A heart attack, also known as a myocardial infarction, occurs when there is a significant decrease or blockage in blood flow to the heart, usually caused by a buildup of fatty, cholesterol-laden plaques in the coronary arteries, a process known as atherosclerosis. In some cases, a plaque can break open and cause a clot, which can obstruct blood flow and cause damage or destruction to a portion of the heart muscle. It is crucial to seek prompt medical attention in the event of a heart attack to prevent death, and emergency services should be contacted immediately by calling 911.
Symptoms
The symptoms of a heart attack can vary from person to person, with some experiencing mild symptoms, severe symptoms, or no symptoms at all. The common symptoms of a heart attack include chest pain that can feel like pressure, tightness, squeezing, or aching, pain or discomfort that spreads to the shoulder, arm, back, neck, jaw, teeth, or upper belly, cold sweat, fatigue, heartburn, indigestion, lightheadedness, sudden dizziness, nausea, and shortness of breath. Women may experience atypical symptoms such as brief or sharp pain felt in the neck, arm, or back. In some cases, sudden cardiac arrest may be the first symptom of a heart attack.
While some heart attacks can occur suddenly, many people may experience warning signs and symptoms hours, days, or weeks before an actual heart attack. Chest pain or pressure that occurs repeatedly and doesn’t go away with rest may be an early warning sign of a heart attack. This chest pain, also known as angina, is caused by a temporary decrease in blood flow to the heart.
Get help right away if you think you’re having a heart attack. Take these steps:
If you suspect that you are experiencing a heart attack, it is crucial to seek emergency medical help immediately. This can be done by calling 911 or your local emergency number. If access to emergency services is not available, you should have someone drive you to the nearest hospital. If there are no other options available, you may drive yourself to the hospital.
If your healthcare provider has prescribed nitroglycerin to you, it is essential to take it as directed while waiting for emergency assistance.
Taking aspirin during a heart attack may help to reduce heart damage by preventing blood clotting. However, it is crucial to follow the advice of your healthcare provider or emergency medical personnel before taking aspirin. Aspirin can interact with other drugs, so it is important to avoid taking it unless advised to do so. Delaying emergency medical help to take aspirin is not recommended. It is always best to call for emergency help first.
What to do if you see someone who might be having a heart attack
If you encounter an unconscious person whom you suspect is having a heart attack, the first step is to call 911 or your local emergency number. After calling for help, check if the person is breathing and has a pulse. If they are not breathing or you cannot find a pulse, begin CPR.
If you are not trained in CPR, perform hands-only CPR by pushing hard and fast on the person’s chest at a rate of about 100 to 120 compressions per minute.
If you are trained in CPR and feel confident in your ability, start by performing 30 chest compressions followed by two rescue breaths. This cycle should be repeated until emergency medical help arrives.
Remember that performing CPR promptly and correctly can greatly increase the person’s chances of survival, so don’t hesitate to take action in an emergency situation.
Causes
The leading cause of heart attacks is coronary artery disease, which occurs when one or more of the coronary arteries become blocked due to the buildup of plaques containing cholesterol. These plaques can narrow the arteries and restrict blood flow to the heart. A heart attack can be triggered by the rupture of a plaque, leading to the formation of a blood clot in the heart.
A heart attack can result from either a complete or partial blockage of a coronary artery. Doctors classify heart attacks based on whether an electrocardiogram (ECG or EKG) shows specific changes, known as ST elevation, that require immediate invasive treatment. Your healthcare provider may use ECG results to categorize these types of heart attacks.
When a medium or large heart artery is completely blocked, it typically results in an ST elevation myocardial infarction (STEMI). A partial blockage often leads to a non-ST elevation myocardial infarction (NSTEMI), although some people with NSTEMI may still have a total blockage.
Not all heart attacks are caused by blocked arteries. Other causes include:
There are other causes of heart attacks besides coronary artery disease. One cause is coronary artery spasm, which is a severe constriction of a blood vessel that is not blocked by cholesterol plaques. This condition may also be referred to as Prinzmetal’s angina, vasospastic angina or variant angina. Heart attacks may also be caused by certain infections, such as COVID-19, that can damage the heart muscle. Another cause is spontaneous coronary artery dissection (SCAD), a serious condition where a tear occurs inside a heart artery.
Risk factors
The risk factors for a heart attack are:
- Age: Men aged 45 and above and women aged 55 and above are more susceptible to heart attacks than younger men and women.
- Tobacco use: Smoking and prolonged exposure to secondhand smoke increases the risk of heart attack.
- High blood pressure: It can damage arteries leading to the heart and when accompanied by other conditions such as obesity, high cholesterol, or diabetes, the risk increases even more.
- High cholesterol or triglycerides: High levels of LDL or “bad” cholesterol can narrow the arteries, while high levels of certain blood fats called triglycerides can increase the risk. Adequate levels of HDL or “good” cholesterol can lower the risk.
- Obesity: It is linked with high blood pressure, diabetes, high levels of triglycerides and bad cholesterol, and low levels of good cholesterol.
- Diabetes: It can increase the risk of heart attack due to the high blood sugar levels that damage the blood vessels.
- Metabolic syndrome: This is a combination of at least three conditions, including a large waist, high blood pressure, low HDL, high triglycerides, and high blood sugar, which can double the risk of heart disease.
- Family history of heart attacks: A history of early heart attack in a brother, sister, parent, or grandparent can increase the risk.
- Inactivity: Lack of physical activity and a sedentary lifestyle increase the risk of heart attack, while regular exercise improves heart health.
- Unhealthy diet: A diet high in sugar, animal fats, processed foods, trans fats, and salt can increase the risk of heart attack, while a diet rich in fruits, vegetables, fiber, and healthy oils lowers the risk.
- Stress: Extreme emotional stress, such as anger, can increase the risk of a heart attack.
- Illegal drug use: Cocaine and amphetamines are stimulants that can trigger a coronary artery spasm leading to a heart attack.
- History of preeclampsia: High blood pressure during pregnancy increases the risk of heart disease later in life.
- Autoimmune condition: Conditions like rheumatoid arthritis or lupus can increase the risk of a heart attack.
Complications
Heart attack complications are often due to heart muscle damage. Potential complications of a heart attack include:
Heart damage resulting from a heart attack can lead to irregular heart rhythms or arrhythmias, which may be severe and even fatal. Additionally, cardiogenic shock can occur when the heart is unable to pump blood properly. Heart failure can result from significant damage to the heart muscle, and this condition can either be temporary or long-lasting. In some cases, a heart attack can trigger pericarditis, which is inflammation of the tissue surrounding the heart. This condition may also be referred to as Dressler syndrome, postmyocardial infarction syndrome, or postcardiac injury syndrome. Finally, a heart attack can increase the risk of cardiac arrest, which occurs when the heart stops without warning due to a sudden change in the heart’s signaling. Immediate treatment is necessary to prevent sudden cardiac death.
Prevention
Even if you have already experienced a heart attack, there are still steps you can take to prevent future occurrences. These preventative measures include maintaining a healthy lifestyle, which entails avoiding smoking, following a heart-healthy diet, managing stress, and engaging in regular exercise. It is also important to manage any other health conditions that can increase the risk of heart attacks, such as high blood pressure and diabetes, by scheduling regular checkups with your healthcare provider. Finally, taking medications as directed by your healthcare provider can help protect and improve heart health.
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