What is a Heart Attack?
A heart attack (myocardial infarction) happens when blood flow to the heart is cut off or severely restricted. The onset is usually sudden and the heart muscle does not get enough oxygen and begins to die.
It is estimated a heart attack happens to someone in the US every 40 seconds, affecting about 790,000 people a year. (1)
A heart attack is a serious life threatening event and emergency medical care is imperative. The longer it is left the more damage occurs and there is less chance of a positive outcome.
One of the main causes of a heart attack is coronary heart disease. This condition happens when the arteries supplying the heart become narrowed due to a buildup of a waxy, fatty substance called plaque.
Called atherosclerosis, this process is slow, happening over several years. When some of this plaque ruptures within the artery wall a blood clot can form around it. If the clot is large it impedes or stops blood flow through the artery.
The part of the heart supplied by the artery does not get enough oxygen rich blood and nutrients begins to die (ischemia). Damage or death of any part of the heart muscle leads to a heart attack. (2)
A quick response to symptoms of a heart attack might help preserve life and limit damage to the heart. A heart attack can sometimes happen and present with no symptoms at all (silent heart attack). When there are symptoms they include:
Chest pain is the most common symptom associated with a heart attack, although this might not be experienced by everyone. For some the pain could be severe and for others mild discomfort, however the onset is usually sudden. It might last more than a few minutes or could come and go.
Generally described as a feeling of tightness, pressure, fullness or squeezing, it is usually felt in the left side or center of the chest. For some this discomfort could feel like heartburn or indigestion.
On occasion, especially in women, the elderly and people with diabetes, chest pain may be absent from other symptoms. (3)
Upper Body Discomfort
Pain or discomfort might be felt radiating to one or both arms, shoulders, the back, neck or jaw. It might also be sensed in the area of abdomen above the belly button at the front. (4)
Shortness of Breath
There are times when shortness of breath might be the only symptom. It can happen alongside chest pain or may occur before it. You might experience this symptom whether at rest or partaking in physical activities. (5)
Accompanying the main symptoms there are others which can manifest. The symptoms can also differ between men and women.
Other symptoms include dizziness or lightheadedness, nausea, vomiting and cold sweats. An unexplained feeling of tiredness, sometimes lasting days at a time (particularly for women), is another symptom of this condition.
Women are more likely to experience these other symptoms than men. (6, 7)
There are factors which can predispose the likelihood of a heart attack. These include certain health conditions which are associated with heart disease like high blood pressure, diabetes and high cholesterol.
Lifestyle choices can also affect the cardiorespiratory system. These include eating an unhealthy diet, smoking, drinking too much alcohol, obesity and lack of physical exercise.
Genetics, age, race and ethnicity, plus gender also play a part. (8)
While there are no stages associated with a heart attack there are different types.
ST Segment Elevation Myocardial Infarction (STEMI)
ST segment is the name given to the familiar pattern indicating the pattern of a heartbeat seen on an electrocardiogram. Myocardial infarction is another name given to a heart attack.
When there are elevated peaks present on the readout, it indicates a complete blockage of an artery feeding blood to the heart. Part of the heart muscle begins to die and a heart attack is experienced. (9)
Non ST Segment Elevation Myocardial Infarction (N STEMI)
We have explained ST segment and myocardial infarction. In this type of heart attack, elevated peaks do not show on an electrocardiogram, which indicates a partial blockage as the possible cause of the heart attack.
While still a serious condition damage to the heart might not be as severe.(10)
The earlier you get emergency care for a heart attack the less damage there is likely to be. Treatment can begin as soon as emergency medical personnel are involved.
Even before diagnosis is confirmed, if a heart attack is suspected, treatment can be started.
These treatments include oxygen therapy, medication to thin the blood and improve blood flow, as well as treatment to relieve chest pain.
Following diagnosis the priority will be to restore blood flow from the arteries to the heart. The treatments to enable this include: (11)
Clot Busting Medication
This type of medicine, called thrombolytic medicine, dissolves blood clots which are blocking the arteries to the heart. This medicine works best if administered immediately or certainly within several hours of the onset of a heart attack.
Percutaneous Coronary Intervention
This non surgical procedure, sometimes called coronary angioplasty, opens narrow or blocked arteries.
It involves a flexible, thin tube with a balloon being inserted through a blood vessel, most often in the thigh or groin. It is threaded through to the blocked artery where the balloon is inflated to compress plaque. This opens up the artery and blood flow to the heart is restored.
A doctor can also put a stent, a small mesh tube, in the artery during this procedure which will help prevent future blockages.
Other Treatments for Heart Attack
Following initial emergency procedures there are other treatment options available including:
Beta blockers are medicines used to help decrease the workload on the heart. They also treat irregular heart beats and are able to relieve chest pain and help prevent further heart attacks.
ACE inhibitors reduce strain on the heart by lowering blood pressure. They also help prevent the heart muscle being weakened further.
Anticoagulants help thin the blood and prevent further clots forming in the arteries. They are also able to stop existing clots increase in size.
Anti clotting medication stop the platelets in the blood clustering together to form clots. Aspirin is one example of an anti clotting medicine.
Other drugs may be prescribed for pain relief, irregular heartbeats, anxiety or high cholesterol.
A surgeon might perform a coronary artery heart bypass. This procedure takes a healthy vein or artery from elsewhere in your body. It is attached to the blocked artery, creating a fresh route for blood flow to the heart.
Follow Up Treatment
There are often ongoing treatments carried out after you have been discharged from hospital. These include medication, following a healthy diet, exercise, weight maintenance or loss and quitting smoking.
You might also be advised to undertake cardiac rehabilitation, a medically supervised program aimed at people with heart issues. Comprised of doctors, nurses, occupational and physical therapists, dietitians and mental health specialists: they help a person recover from and deal with heart issues going forward. (12)
What is a heart attack? A heart attack (myocardial infarction) happens when blood flow to the heart is cut off or severely restricted. The onset is usually sudden and the heart muscle does not get enough oxygen and begins to die.
What are the signs of a heart attack? The main symptoms of a heart attack are pain in the chest which can radiate along the arms, shoulders, neck or jaw and shortness of breath. Other signs are dizziness, lightheadedness, unexplained tiredness, nausea and sickness. There are times when there will be no symptoms at all.
How do you develop a heart attack? The main cause of a heart attack is a complete or partial blockage by plaque in an artery supplying the heart. Certain medical conditions like diabetes, high cholesterol and high blood pressure can predispose you to the likelihood of a heart attack. Other contributing factors involve lifestyle choices and genetics.
What is the best treatment for a heart attack? A doctor will decide the best treatment for you, however, the earlier treatment is started the better the outcome.
What are the long term complications of a heart attack? Many people make a good recovery following a heart attack, living active and full lives. There are lifestyle changes which might help and prevent a heart attack in the future.
Is a heart attack considered a disability? There are occasions when a heart attack might qualify you for disability benefits. It is however assessed on a case by case assessment based on medical records. (13)
Is there a cure for a heart attack? There is no cure for a heart attack, however preventative measures can be taken. Don’t smoke, follow a healthy diet and try to lose weight if you are obese or overweight. Regular exercise and conservative alcohol consumption will also contribute to a healthy heart. (14)
Is a heart attack life threatening? Yes, this is a life threatening condition that requires urgent emergency care. If you suspect you or someone else is having a heart attack call emergency services immediately.
A heart attack is a serious medical condition which happens when blood flow to the heart is cut off or severely restricted.
Medical care is imperative for a positive outcome: emergency services should be called immediately if you or someone else is having symptoms of a heart attack.
The good news is, when treated early, many people return to lead full and active lives.