A heart attack occurs
when blood flow to a part of your heart is blocked for a long enough
time that part of the heart muscle is damaged or dies. Your doctor
calls this a myocardial infarction.
Causes, incidence, and
Most heart attacks are caused by a blood clot that blocks one of
the coronary arteries. The coronary arteries bring blood and
oxygen to the heart. If the blood flow is blocked, the heart is
starved of oxygen and heart cells die.
A hard substance
called plaque can build up in the walls of your coronary arteries.
This plaque is made up of cholesterol and other cells. A heart
attack can occur as a result of plaque buildup.
- The plaque can
develop cracks or tears. Blood platelets stick to these tears
and form a blood clot. A heart attack can occur if this blood
clot completely blocks oxygen-rich blood from flowing to the
heart. This is the most common cause of heart attacks.
- The slow buildup
of plaque may almost block one of your coronary arteries. A
heart attack may occur if not enough oxygen-rich blood can flow
through this blockage. This is more likely to happen when your
body is stressed (for example, by a serious illness).
The cause of heart
attacks is not always known. Heart attacks may occur:
- When you are
resting or asleep
- After a sudden
increase in physical activity
- When you are
active outside in cold weather
- After sudden,
severe emotional or physical stress, including an illness
is a state in which the heart has been damaged so much that it
cannot supply enough blood to the organs of the body. This
condition is a medical emergency.
A heart attack is a
medical emergency. If you have symptoms of a heart attack, call
911 or your local emergency number right away.
- DO NOT try to
drive yourself to the hospital.
- DO NOT DELAY.
You are at greatest risk of sudden death in the early hours of a
Chest pain is the
most common symptom of a heart attack. You may feel the pain in
only one part of your body, or it may move from your chest to your
arms, shoulder, neck, teeth, jaw, belly area, or back.
The pain can be
severe or mild. It can feel like:
- A tight band
around the chest
- Something heavy
sitting on your chest
- Squeezing or
The pain usually
lasts longer than 20 minutes. Rest and a medicine called
nitroglycerin may not completely relieve the pain of a heart
attack. Symptoms may also go away and come back.
Other symptoms of a
heart attack include:
(feeling like your heart is beating too fast or irregularly)
- Shortness of
- Sweating, which
may be very heavy
Some people (the
elderly, people with diabetes, and women) may have little or no
chest pain. Or, they may have unusual symptoms (shortness of
breath, fatigue, weakness). A "silent heart attack" is a heart
attack with no symptoms.
Signs and tests
A doctor or nurse
will perform a physical exam and listen to your chest using a
- The doctor may
hear abnormal sounds in your lungs (called crackles), a heart
murmur, or other abnormal sounds.
- You may
- Your blood
pressure may be normal, high, or low.
troponin blood test can show if you have
heart tissue damage. This test can confirm that you are having a
angiography is often done right away or when you are more stable.
You may also have tests such as an electrocardiogram (ECG).
- This test uses a
special dye and x-rays to see how blood flows through your
- It can help your
doctor decide which treatments you need next.
Other tests to look
at your heart that may be done while you are in the hospital:
- Exercise stress
- Nuclear stress
You will most
likely first be treated in the emergency room.
- You will be
hooked up to a heart monitor, so the health care team can look
at how your heart is beating.
- The health care
team will give you oxygen so that your heart doesn't have to
work as hard.
- An intravenous
line (IV) will be placed into one of your veins. Medicines and
fluids pass through this IV.
- You may get
nitroglycerin and morphine to help reduce chest pain.
(arrhythmias) are the leading cause of death in the first few
hours of a heart attack. These arrythmias may be treated with
medications or cardioversion.
Angioplasty is a
procedure to open narrowed or blocked blood vessels that supply
blood to the heart. Usually a small, metal mesh tube called a
stent is placed at the same time.
- Angioplasty is
often the first choice of treatment. It should be done within 90
minutes after you get to the hospital, and no later than 12
hours after a heart attack.
- A stent is a
small, metal mesh tube that opens up (expands) inside a coronary
artery. A stent is often placed after angioplasty. It helps
prevent the artery from closing up again.
You may be given
drugs to break up the clot. It is best if these drugs are given
within 3 hours of when you first felt the chest pain. This is
called thrombolytic therapy.
Some patients may
also have heart bypass surgery to open narrowed or blocked blood
vessels that supply blood to the heart. This procedure is also
called open heart surgery.
AFTER YOUR HEART
The following drugs
are given to most people after they have a heart attack. These
drugs can help prevent another heart attack. Ask your doctor or
nurse about these drugs:
Antiplatelet drugs (blood thinners) such
clopidogrel (Plavix), or warfarin (Coumadin), to help keep your
blood from clotting
and ACE inhibitor medicines to help protect your heart
- Statins or other
drugs to improve your cholesterol levels
You may need to
take some of these medicines for the rest of your life. Always
talk to your health care provider before stopping or changing how
you take any medicines. Any changes may be life threatening.
After a heart
attack, you may feel sad. You may feel anxious and worry about
being careful in everything you do. All of these feelings are
normal. They go away for most people after 2 or 3 weeks. You may
also feel tired when you leave the hospital to go home.
Most people who
have had a heart attack take part in a cardiac rehab program.
While under the care of a doctor and nurses, you will:
- Slowly increase
your exercise level
- Learn how to
follow a healthy lifestyle
LIVING A HEALTHY
To prevent another
- Keep your blood
pressure, blood sugar, and cholesterol under control.
- Don't smoke.
- Eat a
heart-healthy diet rich in fruits, vegetables, and whole grains,
and low in animal fat.
- Get plenty of
exercise, at least 30 minutes a day, at least 5 days a week
(talk to your doctor first).
- Get checked and
treated for depression.
- Limit yourself
to no more than one drink a day for women, and no more than two
drinks a day for men.
- Stay at a
healthy weight. Aim for a body mass index (BMI) of between 18.5