A heart attack is the blockage of blood flow to an area of the heart. The heart tissue becomes damaged or dies within a short time after blood flow is stopped. If a large or vital area is affected the damage may stop the heart from working.
The coronary arteries deliver oxygen-rich blood to the heart muscle. A heart attacks occurs when blood flow is interrupted in these arteries because of one or more of the following:
The severity of the heart attack will depend on how much of the heart tissue was affected and how long the blockage lasted. The amount of heart tissue that is affected will depend on which artery is blocked. There are two main coronary arteries that gradually split down into smaller branches of arteries. If the blockage occurs in the larger arteries it will affect a larger area of the heart. If the blockage occurs further down in the smaller vessels it affects a smaller area of the heart.
The risk of heart attack is greater in males and older adults.
Factors that affect the health of your blood vessels and increase your chance of developing a heart attack include:
Symptoms can vary but common symptoms include:
Unusual symptoms of heart attack—may occur more frequently in women:
If you think you may be having a heart attack, call for emergency medical services right away.
If the doctor suspects a heart attack it may be confirmed with:
Further testing may be done to look for any damage or changes to the heart. Test will be based on your specific needs but may include:
The first goal of treatment is to improve blood flow and get oxygen to your heart as quick as possible. Treatment includes:
If a blood clot is present, medications may be given to try to break up the clot. The sooner these medications are delivered the better the outcome will be. Ideally, the medications are delivered within the first 6 hours after symptoms appear.
Other blockages, blood clots that don't respond to medication or plaque build up, may need to be surgically managed. The procedure may need to be done immediately for severe blockages or delayed for a few days if there is adequate blood flow. Surgical options include:
Cardiac rehabilitation can help during recovery after a heart attack. It may include monitoring during physical activity in the first few weeks of recovery and education on healthful nutrition and lifestyle changes.
A heart attack can be a major life event. It is common for people to experience depression after having a heart attack. Therapy and medication can help manage these challenges.
Many lifestyle habits influence the health of the blood vessels and heart. Healthy heart habits include:
Small daily doses of aspirin may help some people decrease their risk of aspirin. Aspirin for heart protection should only be done with a doctor's supervision since aspirin can cause complications like bleeding in the stomach or intestines. Aspirin may also interact with other medications like pain medications.
American Heart Association
National Stroke Association
Heart and Stroke Foundation of Canada
The College of Family Physicians of Canada
About heart attacks. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/AboutHeartAttacks/About-Heart-Attacks_UCM_002038_Article.jsp. Updated September 2, 2014. Accessed September 29, 2014.
ST-elevation myocardial infarction (STEMI). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115392/ST-elevation-myocardial-infarction-STEMI. Updated July 25, 2016. Accessed September 28, 2016.
What is a heart attack? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/. Updated December 13, 2013. Accessed September 29, 2014.
7/6/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115392/ST-elevation-myocardial-infarction-STEMI: Antithrombotic Trialists' (ATT) Collaboration, Baigent C, Blackwell L, et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet. 2009;373:1849-1860.
2/3/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115392/ST-elevation-myocardial-infarction-STEMI: Finkle W, Greenland S, et al. Increased risk of non-fatal myocardial infarction following testosterone therapy prescription in men. PLoS One. 2014;9(1).
Last reviewed September 2016 by Michael J. Fucci, DO, FACC
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.