What happens during a heart attack? - Krishna Sudhir

譯者: Ann Chen 審譯者: Hui chu Chen

Approximately 7 million people around the world die from heart attacks every year,

每年全世界 大約有 7 百萬人死於心臟病發作

and cardiovascular disease,

而且導致心臟病發作 及其他疾病（如中風）的心血管疾病

which causes heart attacks and other problems like strokes,

is the world's leading killer.

是全世界的頭號殺手

So what causes a heart attack?

是什麼原因導致心臟病發作呢？

Like all muscles, the heart needs oxygen,

正如所有的肌肉，心臟需要氧氣

and during a heart attack, it can't get enough.

而心臟病發時無法獲得充足的氧氣

Fatty deposits, or plaques,

脂肪沉積物，也就是「斑塊」

develop on the walls of our coronary arteries.

在冠狀動脈壁形成

Those are the vessels that supply oxygenated blood to the heart.

這些血管供應充氧血到心臟

These plaques grow as we age,

隨著年齡增長，這些斑塊會變大

sometimes getting chunky,

有時越來越厚

hardened,

變硬或發炎

or enflamed.

Eventually, the plaques can turn into blockages.

最後，斑塊能形成阻塞

If one of the plaques ruptures or cracks,

假如其中一個斑塊破裂或皸裂

a blood clot will form around it in minutes,

幾分鐘內就會有血塊在其周圍形成

and a partially closed artery can become completely blocked.

而部分阻塞的動脈能變成完全阻塞

Blood flow is cut off to the cardiac muscle

通往心肌的血流被阻斷

and the oxygen-starved cells start to die within several minutes.

在幾分鐘內缺氧的細胞開始死亡

This is a myocardial infarction,

這就是心肌梗塞

or heart attack.

也就是心臟病發作

Things can rapidly deteriorate in the absence of treatment.

如果沒有治療則會急劇惡化

The injured muscle may not be able to pump blood as well,

此外，受損的心肌可能無法泵出血液

and its rhythm might be thrown off.

而且心臟節律也可能紊亂

In the worst case scenario, a heart attack can cause sudden death.

最壞的情況 心臟病發作會造成猝死

And how do you know that someone is having a heart attack?

如何知道某人正在心臟病發作呢？

The most common symptom is chest pain

最常見的症狀是 心肌缺氧所造成的胸痛

caused by the oxygen-deprived heart muscle.

Patients describe it as crushing or vice-like.

病人形容「壓迫感」 或「鉗子鉗住」的感覺

It can radiate to the left arm,

這感覺可以延伸至左臂 下顎、背部或腹部

jaw,

back,

or abdomen.

But it's not always as sudden and dramatic as it is in the movies.

但它並不總是如同電影演的一樣 突發與戲劇性

Some people experience nausea

有些人只會覺得噁心

or shortness of breath.

或喘不過氣來

Symptoms may be less prominent in women and the elderly.

婦女和老年人的症狀可能比較不明顯

For them, weakness and tiredness may be the main signal.

他們的主要徵兆可能只是無力和倦怠

And surprisingly, in many people,

而令人驚訝的是許多人

especially those with diabetes, which affects the nerves that carry pain,

尤其糖尿病患者 傳導疼痛的神經受損

a heart attack may be silent.

心臟病發作可能是無症狀的

If you think that someone might be having a heart attack,

假如你認為某人可能正在心臟病發作

the most important thing is to respond quickly.

最重要的是迅速作出反應

If you have access to emergency medical services, call them.

若你能聯絡緊急醫療服務單位 打電話給他們

They're the fastest way to get to a hospital.

這是送達醫院最快的方法

Taking aspirin, which thins the blood,

服用阿司匹林以減少血塊

and nitroglycerin, which opens up the artery,

和硝化甘油以擴張動脈

can help keep the heart attack from getting worse.

能幫助避免心臟病發作惡化

In the emergency room, doctors can diagnose a heart attack.

在急診室，醫師可以診斷心臟病發作

They commonly use an electrocardiogram

他們通常使用心電圖

to measure the heart's electrical activity

來測量心臟的電氣活動

and a blood test to assess heart muscle damage.

並且做血液檢查 來評估心肌的損傷

The patient is then taken to a high-tech cardiac suite

然後病人被帶到高科技的心導管室

where tests are done to locate the blockages.

在此進行血管阻塞定位的檢查

Cardiologists can reopen the blocked artery

心臟科醫師能將阻塞的動脈再度打通

by inflating it with a balloon in a procedure called an angioplasty.

利用球嚢膨漲以撐開血管的手術 稱為「血管整形術」

Frequently, they also insert a metal or polymer stent

通常他們也會置入 金屬或聚合物的支架

that will hold the artery open.

來維持血管的通暢

More extensive blockages might require coronary artery bypass surgery.

範圍更廣的阻塞 則可能需要「冠狀動脈繞道手術」

Using a piece of vein or artery from another part of the body,

利用取自身體其他部位的靜脈或動脈

heart surgeons can reroute blood flow around the blockage.

心臟外科醫師能使血流改道 繞過阻塞

These procedures reestablish circulation to the cardiac muscle,

這些手術重建心肌的血液循環

restoring heart function.

恢復心臟功能

Heart attack treatment is advancing,

心臟病發作的治療不斷進步中

but prevention is vital.

但預防至關重要

Genetics and lifestyle factors both affect your risk.

基因遺傳和生活方式 都會影響罹病的風險

And the good news is that you can change your lifestyle.

所幸你可改變你的生活方式

Exercise, a healthy diet, and weight loss

運動、健康的飲食和減重

all lower the risk of heart attacks,

都能降低心臟病發作的風險──

whether you've had one before or not.

無論你曾否罹患此疾

Doctors recommend exercising a few times a week,

醫師建議每週運動數次

doing both aerobic activity and strength training.

包括有氧運動和肌力訓練

A heart-healthy diet is low in sugar and saturated fats,

有益心臟健康的飲食 是含低糖和低飽和脂肪

which are both linked to heart disease.

這兩者都與心臟病有關

So what should you eat?

那你應該吃什麼呢？

Lots of fiber from vegetables,

富含大量纖維的蔬菜

chicken and fish instead of red meat,

吃雞肉和魚類──而非紅肉

whole grains and nuts like walnuts and almonds

全穀物和堅果類 例如核桃與杏仁

all seem to be beneficial.

這些都是有益的

A good diet and exercise plan can also keep your weight in a healthy range,

良好的飲食與運動計劃 也能讓體重維持在健康的範圍

which will lower your heart attack risk as well.

同時也降低了心臟病發作的風險

And of course, medications can also help prevent heart attacks.

當然，藥物也能協助預防心臟病發作

Doctors often prescribe low-dose aspirin, for example,

例如，醫師通常會開 低劑量的阿司匹林

particularly for patients who've already had a heart attack

特別是給曾有心臟病發作的病人

and for those known to be at high risk.

以及那些高危險群病患

And drugs that help manage risk factors,

而一些協助治療如高血壓 膽固醇和糖尿病等危險因子的藥物

like high blood pressure, cholesterol, and diabetes,

will make heart attacks less likely, too.

也能減低心臟病發作的可能

Heart attacks may be common, but they don't have to be inevitable.

心臟病發作雖然常見 但並非不可避免

A healthy diet,

健康的飲食

avoiding tobacco use,

避免吸煙

staying fit,

保持體能

and enjoying plenty of sleep and lots of laughter

以及充足的睡眠與盡情歡笑

all go a long way in making sure your body's most important muscle

都能確保這身上最重要的肌肉 持續地跳動

keeps on beating.