blood flow is where the coronary thrombosis (CT) comes in, or maybe it doesn’t. Coronary arteries can become blocked over time from build up of fats (cholesterol) within the walls of the arteries. The thicker the walls, the smaller the aperture or hole inside the vessel and therefore the more the blood flow struggles to function. The plaques inside the walls can thicken so much that they eventually close, or the plaques can become dislodged and block the hole that way, or the plaque can cause a blood clot. A CT is where that blood clot, or thrombus, blocks the artery in this way. This is obviously a very simplified interpretation of a complicated medical situation so please correct me if anything I have said is factually wrong but allow me to express it in very simple terms!
The symptoms of a heart attack tend to be well known, a lot of us are familiar with the left arm pain and severe chest pains that are common. However, it has been made note of recently that these are familiar symptoms for men but women can experience much milder symptoms which can be mistaken for much less life threatening conditions such as indigestion. It is obvious that this could have very severe consequences if not understood by people.
Positively, the British Heart Foundation (BHF) states that on average seven out of ten heart attack sufferers in the UK today will survive. This is a stark comparison to 60 years ago when this would have been only three out of ten on average. Medicine has come a long way in treating and preventing the conditions that people suffer, necessary in that 7.6 million people in the UK today live with some kind of cardiac or circulatory disease. Unfortunately, these diseases are responsible for just over a quarter of all deaths in the UK.
During a post-mortem examination, there are some clear signs that the pathologist can demonstrate in the event of an MI or CT. A dissection of the heart can show patches of scarring in the walls (or myocardium) of the heart that show areas of tissue that have been affected. The dissection also examines three main arteries in the heart and the size of the blockages measured. Sometimes there can be blood clots visible in these vessels. From an APT perspective, when conducting the evisceration, we would not notice these aspects however we may note that the heart may seem unusually large which can be a sign that it has grown from struggling to do it’s basic function. In the event of an unusually large heart this can be described as ‘cardiomegaly’.
I hope that this little venture into the world of heart attacks has been interesting. I could elaborate a lot further in many places but I like to keep my posts to a certain length. I have considered some more focused, deep dives into subjects which would be longer posts but I am unsure if this would be reader friendly. Let me know if you have any thoughts about this!
MG x
References:
Mortuary Gem 
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