Heart Attack

A heart attack occurs when blood flow to the heart muscle is interrupted. Oxygen cannot get to the heart muscle, causing tissue damage or tissue death.

  • Causes

    A heart attack may be caused by:

    • Thickening of the walls of the arteries feeding the heart muscle (coronary arteries)
    • Accumulation of fatty plaques in the coronary arteries
    • Narrowing of the coronary arteries
    • Spasm of the coronary arteries
    • Development of a blood clot in the coronary arteries
    • Embolism that affects the coronary arteries

  • Definition

    A heart attack occurs when blood flow to the heart muscle is interrupted. Oxygen cannot get to the heart muscle, causing tissue damage or tissue death.

    Heart Attack
    Heart Attack
    Copyright © Nucleus Medical Media, Inc.

  • Diagnosis

    Tests may include:

    • Blood tests—To look for certain enzymes found in the blood within hours or days after a heart attack.
    • Urine tests—To look for certain substances found in the urine within hours or days after a heart attack.
    • Electrocardiogram (EKG)—to look for evidence of blockage or damage.
    • Echocardiogram—to examine the size, shape, function, and motion of the heart.
    • Stress test—Records the heart's electrical activity under increased physical stress, usually done days or weeks after the heart attack.
    • Nuclear scanning—show areas of the heart muscle where there is diminished blood flow.
    • Electron-beam computed tomography (EBCT)—to make detailed pictures of the heart, coronary arteries, and surrounding structures.
    • Coronary angiography—to look for narrowing or blockage in the coronary arteries.

  • Prevention

    Preventing or treating coronary artery disease may help prevent a heart attack.

    • Maintain a healthy weight.
    • Begin a safe exercise program. Follow your doctor's advice.
    • If you smoke, quit.
    • Eat a healthy diet. Your diet should be low in saturated fat and rich in whole grains, fruits, and vegetables.
    • Properly treat long-term conditions, like high blood pressure, diabetes, and high cholesterol.
    • Manage stress.
    • Ask your doctor about taking a small, daily dose of aspirin.

      • Although most people are able to tolerate such a low dose of aspirin, even this small amount can rarely lead to serious bleeding, particularly from the gastrointestinal (GI) tract.
      • Aspirin may not work as well when combined with other pain medicines.

  • Risk Factors

    The risk of heart attack is greater in males and older adults.

    Factors that may increase your chance of developing a heart attack include:

    • Obesity
    • Smoking
    • High blood pressure
    • Sedentary lifestyle
    • High blood cholesterol (specifically, high LDL cholesterol, and low HDL cholesterol)
    • High blood triglycerides
    • Diabetes
    • Stress
    • Family members with heart disease
    • Using testosterone therapy medication

  • Symptoms

    Symptoms include:

    • Squeezing, heavy chest pain behind breastbone, especially with:

      • Exercise or exertion
      • Emotional stress
      • Cold weather
      • A large meal
      • Usually comes on quickly
    • Pain in the left shoulder, left arm, or jaw
    • Shortness of breath
    • Sweating, clammy skin
    • Nausea
    • Weakness
    • Loss of consciousness
    • Anxiety, especially feeling a sense of doom or panic without apparent reason

    Unusual symptoms of heart attack (may occur more frequently in women):

    • Stomach pain
    • Back and shoulder pain
    • Confusion
    • Fainting

    If you think you are having a heart attack, call for medical help right away.

  • Treatment

    Treatment includes:

    • Aspirin
    • Oxygen
    • Pain-relieving medicine
    • Nitrate medicines
    • Other antiplatelet agents
    • Beta-blockers and/or angiotensin-converting enzyme (ACE) inhibitor medicines
    • Anti-anxiety medicine
    • Cholesterol-lowering medicines (such as statin drugs)

    Within the first six hours after a heart attack, you may be given medicines to break up blood clots in the coronary arteries.