The Myocardial infarction, or heart attack: everything you need to know.
We’re constantly rushed; we’re stressed out by traffic, by deadlines, by family, and seemingly endless responsibilities. We smoke and we drink to de-stress. And we eat rich, creamy foods, often simply for comfort.
All of the above can be detrimental to our health overall, but the real fact of the matter is that a fast-paced lifestyle takes particular toll on our most vital organ…our heart.
In South Africa, it is estimated that 33 people die per day from heart attacks with the prevalence being significantly higher in men than in women: for every woman that dies of a heart attack, two men die.
What actually happens during a heart attack?
A heart attack, or myocardial infarction (MI), is the death of the heart muscle due to a lack of oxygen. This is usually caused by a decrease or lack of blood supply to the heart.
Myocardial infarctions generally occur when a diseased blood vessel becomes partially or fully blocked by a blood clot. The heart is the hardest working organ in the body, ensuring that all the other organs receive blood enriched with nutrients and oxygen via a network of vessels
In order for the heart to do this very important task, it needs its own blood supply. The network of blood vessels that supply the heart are the coronary arteries and it is these that become blocked during a heart attack.
How do I know if I am having a heart attack?
A person experiencing a heart attack may have severe chest pain (a heavy pressure on the chest) or pain in the arms or neck, usually lasting approximately 15 minutes. Some individuals may only experience mild discomfort like indigestion or heart burn.
Additional symptoms could include nausea, sweating, shortness of breath and faintness.
Prognosis after a heart attack
If a large portion of the heart is damaged at the time of the heart attack, the person may die. This is, however, quite uncommon. Historically, the probability of death after suffering a heart attack has been extremely high. People are now more aware of the symptoms and the necessity for early treatment. Due to this, there has been an improvement in treatment for heart attacks within the medical fraternity, and these factors have led to a decrease of the death rate following a heart attack, of about 30 percent. More than half of the deaths occur before arrival at the hospital.
The long-term prognosis for both quality and length of life depends on the amount of damage done during the initial heart attack. Depending on the extent of this damage, and which coronary vessels are affected, the person may develop complications or chronic problems. These could include:
- Arrhythmias (abnormal heart rhythms) – this is when electrical “short circuits” develop, resulting in abnormal heart rhythms, some of which can be fatal.
- Heart failure – when the damage to the heart muscle is severe enough to stop the heart from adequately pumping blood through the heart chambers and into the rest of the body. This can be either a temporary or chronic problem.
- Heart rupture – this is when a weakened area of the heart ruptures, leaving a hole in the heart. This tends to be fatal.
- Valve problems – this is s when the heart valves are no longer functioning properly
Am I at risk?
A heart attack is always more serious for those with certain characteristics. These include:
- The elderly.
- People with a history of heart disease or risk factors for heart disease (raised cholesterol, high blood pressure, raised BMI, sedentary lifestyle, smoking).
- People with heart failure.
- Diabetics
- Those on long-term dialysis for kidney failure
- Smokers
Can I still get cover if I have had a heart attack?
The risk of a second heart attack is highest in the first year after the initial event.
Insurance companies will need to know:
- The extent of the damage to the heart.
- Treatment given at time of heart attack.
- Which vessels were involved.
- Any associated complications.
- Any co-morbid conditions, such as diabetes.
- Any risk factors for a cardiovascular event such as raised cholesterol or hypertension, and the control of these factors, such as the monitoring of family history.
It will be requested that the applicant undergoes medical examinations. These could include:
- A stress ECG.
- Blood tests, such as cholesterol.
- Medical examinations, such as a blood pressure check.
If I have a heart attack, when will I be paid out?
Not all companies will pay out on all heart attacks under critical illness cover. Whether a claim is paid or not depends on the definition in the person’s critical illness policy.
Most large insurance companies in South Africa use the SCIDEP definition, which means that the company uses the standardised definition for heart attacks as described by ASISA. This definition has four levels with certain requirements that the client needs to fulfil before a claim will be paid.
In terms of SCIDEP, on Liberty’s most comprehensive critical illness benefit offering (Living Lifestyle with Top-Up and Extended Options), we pay the full cover amount at all four of the SCIDEP heart attack severity levels defined.
Each level of the definition requires a clinical history of chest pain, specific ECG changes that are seen at the time of a heart attack, and certain enzyme readings will need to have reached specific levels. Each of these contribute to qualifying for a pay-out.
In conclusion, a heart attack is a serious cardiovascular event which can lead to death or chronic health problems. Most of us know that a healthy lifestyle, and regular blood pressure and cholesterol checks can help reduce that risk. However, if an MI happens, an individual will still need to have the correct cover in place to avert financial problems. This cover can include critical illness products, occupational disability and income protection.