Heart Attack and Hydration

What is a heart attack?

Did you know that heart attacks are 27% more likely to happen around the time of your birthday? Did you also know that CT Scans of Egyptian mummies have revealed that many of them had heart attacks proving that coronary heart disease is not just caused by modern-day lifestyles? 

Heart attacks, also called acute Myocardial Infarctions (AMI), are caused by a decrease/ stoppage of blood flow to the heart. This results in the necrosis of heart muscle.

This is generally because of a blood clot in the epicardial artery (an artery that supplies that territory of heart muscle). Sometimes it can happen without a blood clot, like when there are other issues such as rapid heart rate, and a drop in blood pressure. When the blood supply does not meet oxygen demand myocardial damage occurs without a blood clot.¹

Clots and reduced oxygen supply can both be responsible for the cessation of blood flow and occur without forewarning. Sometimes these etiological signs can notify of ischemia (reduced blood flow) through angina attacks or chest pain. Treatments include extracting obstruction from arteries, open balloons, and replacement of blocked arteries. This is because typically heart attacks occur due to the closure of arteries.  Causes or risk factors are factors include hypertension, dyslipidemia, diabetes, smoking, use of illicit substances, and hemostatic dysfunction or bleeding disorders.

Typically, patients with myocardial infarction will be put on a thorough medical regimen of antianginal therapies, disease-changing therapies, treatment of causes and lifestyle modifications. Including smoking cessation, weight loss, limiting alcohol use and regular aerobic exercise.²

Symptoms of a heart attack

International guidelines state that people born as women are more likely to get symptoms compared to others. They would be atypical symptoms like epigastric pain, dyspepsia, or breathlessness. Hyperlipidemia, hypertension, and other symptoms are categorized as typical or atypical symptoms. Typical pain symptoms were those that patients experience in the chest, arm, or jaw pain. They also exhibit pain that is dull, heavy, pressurising, squeezing, crushing, achey or gripping in nature. Atypical symptoms are also seen in patients with back pain, presenting a burning, stabbing, and indigestion like feeling. It can also be any other pain without description or presentation. Associated symptoms may also radiate pain in the right arm, left arm, neck, jaw, back, along with nausea, vomiting, sweating, dyspnea, and palpitations.³

Drinking enough water helps prevent a heart attack.

Explain how

Recent findings support the fact drinking water throughout life not only helps body functions but also helps reduce heart problems. Adults aged 45-66, with higher than normal levels of sodium in their blood, had a greater risk for developing cardiovascular disease. In midlife, if a person hydrates insufficiently, they have been shown to have a greater risk of heart tissue damage and artery wall thickening.  On average, the recommended dose is 1.5 - 2.1 liters. 

In healthy people, dehydration is reflected in increased sodium concentration in the blood. Normal sodium levels are between 135 and 146 mmol/L. Water and levels of the antidiuretic hormone, are needed to maintain healthy levels of sodium in the body. Plasma tonicity is the ability of an extracellular solution to make water move into or out of a cell by osmosis. This increases due to decreased water intake. Central osmoreceptor cells are activated and Anti Diuretic Hormone is released from the posterior pituitary gland. ADH will act on the kidney resulting in a lower volume of concentrated urine. During the absence of hyperglycemia and renal failure, sodium concentration determines plasma tonicity. A normal level of sodium is also a determinant of ADH secretion. ADH secretion and tonicity are accompanied by a decrease in plasma volume and result in the activation of renin-angiotensin system which is a known causative factor of hypertension and heart failure.⁴

When the body is dehydrated it means your heart will work harder to pump blood resulting in faster heartbeats, palpitations and irregular heartbeats. Blood also becomes thicker and constricts blood vessel wells. This is how a person gets high blood pressure causing additional strain on their heart⁵

Staying hydrated after a heart attack

Drinking too much water after an attack can cause edema (swelling), weight gain, and shortness of breath. It is important to reduce water intake after a heart attack. Limiting how much you drink and how much salt (sodium) you take in can help prevent these symptoms. When it's not a major event, water intake need not be restricted, but for worse attacks, water intake should be only about 6-9 cups. Some foods like ice cream contain fluids, so be wary. When eating foods such as chunky soups, use a fork to take only the solids. When thirsty, chewing a piece of gum, drinking 1 cup or less, staying cool, and reducing salty foods, are ways for consuming limited/ healthy amounts of water.

Why do you need to watch your liquid intake after a heart attack?

In heart failure, the body retains fluids resulting in raised blood pressure. It is more work for the heart. Fluids builds  in the lungs resulting in shortness of breath. There is extreme difficulty in breathing. Swelling happens on the ankles, hands, and face. The extra fluid buildup results in nausea and bloating. That's why it is necessary to watch water intake and limit it to the necessary amounts. 

Dangers of excess fluid in the body

Fluid retention can cause a lot of harm not only to the heart but also to the kidneys. Major organs that are affected by this include liver, GI tract, and even the brain. There is an increase in body weight. This, coupled with adverse events like confusion and delirium, and also in extreme cases, associated mortality. The risks of pathological problems associated with this can be reduced by maintaining fluids to amounts needed for healthy functioning of the body, and internally there is a correct balance to replace normal and pathological losses of water and sodium. Even the skin shows signs of affected trauma, including slower wound recovery, edema and weakness.⁶

What liquids are best to have after a heart attack?

Fluid-like water can be replaced with pieces of fruit supply your daily fluids allowance. This is good as it takes longer to consume and is better at thirst quenching.

Sucking on boiled lollies and lemons instead of drinking. A refreshing mouthwash can be used when the mouth feels dry. Keeping space between fluid intake, sipping instead of gulping, and limiting salty and sugary drinks.

When should you contact a doctor?

There are many signs as to when to call the doctor. These include tiredness and weakness. Shortness of breath when active or at rest, or an hour or two after sleeping. Wheezing, chronic coughing, trouble breathing, and swelling in feet, ankles and hips.⁷

Conclusion

Heart attacks are very prevalent due to our stressful lifestyles triggering many risk factors. It is important for sufferers of heart attacks to watch hydration levels to prevent an incresase in future attacks. It is also important to do self-care, give heed to warning signs, and increase adherence to a cardiac rehabilitation program to have a healthy, disease free, and happy life.