Heart attacks can happen in a variety of ways:

The connective tissues surrounding the heart cells may become so densely packed that the heart cells simply suffocate and die. To learn how to find the best Cardiologists In Bangalore, click here

Angina attacks are possible if acidification and low oxygenation have destroyed the heart muscles.

The capillary and artery basal membranes are blocked, and the heart can no longer receive oxygen. A heart attack then occurs at the site where the protein storage capacity was first exceeded.

A blood clot breaks free from a clogged and injured blood vessel, enters the heart, and cuts off the heart's oxygen supply. The same situation can result in a stroke.
Research Issues The Importance of Opening Arteries

The growing understanding of the causes of heart attacks calls into question the value or utility of opening blocked arteries. For starters, the increasingly popular aggressive treatments of opening arteries with bypass surgery, angioplasty, and stints do little or nothing to prevent an occlusion from recurring. Although bypass surgery has been shown to extend the lives of some severely ill patients, it does not prevent heart attacks. As we will see, heart attacks are caused by one of the four factors listed above rather than an arterial blockage, as most people believe. Overall, none of the currently used surgical procedures have been shown to significantly reduce heart disease mortality.

One of the main reasons for these treatments' poor success rate is that the majority of heart attacks do not begin with obstructions that narrow arteries. To combat the heart disease epidemic, which is sweeping most industrialized countries and is now spreading to developing countries, we must rely primarily on preventative measures. However, because these approaches are so inexpensive, they are not financially rewarding for those in charge of health care. Eating less protein, regular exercise, early bedtimes, regular mealtimes and balanced meals, drinking enough water, avoiding junk foods, quitting smoking, reducing alcohol consumption, removing stress sources, and so on are all preventative measures.

To the surprise of heart specialists, the old model of understanding heart disease is rapidly disintegrating. "There has been a culture in cardiology that the narrowings were the problem and that if you fix them, the patient does better," Dr. David Waters, a cardiologist at the University of California, San Francisco, explained. This theory made so much sense to surgeons, cardiologists, and laypeople that no one questioned it for decades, except those few (including myself) who were more interested in discovering the true causes of heart disease. The most recent scientific discoveries have finally exposed this theory's major flaws, leaving little room for debate.

Until recently, it was thought that coronary disease developed like sludge in a pipe. Plaque builds up slowly over time, and once a coronary artery is completely blocked, no blood can get to the heart, and the patient suffers a heart attack. To avoid this disaster, the most obvious rational "solution" to this problem was to perform bypass surgery or angioplasty to replace or open the narrowed artery before it completely closed. The assumption that this would prevent heart attacks and extend life appeared unquestionable. However, as medical research shows, this theory is no longer valid (it never was) and thus misleading. The Coronary Artery Bypass Surgery Cooperative Study Group published a study in the New England Journal of Medicine that clearly demonstrated that the three-year survival rate for heart disease patients undergoing bypass surgery is nearly the same as for patients who did not have surgery.

According to numerous heart disease studies, the majority of heart attacks do not occur as a result of an artery being narrowed by plaque. Instead, heart attacks occur when a plaque area bursts in a coronary artery, causing blood clots to form and abruptly block blood flow to the heart, according to researchers. In fact, in 75 to 80 percent of cases, the hardened plaque obstructing an artery is not the culprit, and bypass surgery or stinting should not even be considered. Soft and fragile plaque is the most dangerous type. It causes no symptoms and would not even be considered a blood flow obstruction. Soft, newly formed plaque patches are much more likely to break off than hard, old plaque patches, and when they do, blood clots form and enter the heart, causing a heart attack. As a result, creating a bypass around hardened arteries does nothing to reduce the risk of a future heart attack. As a result, many heart attacks occur in people who have no arterial occlusions. As a result, a person may be fine jogging one day and have a heart attack (or stroke) the next. If a narrowed artery was the cause, the person would be unable to exercise due to severe chest pain or breathing difficulties.

In the majority of heart patients, there are hundreds of vulnerable plaque sites in their arteries. Because it is impossible to replace all of these injured, plaque-ridden sections, current interventional procedures cannot prevent heart attacks. This, however, does not imply that fewer bypasses or stint operations are performed. The multibillion-dollar stint industry appears to be unstoppable.

Heart researchers and some cardiologists are becoming increasingly frustrated that their findings are not being taken seriously enough by doctors and patients. "There is just this embedded belief that repairing an artery is a good thing," Dr. Eric Topol, an interventional cardiologist at the Cleveland Clinic in Ohio, explained. It's almost fashionable to have one's arteries repaired just in case. Dr. Topol observes that an increasing number of people who have no symptoms are receiving stints. Over one million Americans chose a stint operation in 2004.

Despite the fact that many doctors are aware that the old heart disease theory no longer holds true, they are under pressure to open blocked arteries regardless of whether patients have symptoms or not. "If you're an invasive cardiologist and Joe Smith, the local internist, is sending you patients, and you tell them they don't need the procedure, pretty soon Joe Smith doesn't send you any more," Dr. David Hillis, an interventional cardiologist at the University of Texas Southwestern Medical Center in Dallas, explained. Sometimes you can talk yourself into doing something even if you don't think it's right."

According to Dr. Topol, most patients visit a cardiologist with a vague complaint such as indigestion or shortness of breath, or because a heart scan revealed calcium deposits or plaque buildup. The cardiologist does his job by placing the patient in the cardiac catheterization room and examining the arteries with an angiogram. If you are middle-aged or older and live in a developed country like America, you are most likely to have arteriosclerosis, and an angiogram will show a narrowing. It won't take much convincing to tell you that you need a stint. "It's this train where you can't get off at any station along the way," Dr. Topol said. "Once you get on the train, you're getting the stints. Once you get in the cath lab, it's pretty likely that something will get done."

Dr. Hillis believes the American psyche is convinced that the worth of medical care is directly related to its aggressiveness. Hillis has tried to explain the evidence to his patients, but with little success. "You end up reaching a level of frustration," he said. "I think they have talked to someone along the line who convinced them that this procedure will save their life. They are told if you don't have it done you are, quote, a walking time bomb."

Even more disquieting, Dr. Topol said, is that stinting can actually cause minor heart attacks in about 4 percent of patients. This means that, out of the 1 million stint patients in 2004, 40,000 ended up suffering heart damage from a procedure meant to prevent it, heart damage that they may never have developed without undergoing the procedure. According to a report published in the New England Journal of Medicine (October 15, 2004), the two stints that are currently approved by the Food and Drug Administration (FDA), the Cordis Cypher sirolimus-eluting stint and the Boston Scientific Taxus Express paclitaxel-eluting stint, have been associated with highly publicized adverse events after they were approved for marketing.

Bypass, angioplasty and stint operationsare really not about preventing heart attacks per se. The obvious purpose of these procedures is symptom relief. Patients are satisfied that "something" was done, relieved of the anxiety of dying from a sudden heart attack. And the doctors are satisfied that their patients are happy. The drug industry is satisfied because the patients are doomed to taking expensive drugs for the rest of their lives.