A heart attack (myocardial infarction) is a medical emergency where the heart muscle begins to die due to insufficient blood flow, usually caused by a blockage in the arteries. Without quick restoration of blood flow, it can lead to permanent damage and death. Symptoms include chest pain that may spread, requiring immediate hospital treatment.
A heart attack (myocardial infarction) causes chest pain, nausea, sweating, and shortness of breath. Early detection and prompt treatment are crucial. Unlike cardiac arrest, where the heart stops entirely, a heart attack can lead to cardiac arrest if untreated. Both are medical emergencies.
This article explains the symptoms, causes, and treatment options for a heart attack.
What exactly happens during a heart attack?
A heart attack results in injury or death to a heart muscle when blood flow to that area of the heart stops or is drastically decreased. This damage impairs the heart’s ability to pump effectively, potentially disrupting blood flow to the rest of the body. If not corrected quickly, this can be fatal.
How common is a heart attack?
In the United States, about 800,000 people suffer from heart attacks annually. Coronary artery disease, the leading cause of death in the US, is the cause of the majority of heart attacks.
Signs and Symptoms
What does a heart attack feel like?
A heart attack frequently causes chest pain for many victims. It may feel heavy or constricting, uncomfortable, or excruciatingly painful. It may begin in your chest and move (or radiate) to other parts of your body, such as your back, shoulders, neck, chin, left arm (or both arms), and down toward your waist.
Many times, people mistakenly believe they have heartburn or indigestion when they are actually having a heart attack.
Some people merely feel queasy, sweat, or have shortness of breath.
What are the symptoms of a heart attack?
Numerous symptoms can accompany a heart attack, some of which are more typical than others.
The most common symptoms of a heart attack that people report include:
- Chest pain (angina).
- Shortness of breath or trouble breathing.
- Trouble sleeping (insomnia).
- Nausea or stomach discomfort.
- Heart palpitations.
- Anxiety or a feeling of “impending doom.”
- Feeling lightheaded, dizzy or passing out.
Individuals classified as male at birth (AMAB) are expected to experience distinct symptoms of a heart attack than those assigned as female at birth (AFAB). Individuals who identify as AFAB are less likely to experience indigestion-like chest pain or discomfort. Breathlessness, exhaustion, and insomnia that began before to the heart attack are more common in them. Along with pain in the back, shoulders, neck, arms, or belly, they also experience nausea and vomiting.
Causes
A whole or partial occlusion of an artery close to the heart is the most frequent cause of a heart attack.
The majority of heart attacks are caused by occlusion of a blood artery supplying the heart. Plaque, a sticky material that can accumulate inside your arteries, is typically the cause of this (much like how putting oil down your kitchen sink will clog your home plumbing). The accumulation is known as atherosclerosis. Coronary artery disease is the term for the accumulation of a significant quantity of atherosclerotic plaque in the blood arteries that supply the heart.
Occasionally, plaque buildup within the coronary (heart) arteries may burst or rupture, leaving a blood clot lodged where the rupture occurred. A heart attack may result from the clot obstructing the artery, which would rob the heart muscle of blood.
Although it is uncommon and only accounts for roughly 5% of all heart attacks, burst plaque can nevertheless cause a heart attack. The following conditions can lead to this type of heart attack:
This may be the consequence of coronary heart disease, when the arteries narrow due to the buildup of plaque, which is composed of cholesterol and other materials. This has the potential to block blood flow over time.
Less common causes include:
- the abuse of substances that restrict blood arteries, such cocaine
Overview
A heart attack occurs when a blocked coronary artery prevents blood from reaching the heart muscle.
What increases the risk of a heart attack?
Your chance of suffering a heart attack is influenced by multiple important factors. Regretfully, there are several of these heart attack risk factors that you cannot change:
Age and sex: With age comes an increased risk of heart attack. Your sexual orientation affects when the risk of a heart attack begins to rise. Those who were assigned male at birth (AMAB) have a higher 45-year-old heart attack risk. The risk of a heart attack rises for those who were assigned female at birth (AFAB) after menopause or around age 50.
Family history of heart disease: Your genetics are comparable to those of your parent or sibling, so if they have a history of heart disease or heart attack, especially when they were younger, you are at even higher risk. If a first-degree family (biological sibling or parent) was diagnosed with heart disease at age 65 or under if they are AFAB, or at age 55 or younger if they are AMAB, then your risk increases.
Lifestyle: Making heart-healthy lifestyle decisions can raise your chance of suffering a heart attack. This covers habits including drug usage, excessive alcohol use, smoking, eating meals rich in fat, and not exercising.
Certain health conditions: Certain medical disorders place undue strain on the heart and raise the possibility of a heart attack. This includes having a history of preeclampsia, diabetes, obesity, high blood pressure, high cholesterol, or eating problems.
What are the complications of a heart attack?
Complications associated with heart attacks include:
- Arrhythmias (abnormal heart rhythms).
- Heart failure.
- Heart valve problems.
- Stroke.
- Sudden cardiac arrest.
- Depression and anxiety.
- Cardiogenic shock.
- Mechanical complications of a heart attack, such as a ventricular septal defect or free wall rupture. These are more likely to happen with delayed treatment of a heart attack.
Diagnosis and Tests
How can I tell if I’ve had a heart attack?
Heart attacks are often diagnosed by medical professionals in an emergency department. You should have a physical checkup if you exhibit symptoms of a heart attack. A medical professional will listen to your heart and lung sounds and take your blood pressure, pulse, and oxygen saturation levels. Additionally, they’ll inquire about the symptoms you encountered. Someone who was with you may be asked to explain what transpired.
What tests are used to diagnose a heart attack?
A healthcare provider will diagnose a heart attack using these methods:
Blood tests: Looking for cardiac troponin in your blood is one of the most accurate ways to determine whether you’ve had a heart attack. This particular chemical signature is always present in your bloodstream following a heart attack due to damage to the heart muscle cells.
Electrocardiogram (EKG or ECG): When you visit the ER with symptoms of a heart attack, this is one of the initial tests you receive. The electrical impulses coming from your heart can help determine whether an injury is happening or if there are any irregularities in the rhythm.
Echocardiogram: With the use of ultrasonography (high-frequency sound waves), an echocardiogram creates an image of your heart’s interior and exterior. It can demonstrate how effectively your heart contracts and how well the valves function.
Coronary angiogram or heart catheterization: This technique can assist identify any blockages in your heart’s blood arteries by using contrast dye and X-rays to reveal them.
Heart computed tomography (CT) scan: This produces an extremely thorough scan of your heart and its blood vessels to determine whether the major coronary arteries have significantly narrowed or hardened.
Heart MRI (magnetic resonance imaging): This test creates a picture of your heart using computer processing and a strong magnetic field. It may indicate issues with the blood flow to your heart via the arteries.
Exercise stress test: When you’re physically engaged, this test can involve nuclear scans, an echocardiography, or an ECG to assist determine whether your heart is getting adequate blood flow.
Nuclear heart scans: These scans identify parts of your heart that are damaged or receiving insufficient blood flow by using computer-enhanced techniques like computed tomography (CT) and a radioactive tracer that the physician injects into your blood. These scans might be either positron emission tomography (PET) or single-photon emission computed tomography (SPECT).
Management and Treatment
How is a heart attack treated?
Restoring blood supply to the damaged heart muscle as quickly as feasible is the goal of treating a heart attack. There are several ways this might occur, from medicine to surgery. Many of the following techniques will probably be used throughout treatment.
Supplemental oxygen is frequently given in addition to other heart attack therapies to patients who are experiencing difficulty breathing or have low blood oxygen levels. Either a mask that covers your mouth and nose or a tube that rests just below it can be used to breathe in oxygen. This lessens the pressure on your heart and raises the quantity of oxygen circulating in your blood.
Medications
These may include:
- Anti-clotting medications: Includes aspirin and other blood thinners.
- Nitroglycerin: Relieves chest pain and widens blood vessels for easier blood flow.
- Thrombolytic (clot-busting) medications: Used within the first 12 hours after a heart attack.
- Anti-arrhythmia medications: Prevent or stop life-threatening heart rhythm malfunctions (arrhythmias) caused by heart attacks.
- Pain medications: Morphine is commonly used to alleviate chest pain.
- Beta-blockers: Slow down the heart rate to help recovery from a heart attack.
- Antihypertensives: Lower blood pressure to aid heart recovery.
- Statins: Stabilize plaque in blood vessels, reduce cholesterol, and lower the risk of another heart attack.
Coronary artery bypass grafting
Individuals who have significant coronary artery blockages may receive coronary artery bypass grafting (CABG). Physicians frequently refer to this procedure as bypass or open heart surgery.
During CABG, a blood vessel from another part of your body—typically your arm, leg, or chest—is used to create a blood diversion. This gets blood to your heart muscle by rerouting it around one or more blocked arterial portions.
Complications/side effects of the treatment
Depending on the treatment, adverse effects can include:
- Nausea and vomiting.
- Weakness.
- Lightheadedness.
- Bleeding.
- Infection.
- Damage to a blood vessel.
- Arrhythmia.
- Kidney issues.
- Stroke.
How soon after treatment will I feel better?
As you get therapy, your heart attack symptoms should generally go away. It’s likely that you will feel weak and exhausted for a few days after leaving the hospital during your stay. Your doctor will advise you on how to rest, which drugs to take, and other matters.
Depending on the therapy approach, recovery from the treatments also differs. After a heart attack, the typical hospital stay lasts four to five days. You should generally anticipate spending the following amount of time in the hospital:
Medication only: The typical length of stay in the hospital for someone who just gets medication is roughly six days.
PCI: Considering that PCI is a less invasive way of treating a heart attack than surgery, recovery from it is simpler. PCI patients often stay for four days on average.
CABG: Because cardiac bypass surgery is a significant surgery, recovery takes longer. Eight to twelve days is the typical duration of stay for CABG patients.
Prevention
Can a heart attack be prevented?
Generally speaking, there are a lot of things you can do to potentially avoid having a heart attack. Nevertheless, despite your best efforts, there are some things that can still cause a heart attack, such as your family history, which you cannot alter. However, lowering your risk might delay or lessen the severity of a heart attack if it does occur.
How can I lower my risk?
You can lower your risk of having a heart attack in numerous ways, even though you cannot change some risk factors. Among them are:
Scheduling a checkup: Locate a primary care physician (PCP) and schedule a wellness appointment or examination with them at least once a year. Many of the early warning symptoms of heart disease, including changes you can’t feel, can be detected by an annual checkup. These comprise your cholesterol, blood sugar, blood pressure, and other measurements.
Quitting tobacco products: This covers all vaping goods and smokeless tobacco.
Exercising regularly: Five days a week, aim for 30 minutes of moderately vigorous exercise.
Eating nutritious foods: Diets like Dash and the Mediterranean are two examples. Consuming meals made primarily of plants is a great substitute for consuming large amounts of processed meats and saturated fats.
Maintaining a weight that’s healthy for you: Your primary care physician can provide you advice on a healthy target weight as well as point you in the direction of tools and resources to help you get there.
When I have a heart attack, what should I anticipate?
After you leave the hospital, your heart attack treatment doesn’t finish. You will need to take recommended medications and adjust your daily routine due to your increased risk of suffering another heart attack.
When can I resume my usual activities?
The amount of recovery from a heart attack varies on the severity of the attack, the timing of treatment initiation, the kind of treatments received, and any pre-existing medical issues.
Your healthcare practitioner can go over what to expect and the following steps in your recovery. Generally speaking, most people can resume their regular activities or go back to work two weeks to three months after having a heart attack. Cardiac rehabilitation can assist patients in returning to their previous level of physical activity in a safe and progressive manner.
Outlook for a heart attack
Many people today are heart attack survivors. However, the prognosis is worse for those who:
- Are over 65.
- Have heart failure.
- Have diabetes.
- Already had a heart attack.
Within six months or sooner, there is a risk of another heart attack or death, prompting healthcare providers to actively manage these risks. Premenopausal individuals assigned female at birth (AFAB) under 45 generally fare better compared to their assigned male at birth (AMAB) counterparts of the same age, likely due to estrogen’s heart-protective effects. However, after menopause, AFAB individuals tend to have worse outcomes as estrogen’s protective benefits diminish.
Specifically:
- AFAB individuals aged 45-65 who have had a heart attack face a higher risk of death within a year compared to AMAB individuals of the same age.
- AFAB individuals over 65 have a heightened risk of death within weeks following a heart attack compared to AMAB individuals in the same age group.
When should I see my healthcare provider?
You are at higher risk of experiencing another heart attack. To prevent future incidents, your healthcare professional will likely recommend testing, ongoing monitoring, and treatment, including some of the following measures:
Heart scans: These tests can assess the extent of heart damage caused by the heart attack and detect any long-term cardiac complications, similar to the diagnostic methods used during initial heart attack diagnosis. They also help identify signs of circulation and cardiac issues that increase the likelihood of future heart attacks.
Stress test: Exercise stress tests and cardiac scans can reveal issues that may become more apparent when your heart is working harder to pump blood through your body.
Cardiac rehabilitation: These programs can assist in improving your overall health and lifestyle, reducing the likelihood of experiencing another heart attack.