Diagnosis

The diagnosis of a heart attack is based on symptoms and test results. Some main tests to diagnose a heart attack include an ECG, blood tests, echocardiography, and coronary catheterization (Heart Attack 2015). 

An ECG monitors heart rate and rhythm and is able to determine how much damage to the heart muscle has occurred (Heart Attack 2015). Blood can be drawn to measure cardiac enzyme levels which indicate heart muscle damage (Heart Attack 2015). These specific enzymes are released when heart muscle cells are injured, such as potassium (Heart Attack 2015). Troponin levels are also an important indicator; they are proteins released from heart cells when the cells are damaged due to poor blood circulation to the heart (Heart Attack 2015). 

Echocardiography can show images of the heart and damaged heart structures and what locations the heart is not able to pump normally (Heart Attack 2015). 

A coronary catheterization, also known as an angiogram, is when a dye is injected into the arteries of the heart through a thin tube; this allows the arteries to appear visible on an X-ray showing possible areas of blockage (Heart Attack – Mayo Clinic 2015). 

An exercise stress test can also be used to measure how the heart responds to exercise and exertion (Heart Attack – Mayo Clinic 2015). 

      

Heart attack – Mayo Clinic. (2015, January 1). Retrieved January 31, 2015, from http://www.mayoclinic.org/diseases-conditions/heart-attack/basics/tests-diagnosis/con-20019520

Heart Attack: Symptoms, Diagnosis, Treatment, and More - WebMD. (2015, January 1). Retrieved January 31, 2015, from http://www.webmd.com/heart-disease/guide/heart-disease-heart-attacks?page=2#3

The Widow Maker of Coronary Artery Disease – youtube.com. (2015, June). Retrieved January 31, 2015, from https://www.youtube.com/watch?v=bAvxVUpv-rs

Pathophysiology

The widowmaker is a partial or full blockage of the left anterior descending (LAD) artery of the heart. The LAD supplies blood to the left ventricle which pumps blood to the rest of the body (Conjecture Corporation, 2015). When this artery is occluded, the rest of the body, as well as the heart, are deprived of oxygen. Because the heart is not getting enough blood and is not pumping properly, a person suffers from a myocardial infarction, also known as a heart attack. Because the LAD is a major source for blood to the heart, blockage induces a massive heart attack, and those who suffer one often die, creating the nickname widowmaker (Conjecture Corporation, 2015).

https://www.youtube.com/watch?v=3uSmUagTtsA

(Lee Memorial Health System, 2015)

Heart attacks are most often caused by build-up of fat and cholesterol which form a plaque in the arteries; this plaque blocks blood flow and damages the heart muscle (Mayo 2015). The plaque can rupture and a blood clot forms, depending on the size of the clot it can completely block blood flow through the coronary arteries (Mayo 2015).

Risk factors (Mayo 2015).

• Tobacco use – smoking and long-term exposure to secondhand smoke
• High blood pressure – can damage arteries by speeding up narrowing of the arteries
• High blood cholesterol or triglyceride levels – high levels of LDL cholesterol can narrow arteries, high levels of HDL lowers risk of heart attack
• Diabetes – causes high blood sugar levels which increases risk for heart attack
• Family history if heart attack
• Lack of physical activity – contributes to obesity and high cholesterol levels
• Obesity – association with high blood pressure, diabetes, high cholesterol and triglyceride increases risk
• Stress
• Illegal drug use – can cause spasm of coronary arteries 

Conjecture corporation.What is a Widow Maker? (2003-2015).  Retrieved January 24, 2015, from http://www.wisegeek.org/what-is-a-widow-maker.htm#comments  

Lee Memorial Health System. Watching Out For the Widow Maker. (2014, March 7). Retrieved January 18, 2015, from https://www.youtube.com/watch?v=3uSmUagTtsA

Mayo Foundation for Medical Education and Research. Heart attack. (1998-2015).  Retrieved January 25, 2015, from http://www.mayoclinic.org/diseases-conditions/heart-attack/basics/definition/con-20019520 

Epidemiology

Heart disease is the leading cause of death in the United States (Heat Attack, 2013). There are many different types of conditions related to heart disease, all of which can lead to heart attack.  Coronary Artery Disease is both the most common type of heart disease and the main cause of heart attack (Heat Attack, 2013). Heart disease accounts for every 1 out of 4 deaths, which equals 600,000 people a year (Heat Attack, 2013).

Heart disease is the leading cause of death for most ethnicities, percentages as follows from 2008 (Heat Attack, 2013):

Race of Ethnic Group                         % of Deaths

African Americans                              24.5

American Indians or Alaska Natives  18.0

Asians or Pacific islanders                  23.2

Hispanics                                             20.8

Whites                                                 25.1

All                                                        25

 As shown in the graph, heart disease death rates are concentrated more in the southern states. In terms of gender, woman account for slightly over half of the death rates (Heart Disease Facts, (2015). The number of women who die from heart attacks is six times more than the number who dies from breast cancer (Heart Disease Facts, 2015).

In the United States 1.2 million people have a heart attack each year, of these roughly 785,000 people have an initial heart attack while nearly 500,000 experience recurring heart attacks (Heat Attack, 2013).  

In the United States, every 34 seconds someone has a heart attack, while every minute someone dies due to heart attack (Heat Attack, 2013). 4 out of 10 people suffering from a heart attack will die (cite). Both men and women share similar statistics on heart disease-related deaths (Heat Attack, 2013).

Heart Attack. (2013, March 12). Retrieved January 18, 2015, from http://www.cdc.gov/heartdisease/heart_attack.htm

Heart Disease Facts. (2015). Retrieved January 18, 2015, from http://www.theheartfoundation.org/heart-disease-facts/heart-disease-statistics/

Overview 

The widowmaker is another name for the left anterior descending coronary artery of the heart (LAD). The LAD is a main source of blood flow to the heart, particularly the left ventricle, and blockage in this artery is very critical. When this artery is blocked, a majority of the heart isn’t circulating oxygenated blood which leads to heart muscle damage and death. Coronary artery disease, which leads to heart attack, has consistently been the leading cause of death in the United States; the widowmaker is an important reason why. Without sufficient blood supply to the left side of the heart, the rest of the body is deprived of oxygen.    

The LAD is nicknamed the widowmaker because if this artery has 100% blockage it causes a massive heart attack; once the widow maker hits, the survival time is limited to a few minutes to hours. The heart attack causes cardiac arrest which leads to the individual’s death within 10 to 20 minutes of lack of circulation throughout the heart. Recovery from this particular heart attack is very unlikely, with an estimated survival rate between 5% and 10%.  

Initial symptoms can vary and may not be thought of as critically important. Early symptoms may be mistaken for general flu, food poisoning, or general feelings of discomfort or illness, and won’t be noticed as needing immediate attention until it is too late. Even with immediate attention from paramedics, many patients do not survive after the first hour of treatment. Initial CPR is used, oxygen therapy, medications that dissolve blood clots and/or removing the clot and improving blood flow through surgery.  

There have been several famous celebrities and entertainers that have died from the widowmaker.

-Tim Russert, a former NBC News Washington Burea Chief.

-Daryl Kile, a professional baseball pitcher for the St. Louis Cardinals.

What is a Widow Maker? (2003-2015). Conjecture corporation. Retrieved January 24, 2015, from http://www.wisegeek.org/what-is-a-widow-maker.htm#comments