A heart attack happens when there is a loss of blood supply to part of the heart muscle. It often results from a blockage in a nearby artery.
A person who is experiencing a heart attack — or myocardial infarction — will feel pain in their chest and other parts of their body, as well as other symptoms.
Spotting the early signs of a heart attack and getting prompt treatment is crucial and can save a person’s life.
A heart attack is different from cardiac arrest, in which the heart stops working completely. Both are medical emergencies, and without treatment, a heart attack can lead to cardiac arrest.
This article looks at how heart attacks happen and how to treat and prevent them.
As heart attacks can be fatal, it is crucial to recognize the warnings as soon as possible and contact emergency services.
- a feeling of pressure, tightness, pain, squeezing, or aching in the chest
- pain that spreads to the arms, neck, jaw, or back
- a feeling of crushing or heaviness in the chest
- a feeling similar to heartburn or indigestion
- nausea and sometimes vomiting
- feeling clammy and sweaty
- shortness of breath
- feeling lightheaded or dizzy
- in some cases, anxiety that can feel similar to a panic attack
- coughing or wheezing, if fluid builds up in the lungs
The symptoms can vary in their order and duration — they may last several days or come and go suddenly.
The following may also develop:
- Hypoxemia: This involves low levels of oxygen in the blood.
- Pulmonary edema: This involves fluid accumulating in and around the lungs.
- Cardiogenic shock: This involves blood pressure dropping suddenly because the heart cannot supply enough blood for the rest of the body to work adequately.
Females and males sometimes experience heart attacks differently. Learn about heart attack symptoms in females here.
A heart attack is life threatening and needs emergency attention.
Nowadays, many people survive heart attacks, due to effective treatment. Delaying treatment, however, dramatically reduce the chances of survival.
Call 911 immediately
- Be ready to explain what has happened and where you are.
- Stay calm and follow all instructions from the emergency team.
While waiting for the team to arrive, talk to the person, and reassure them that help is on the way.
If the person stops breathing, take the following steps:
Do manual chest compressions:
- Lock your fingers together and place the base of your hands in the center of the chest.
- Position your shoulders over your hands, lock your elbows, and press hard and fast, at a rate of 100–120 compressions per minute. Press to a depth of 2 inches.
- Continue these movements until the person starts to breathe or move, until someone else can take over, or until you are exhausted.
- If possible, take turns without pausing the compressions.
Use an automatic external defibrillator (AED)
- AEDs are available in shopping malls and many other public places.
- An AED provides a shock that may restart the heart.
- Remain calm and follow the instructions. Most newer AEDs talk you through the steps.
When the emergency team arrives, they will take over the person’s care.
Give the team as much detail as possible about the person’s health and what was happening before the event.
The team will try to stabilize the person’s condition, including providing oxygen.
In the hospital, a medical team will perform tests and provide appropriate treatment.
Many approaches can help, but three common options are:
- medications, including those to dissolve blood clots
- percutaneous coronary intervention, a mechanical method of restoring blood flow to any damaged tissue
- coronary artery bypass grafting, commonly called a heart bypass, diverts blood around damaged areas of the arteries to improve blood flow
The healthcare team will also work with the individual to develop a treatment plan designed to prevent future attacks.
Some people experience complications after a heart attack. Depending on how severe the event was, these may include:
- Depression: This is common after a heart attack, and engaging with loved ones and support groups can help.
- Arrhythmia: The heart beats irregularly, either too fast or too slowly.
- Edema: Fluid accumulates and causes swelling in the ankles and legs.
- Aneurysm: Scar tissue builds up on the damaged heart wall, which causes thinning and stretching of the heart muscle, eventually forming a sac. This can also lead to blood clots.
- Angina: Insufficient oxygen reaches the heart, causing chest pain.
- Heart failure: The heart can no longer pump effectively, leading to fatigue, difficulty breathing, and edema.
- Myocardial rupture: This is a tear in a part of the heart, due to damage caused by a heart attack.
Ongoing treatment and monitoring can help reduce the risk of these complications.
There are various ways to lower the risk of a heart attack. The American Heart Associaton advise people to make heart health a priority.
Ways to do this include:
- avoiding or quitting smoking
- having a balanced, healthful diet
- getting regular exercise
- managing diabetes, high cholesterol levels, high blood pressure, and other conditions
- limiting alcohol intake
- maintaining a healthy body weight
- whenever possible, avoiding stress or practicing ways to reduce it
Knowing the symptoms of a heart attack can help a person get prompt treatment, and this increases the chances of a positive outcome.
In the hospital, a doctor will ask about symptoms. When making a diagnosis and drawing up a treatment strategy, they will take into account the person’s:
- overall health
- medical history
- family history
They will also need to carry out tests, which include:
- imaging tests, such as X-rays, CT scans, and echocardiograms
- electrocardiography, to measure electrical activity in the heart
- blood tests, which can confirm that a heart attack has occurred
- cardiac catheterization, which enables a doctor to examine the inside of the heart
Recovering can take time, depending on the severity of the heart attack and other factors, such as the cause and the person’s age.
Some factors involved include:
- Cardiac rehabilitation: The healthcare team will help the person make a plan to restore their health and prevent another heart attack.
- Resuming physical activity: A healthcare provider can help develop a suitable activity plan.
- Returning to work: The timing of this depends on the person’s job and the severity of the heart attack.
- Driving: A doctor will advise about the timing, which varies from person to person.
- Sex: Most people can resume sexual activity after 4–6 weeks. Erectile dysfunction can result from medication use, but treatment can help resolve this.
Many people experience depression during recovery from a heart attack, but counseling, support groups, and treatments can help.
The most common cause of a heart attack is a blockage in one of the arteries near the heart.
This can result from coronary heart disease, in which plaque — made up of cholesterol and other substances — collects in the arteries, narrowing them. Over time, this can obstruct the flow of blood.
Less common causes include:
- the misuse of drugs, such as cocaine, which causes the blood vessels to narrow
- low oxygen levels in the blood, due, for example, to carbon monoxide poisoning
As the AHA note, the following can increase the risk of a heart attack:
- older age
- male sex
- high cholesterol levels
- high blood pressure
- other health conditions, such as obesity or diabetes
- having a diet high in processed foods and added fats, sugars, and salt
- low activity levels
- genetic factors and family history
- a high alcohol intake
- high levels of stress
Often, a heart attack results from a combination of factors.
In addition, the AHA report that Black Americans, Latinx Americans, Native Americans, Native Hawaiians, and some Asian Americans have increased risks of high blood pressure and dying of heart disease, compared with their white counterparts.
A heart attack can be life threatening and needs immediate medical attention.
Key warnings include pain and tightness in the chest, pain in other parts of the body, and difficulty breathing.
If anyone has symptoms of a heart attack, someone should call 911 at once. With prompt treatment, there is often a good chance of a positive outcome.