Heart Attack

What is a heart attack?

A heart attack (the medical term is myocardial infarction) occurs when there is a sudden reduction in the amount of blood flowing to the heart.

One or more of the arteries that supply blood to the heart is blocked. Blockages often form over many years as plaque builds up.

Heart attacks typically occur suddenly. Though symptoms can last anywhere from hours to days.

Get medical attention right away. A heart attack can be fatal.

What are the silent signs of a heart attack

You’re probably familiar with the most common symptom of a heart attack: sudden chest pain that is squeezing or feels like pressure. It is typically located in the center or left side of the chest.

But not everyone gets this dramatic pain. Less noticeable symptoms include more mild pain or discomfort in the center of your chest. It may radiate to the arm, jaw, neck. or back.

Some people, especially women, don't always have chest pain. Instead, they experience nausea, vomiting, sweating, fatigue, trouble breathing, or lightheadedness. Some people, especially diabetics, may not notice any symptoms (so-called “silent heart attacks”).

Heart attack symptoms are sometimes confused with gastric reflux or indigestion. Do not ignore symptoms that do not go away within minutes or worsen. Other warning signs of a heart attack are sweating, nausea, trouble breathing, fatigue, or lightheadedness.

It’s not always possible to know if symptoms are a sign of a heart attack or a less serious condition. So head to the emergency room for testing.

Main symptoms of a heart attack

• Pressure or squeezing chest pain
• Sweating (including cold sweat)
• Nausea or vomiting
• Sudden fatigue
• Difficulty catching one’s breath or shortness of breath while talking or walking on flat ground
• Lightheadedness

Sometimes the pain is felt in the arm, jaw, neck or back.

What makes heart attacks more likely

• Being 45 and older for men and 55 and older for women,
• Obesity,
• Not being active, including sitting for long periods,
• High blood pressure, diabetes, high cholesterol, or high triglyceride levels,
• Exposure to environmental pollution, and tobacco use (including electronic cigarettes and secondhand smoke exposure).
• Family history for coronary heart disease. If your parents and siblings had a heart attack at a young age, it may mean there’s a genetic predisposition.

Next steps after a heart attack

Someone should call 911. If available, take 324 mg of aspirin as soon as possible. (Unless you are allergic to or have been instructed not to take aspirin.) Aspirin thins the blood and may stop more blockages from forming.

Heart attack treatments

Usually, doctors try a combination of treatments to clear blocked arteries and get the blood flowing.

Most patients will undergo cardiac catheterization. It is minimally invasive (typically with no incision). A catheter (a long, thin tube) is threaded into an artery in the wrist or groin until it reaches the arteries of the heart.

Based on the location and severity of the blockage, patients may undergo stenting or coronary artery bypass grafting surgery. Generally, these procedures are for blockages of more than 70%.

Many factors determine whether your doctor recommends surgery or a stent, including how many arteries are clogged, which specific arteries are affected, and any other illnesses you have.

Your doctor may try medications like aspirin, cholesterol-lowering drugs (e.g., statins), and ones that treat high blood pressure and diabetes. And also advise you to make lifestyle changes, like stopping smoking and following a heart-healthy diet.

After having a heart attack, you will be given a prescription to complete a cardiac rehabilitation program.

Medications for heart attacks

The medications used to treat heart attack include:

• Aspirin thins the blood and prevents additional clots from forming.
• Clopidogrel, ticagrelor, or prasugrel are blood thinners. Usually, they are prescribed after stenting to more effectively thin the blood and prevent stents from clotting.
• Heparin is a blood thinner given intravenously in the hospital after a heart attack.
• Statins lower cholesterol and inflammation and keep more plaque from forming.
• Beta-blockers decrease demand on the heart and suppress abnormal heart rhythms.
• Nitrates improve blood flow in the heart's arteries and decrease demand on the heart.
• ACE inhibitors or angiotensin receptor blockers help with recovery from a heart attack. They are typically prescribed for severe heart attacks.

Heart attack prevention

• Maintain an active lifestyle (at least 150 minutes per week of moderate-intensity aerobic exercise and two sessions per week of moderate-heavy intensity resistance training) and a healthy weight.
• Stop smoking (and using electronic cigarettes) and avoid secondhand smoke and environmental pollution.
• Treat illness like hypertension, high cholesterol levels, and diabetes.
• Following a heart-healthy diet by eating mostly fruits, vegetables, whole grains, low-fat dairy, skinless poultry, fish, and nuts/legumes. Limit saturated fat, trans fat, sodium, red meat, sweets, and sugar-sweetened beverages.
• Taking preventative medications, like aspirin and statins, as prescribed by your physician.