Patient education: Heart attack (The Basics)

What is a heart attack? — 

This is when 1 of the "coronary arteries" gets completely or partly blocked. The coronary arteries supply blood to the heart. When blood cannot flow through an artery, part of the heart is damaged.

Heart attacks are usually the result of a condition called "coronary artery disease" or "coronary heart disease." In this disease, fatty deposits called "plaques" form on the walls of the coronary arteries (figure 1). These plaques sometimes break open and cause blood clots to form. Then, the blood clot can block off the artery and keep blood from reaching parts of the heart muscle. That is what causes most heart attacks (figure 2).

A heart attack is also called a "myocardial infarction" ("MI").

What are the symptoms of a heart attack? — 

People having a heart attack often have (figure 3):

●Chest pain, pressure, or discomfort

●Pain in the neck, arm, throat, back, or other part of the upper body

●Shortness of breath

●Nausea, vomiting, burping, or heartburn

●Sweating or cold, clammy skin

●Fast or uneven heartbeat

●Dizziness or feeling lightheaded

Chest pain or discomfort is the most common symptom of a heart attack in both females and males. However, females are more likely to have symptoms other than chest pain.

If you think you might be having a heart attack, call for an ambulance right away (in the US and Canada, call 9-1-1). Do not try to get to the hospital on your own.

Is there a test for a heart attack? — 

Yes. If your doctor thinks you are having a heart attack, they might order 1 or more of these tests:

●Electrocardiogram ("ECG") – This measures the electrical activity in the heart. A heart attack can change the patterns seen on the ECG.

●Blood tests – During a heart attack, the heart releases certain chemicals. If these chemicals are in your blood, it might mean you are having a heart attack.

●Echocardiogram – This uses sound waves to create images of the heart as it beats. During a heart attack, not all parts of the heart pump normally.

●Cardiac catheterization ("cardiac cath") – The doctor puts a thin tube into a blood vessel in the leg or arm. They move the tube up to the heart. Then, they put a dye that shows up on X-ray into the tube. This part of the test is called "coronary angiography." It can show whether any of the arteries in the heart are clogged.

How is a heart attack treated? — 

If you go to the hospital while you are having a heart attack, the doctors and nurses will do a few things:

●They might give you oxygen through a mask or a tube in your nose.

●They will give you medicines to ease chest pain and discomfort. They might also give you medicine to help you relax.

●They will give you medicines to help prevent more blood clots from forming.

●They might give you a medicine called a "beta blocker." This can help reduce the damage caused by a heart attack.

●They will try to get blood flowing again through your clogged artery. They can do this in 1 of 2 ways:

•Medicines – You might get medicines through a thin tube that goes into a vein, called an "IV," to break up clots. These are sometimes called "clot-busting" medicines.

•Stenting – This can be done along with cardiac cath. It involves putting a tiny metal tube called a "stent" into your blocked artery to hold it open.

●If you cannot get a stent, or if the stent does not work, your doctor might suggest open heart surgery. This is also called "coronary artery bypass grafting" or "bypass surgery" (figure 4). During this surgery, a surgeon uses pieces of blood vessels from other parts of your body to re-route blood. This creates a new path for blood to get around the clogged part of your artery.

After a heart attack, you will likely stay in the hospital for 3 to 5 days, unless the heart attack led to other problems that need treatment.

What happens after a heart attack? — 

You will probably need to:

●Take more medicines than before – It is very important you take all your medicines exactly as instructed. The medicines given after a heart attack can help prevent other heart attacks, and they reduce the chances of having a stroke or dying. If you got a stent, you will also need to take medicines to help it work properly.

If you can't afford your medicines, or if the medicines give you side effects, tell your doctor. There are often ways to solve these problems.

●Change your diet – Try to avoid fried foods and sugary foods. Eat lots of fruits and vegetables, and foods with a lot of fiber.

●Lose weight, if you have excess body weight – Having a healthy body weight reduces the chance of another heart attack and can make you feel better.

●Get more physical activity – This can include walking, gardening, or any activity that gets you to move more. Staying active can help reduce your risk of having another heart attack or dying. Even gentle forms of exercise are good for your health.

●Go to cardiac rehabilitation ("rehab") – After a heart attack, your doctor might recommend cardiac rehab. There, doctors, nurses, and other health professionals teach you how to keep your heart healthy. This includes building strength and learning how to exercise safely after a heart attack. You will also learn how to reduce your risk of having another heart attack.

More on this topic

Patient education: Heart attack – Discharge instructions (The Basics)
Patient education: Medicines after a heart attack (The Basics)
Patient education: What can go wrong after a heart attack? (The Basics)
Patient education: Coronary artery disease (The Basics)
Patient education: Living with coronary artery disease (The Basics)
Patient education: Chest pain (The Basics)
Patient education: Angina (The Basics)
Patient education: ECG and stress test (The Basics)
Patient education: Troponin test (The Basics)
Patient education: Echocardiogram (The Basics)
Patient education: Cardiac catheterization (The Basics)
Patient education: Nuclear heart testing (The Basics)
Patient education: Stenting for the heart (The Basics)
Patient education: Coronary artery bypass graft surgery (The Basics)
Patient education: Clot-dissolving medicines for heart attack or stroke (The Basics)
Patient education: Lowering your risk of heart disease (The Basics)
Patient education: Heart-healthy diet (The Basics)
Patient education: Weight loss treatments (The Basics)
Patient education: Exercise and movement (The Basics)
Patient education: Cardiac rehabilitation (The Basics)

Patient education: Heart attack (Beyond the Basics)
Patient education: Heart attack recovery (Beyond the Basics)
Patient education: Chest pain (Beyond the Basics)
Patient education: Medications for angina (Beyond the Basics)
Patient education: Angina treatment — medical versus interventional therapy (Beyond the Basics)
Patient education: Stenting for the heart (Beyond the Basics)
Patient education: Coronary artery bypass graft surgery (Beyond the Basics)
Patient education: Recovery after coronary artery bypass graft surgery (CABG) (Beyond the Basics)
Patient education: Losing weight (Beyond the Basics)
Patient education: Exercise (Beyond the Basics)