A heart attack happens when the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart can't get oxygen. If blood flow isn't restored quickly, the section of heart muscle begins to die.
Heart attack treatment works best when it's given right after symptoms occur. If you think you or someone else is having a heart attack, even if you're not sure, call doctor right away.
Heart attacks most often occur as a result of coronary heart disease (CHD), also called coronary artery disease. It is a condition in which a waxy substance called plaque builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart.
When plaque builds up in the arteries, the condition is called atherosclerosis. The buildup of plaque occurs over many years.
Eventually, an area of plaque can rupture (break open) inside of an artery. This causes a blood clot to form on the plaque's surface. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery.
If the blockage isn't treated quickly, the portion of heart muscle fed by the artery begins to die. Healthy heart tissue is replaced with scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems.
A less common cause of heart attack is a severe spasm (tightening) of a coronary artery. The spasm cuts off blood flow through the artery. Spasms can occur in coronary arteries that aren't affected by atherosclerosis.
Heart attacks can be associated with or lead to severe health problems, such as heart failure and life-threatening arrhythmias.
Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Arrhythmias are irregular heartbeats. Ventricular fibrillation is a life-threatening arrhythmia that can cause death if not treated right away.
Acting fast at the first sign of heart attack symptoms can save your life and limit damage to your heart. Treatment works best when it's given right after symptoms occur.
Many people aren't sure what's wrong when they are having symptoms of a heart attack. Some of the most common warning symptoms of a heart attack for both men and women are:
Other possible symptoms of a heart attack include:
Not all heart attacks begin with the sudden, crushing chest pain that often is shown on TV or in the movies, or other common symptoms such as chest discomfort. The symptoms of a heart attack can vary from person to person. Some people can have few symptoms and are surprised to learn they've had a heart attack. If you've already had a heart attack, your symptoms may not be the same for another one.
If you think you or someone else may be having heart attack symptoms or a heart attack, don't ignore it or feel embarrassed to call for help. Call doctor for emergency medical care. Acting fast can save your life.
Do not drive to the hospital or let someone else drive you. Call an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room. Take a nitroglycerin pill if your doctor has prescribed this type of treatment.
Other Names
A heart attack happens if the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart can't get oxygen. Most heart attacks occur as a result of coronary heart disease (CHD).
It is a condition in which a waxy substance called plaque builds up inside of the coronary arteries. These arteries supply oxygen-rich blood to your heart.
When plaque builds up in the arteries, the condition is called atherosclerosis. The buildup of plaque occurs over many years.
Eventually, an area of plaque can rupture (break open) inside of an artery. This causes a blood clot to form on the plaque's surface. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery.
If the blockage isn't treated quickly, the portion of heart muscle fed by the artery begins to die. Healthy heart tissue is replaced with scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems.
A less common cause of heart attack is a severe spasm (tightening) of a coronary artery. The spasm cuts off blood flow through the artery. Spasms can occur in coronary arteries that aren't affected by atherosclerosis.
What causes a coronary artery to spasm isn't always clear. A spasm may be related to:
Certain risk factors make it more likely that you'll develop coronary heart disease (CHD) and have a heart attack. You can control many of these risk factors.
The major risk factors for a heart attack that you can control include:
Some of these risk factors - such as obesity, high blood pressure, and high blood sugar - tend to occur together. When they do, it's called metabolic syndrome.
In general, a person who has metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone who doesn't have metabolic syndrome.
Risk factors that you can't control include:
Lowering your risk factors for coronary heart disease can help you prevent a heart attack. Even if you already have coronary heart disease, you still can take steps to lower your risk for a heart attack. These steps involve making heart-healthy lifestyle changes and getting ongoing medical care for related conditions that make heart attack more likely. Talk to your doctor about whether you may benefit from aspirin primary prevention, or using aspirin to help prevent your first heart attack.
A heart-healthy lifestyle can help prevent a heart attack and includes heart-healthy eating, being physically active, quitting smoking, managing stress, and managing your weight.
Treat Related Conditions
Treating conditions that make a heart attack more likely also can help lower your risk for a heart attack. These conditions may include:
Have an Emergency Action Plan
Make sure that you have an emergency action plan in case you or someone in your family has a heart attack. This is very important if you're at high risk for, or have already had, a heart attack.
Write down a list of medicines you are taking, medicines you are allergic to, your health care provider's phone numbers (both during and after office hours), and contact information for a friend or relative. Keep the list in a handy place (for example, fill out this wallet card) to share in a medical emergency.
Talk with your doctor about the signs and symptoms of a heart attack, when you should call doctor, and steps you can take while waiting for medical help to arrive.
Not all heart attacks begin with the sudden, crushing chest pain that often is shown on TV or in the movies. In one study, for example, one-third of the patients who had heart attacks had no chest pain. These patients were more likely to be older, female, or diabetic.
The symptoms of a heart attack can vary from person to person. Some people can have few symptoms and are surprised to learn they've had a heart attack. If you've already had a heart attack, your symptoms may not be the same for another one. It is important for you to know the most common symptoms of a heart attack and also remember these facts:
Some heart attacks occur without any symptoms or with very mild symptoms.
The most common warning symptoms of a heart attack for both men and women are:
The symptoms of angina (an-JI-nuh or AN-juh-nuh) can be similar to the symptoms of a heart attack. Angina is chest pain that occurs in people who have coronary heart disease, usually when they're active. Angina pain usually lasts for only a few minutes and goes away with rest.
Chest pain or discomfort that doesn't go away or changes from its usual pattern (for example, occurs more often or while you're resting) can be a sign of a heart attack.
All chest pain should be checked by a doctor.
Pay attention to these other possible symptoms of a heart attack:
Not everyone having a heart attack has typical symptoms. If you've already had a heart attack, your symptoms may not be the same for another one. However, some people may have a pattern of symptoms that recur.
The more signs and symptoms you have, the more likely it is that you're having a heart attack.
The signs and symptoms of a heart attack can develop suddenly. However, they also can develop slowly - sometimes within hours, days, or weeks of a heart attack.
Any time you think you might be having heart attack symptoms or a heart attack, don't ignore it or feel embarrassed to call for help. Call doctor for emergency medical care, even if you are not sure whether you're having a heart attack. Here's why:
Your doctor will diagnose a heart attack based on your signs and symptoms, your medical and family histories, and test results.
It is a simple, painless test that detects and records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). It can also records the strength and timing of electrical signals as they pass through each part of the heart.
It can show signs of heart damage due to coronary heart disease (CHD) and signs of a previous or current heart attack.
During a heart attack, heart muscle cells die and release proteins into the bloodstream. Blood tests can measure the amount of these proteins in the bloodstream. Higher than normal levels of these proteins suggest a heart attack.
Commonly used blood tests include troponin tests, CK or CK-MB tests, and serum myoglobin tests. Blood tests often are repeated to check for changes over time.
Coronary angiography (an-jee-OG-ra-fee) is a test that uses dye and special x rays to show the insides of your coronary arteries. This test often is done during a heart attack to help find blockages in the coronary arteries.
To get the dye into your coronary arteries, your doctor will use a procedure called cardiac catheterization (KATH-e-ter-ih-ZA-shun).
A thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. The tube is threaded into your coronary arteries, and the dye is released into your bloodstream.
Special x rays are taken while the dye is flowing through the coronary arteries. The dye lets your doctor study the flow of blood through the heart and blood vessels.
If your doctor finds a blockage, he or she may recommend a procedure called percutaneous (per-ku-TA-ne-us) coronary intervention (PCI), sometimes referred to as coronary angioplasty (AN-jee-oh-plas-tee). This procedure can help restore blood flow through a blocked artery. Sometimes a small mesh tube called a stent is placed in the artery to help prevent blockages after the procedure.
Early treatment for a heart attack can prevent or limit damage to the heart muscle. Acting fast, by calling doctor at the first symptoms of a heart attack, can save your life. Medical personnel can begin diagnosis and treatment even before you get to the hospital.
Certain treatments usually are started right away if a heart attack is suspected, even before the diagnosis is confirmed. These include:
Once the diagnosis of a heart attack is confirmed or strongly suspected, doctors start treatments promptly to try to restore blood flow through the blood vessels supplying the heart. The two main treatments are clot-busting medicines and percutaneous coronary intervention, also known as coronary angioplasty, a procedure used to open blocked coronary arteries.
Thrombolytic medicines are used to dissolve blood clots that are blocking the coronary arteries. To work best, these medicines must be given within several hours of the start of heart attack symptoms. Ideally, the medicine should be given as soon as possible.
Percutaneous coronary intervention is a nonsurgical procedure that opens blocked or narrowed coronary arteries. A thin, flexible tube (catheter) with a balloon or other device on the end is threaded through a blood vessel, usually in the groin (upper thigh), to the narrowed or blocked coronary artery. Once in place, the balloon located at the tip of the catheter is inflated to compress the plaque and related clot against the wall of the artery. This restores blood flow through the artery. During the procedure, the doctor may put a small mesh tube called a stent in the artery. The stent helps to keep the blood vessel open to prevent blockages in the artery in the months or years after the procedure.
Other treatments for heart attack include:
Your doctor may prescribe one or more of the following medicines.
You also may be given medicines to relieve pain and anxiety, and treat arrhythmias. Take all medicines regularly, as your doctor prescribes. Don't change the amount of your medicine or skip a dose unless your doctor tells you to.
Coronary artery bypass grafting also may be used to treat a heart attack. During coronary artery bypass grafting, a surgeon removes a healthy artery or vein from your body. The artery or vein is then connected, or grafted, to bypass the blocked section of the coronary artery. The grafted artery or vein bypasses (that is, goes around) the blocked portion of the coronary artery. This provides a new route for blood to flow to the heart muscle.
Treatment for a heart attack usually includes making heart-healthy lifestyle changes. Your doctor also may recommend:
Taking these steps can lower your chances of having another heart attack.
Your doctor may recommend cardiac rehabilitation (cardiac rehab) to help you recover from a heart attack and to help prevent another heart attack. Nearly everyone who has had a heart attack can benefit from rehab. Cardiac rehab is a medically supervised program that may help improve the health and well-being of people who have heart problems.
The cardiac rehab team may include doctors, nurses, exercise specialists, physical and occupational therapists, dietitians or nutritionists, and psychologists or other mental health specialists.
Rehab has two parts:
Many people survive heart attacks and live active, full lives. If you get help quickly, treatment can limit damage to your heart muscle. Less heart damage improves your chances for a better quality of life after a heart attack.
After a heart attack, you'll need treatment for coronary heart disease (CHD). This will help prevent another heart attack. Your doctor may recommend:
If you find it hard to get your medicines or or complete your cardiac rehabilitation program, talk with your doctor. Don't stop the medicines or program because it can help you prevent another heart attack.
After a heart attack, most people who don't have chest pain or discomfort or other problems can safely return to most of their normal activities within a few weeks. Most can begin walking right away.
Sexual activity also can begin within a few weeks for most patients. Talk with your doctor about a safe schedule for returning to your normal routine.
Driving usually can begin within a week for most patients who don't have chest pain or discomfort or other disabling problems. People who have complications shouldn't drive until their symptoms have been stable for a few weeks.
After a heart attack, many people worry about having another heart attack. Sometimes they feel depressed and have trouble adjusting to new lifestyle changes.
Talk about how you feel with your health care team. Talking to a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life.
Joining a patient support group may help you adjust to life after a heart attack. You can see how other people who have the same symptoms have coped with them. Talk with your doctor about local support groups or check with an area medical center.
Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you.
Once you've had a heart attack, you're at higher risk for another one. Knowing the difference between angina and a heart attack is important. Angina is chest pain that occurs in people who have coronory heart disease.
The pain from angina usually occurs after physical exertion and goes away in a few minutes when you rest or take medicine as directed.
The pain from a heart attack usually is more severe than the pain from angina. Heart attack pain doesn't go away when you rest or take medicine.
If you don't know whether your chest pain is angina or a heart attack, call your doctor.
The symptoms of a second heart attack may not be the same as those of a first heart attack. Don't take a chance if you're in doubt. Always call your doctor right away if you or someone else has heart attack symptoms.
Unfortunately, most heart attack victims wait 2 hours or more after their symptoms start before they seek medical help. This delay can result in lasting heart damage or death.