What is heart attack?

Heart attack: Overview

A heart attack is an event that occurs when part of the heart muscle does not get enough blood and oxygen. This part of the heart starts to die. A heart attack is also called a myocardial infarction, or MI.

A heart attack most often happens because blood flow through one or more of the coronary arteries is blocked. This blockage is usually caused by a blood clot that forms when plaque in the artery breaks open.

After a heart attack, you may be worried about your future. Over the next several weeks, your heart will start to heal. Though it can be hard to break old habits, you can reduce your risk of having another heart attack. You can do this by making some lifestyle changes and by taking medicines.

Heart Attack

A heart attack is an event that occurs when part of the heart muscle does not get enough blood and oxygen. This part of the heart starts to die.

A heart attack most often happens because blood flow through one or more of the coronary arteries is blocked. This blockage is usually caused by a blood clot that forms when plaque in the artery breaks open.

Quick treatment that restores blood flow to the heart can help save lives.

The medical name for a heart attack is myocardial infarction, or MI. It may also be called acute coronary syndrome.

What happens during a heart attack?

During a heart attack, part of the heart muscle does not get enough blood and oxygen. This part of the heart starts to die. If a large part of the heart is damaged, you may develop other problems, such as heart valve disease.

What are the symptoms of a heart attack?

Symptoms of a heart attack include:

  • Chest pain or pressure, or a strange feeling in the chest.
  • Sweating.
  • Shortness of breath.
  • Nausea or vomiting.
  • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
  • Lightheadedness or sudden weakness.
  • A fast or irregular heartbeat.

For men and women, the most common symptom is chest pain or pressure. But women are somewhat more likely than men to have other symptoms like shortness of breath, tiredness, nausea, and back or jaw pain.

And people have other ways to describe the pain from a heart attack. It may feel like discomfort, pressure, squeezing, or heaviness in the chest. It may also feel like weight, tightness, or a dull ache. The exact location of the pain is often difficult to point out. The pain may spread down the left shoulder and arm and to other areas.

How is a heart attack treated?

Treatment can start in an ambulance with medicines and oxygen. At the hospital, your doctor will work right away to return blood flow to your heart muscle. You may get medicines to break up clots and help blood flow. You might have angioplasty or bypass surgery to improve blood flow to your heart.

Reducing your risk for heart attack

A heart-healthy lifestyle and medicines can help lower your risk of a heart attack.

  • Try to quit or cut back on using tobacco and other nicotine products.

    This includes smoking and vaping. If you need help quitting, talk to your doctor about stop smoking programs and medicines. These can increase your chances of quitting for good. Try to avoid secondhand smoke too.

  • Eat heart-healthy foods.

    These include vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit alcohol, sodium, and sugar.

  • Be active.

    Try for 30 minutes on most days of the week. Ask your doctor what level of exercise is safe for you.

  • Stay at a weight that's healthy for you.

    Talk to your doctor if you need help with your weight goals.

  • Manage other health problems.

    These include high blood pressure, high cholesterol, and diabetes.

  • If you think you may have a problem with alcohol or drug use, talk to your doctor.
  • Get plenty of sleep.

    Try to get 7 to 9 hours of sleep each night.

  • Take medicines as prescribed.

    If you're at high risk of a heart attack or stroke and you're at low risk of bleeding, your doctor might talk to you about taking an aspirin every day to lower your risk. Don't start taking daily aspirin without talking to your doctor first.

How is a heart attack diagnosed?

To check for a heart attack, your doctor will take a history and do a physical exam. You may have an EKG and a blood test that can show signs of heart damage. Imaging tests or a coronary angiogram may be done to check how well blood is flowing to the heart muscle.

After a Heart Attack: Taking an Aspirin or Antiplatelet

How can you care for yourself after a heart attack?

You will leave the hospital after a heart attack when it is safe for you to do so. You can then take steps to improve your heart health and help prevent another heart attack. These steps include taking medicine, doing cardiac rehabilitation, and making healthy lifestyle changes, such as eating heart-healthy foods.

Resuming sex after a heart attack

Think about resuming sex slowly over time. You can start with ways of being intimate that are easy on your heart, like kissing and caressing. When you and your partner decide to start having sexual intercourse again, it might be helpful to keep in mind the following:

  • Talk honestly to your partner about your concerns and feelings.

    Your partner may have the same worries that you have.

  • Choose a time when you are relaxed and comfortable in a place that will be free from interruptions.
  • Wait 1 to 3 hours after eating a full meal so that digestion can take place.
  • Be aware that anxiety on the part of either partner may interfere with sexual arousal and performance.
  • Stop and rest if you have any angina symptoms.

    Call 911 if your symptoms do not go away with rest or are not getting better within 5 minutes after you take a dose of nitroglycerin.

  • Tell your doctor if you have angina symptoms during sex.

How do doctors assess risk for heart attack and stroke?

Your doctor looks at several things to find your risk for heart attack or stroke. The doctor looks at your cholesterol levels, blood pressure, age, sex, and race. Other things they'll look at include if you have diabetes, if you smoke, or if someone in your family has or had early coronary artery disease.

Heart attack: Fast facts

What causes a heart attack?

A heart attack is caused when not enough blood and oxygen reach part of the heart muscle. This most often happens because blood flow through one or more of the coronary arteries is blocked. This blockage is usually caused by a blood clot that forms when plaque in the artery breaks open.

What are some common complications of a heart attack?

The most common complications of a heart attack are heart rhythm problems (arrhythmias), heart failure, heart valve disease, and pericarditis. The risk of having complications depends on many things. This includes the amount of heart tissue affected by the heart attack, whether you were given medicines to prevent complications, and your general health.

What to do if you think you're having a heart attack

If you think you're having a heart attack, act fast. Quick treatment could save your life.

  1. Call 911 right away.
    • Do not wait to call 911. Getting help fast can save your life.
    • Describe your symptoms, and say that you could be having a heart attack.
  2. Stay on the phone. The emergency operator will give you further instructions.

    The operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Aspirin helps keep blood from clotting, so it may help you survive a heart attack.

  3. Wait for an ambulance. Do not try to drive yourself.

    By taking an ambulance, you may be able to get treatment before you arrive at the hospital.

The best choice is to go to the hospital in an ambulance. The paramedics can begin lifesaving treatments even before you arrive at the hospital. If you cannot reach emergency services, have someone drive you to the hospital right away. Do not drive yourself unless you have absolutely no other choice.

If you witness a person become unconscious, call 911 or other emergency services and start CPR (cardiopulmonary resuscitation). The emergency operator can coach you on how to do CPR.

Reducing risk of another heart attack with medicine: When to call

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

Alan's Story: Coping with change after a heart attack

Alan, 73
Read more about Alan and the lessons he's learned about diet and exercise.
"I've had to work at keeping my weight under control, and that has really helped my cholesterol. When you have heart disease, you learn to eat better for the rest of your life. And if you don't, you're asking for trouble."

Alan is something of a miracle man. At the age of 32, he had a massive heart attack. But more than 40 years, 4 bypass surgeries, 30 angioplasties, and a combined pacemaker/defibrillator later, he's still thriving. He learned how to cope with heart disease the hard way.

Alan had always been healthy and athletic. Except for the occasional cold, he was never sick. So the heart attack came as a shock.

But he was a smoker. And when he had his first bypass surgery a few years later, Alan learned that he was born with very small heart arteries. The combination proved too much for his heart to take.

"At some point in my life, I was going to have a heart attack. Smoking just sped it up," says Alan, 73. "It happened while I was playing basketball with some guys from work. I started getting pains in my chest. The next thing I knew, I was on the floor."

Lessons learned about heart disease

After the heart attack, Alan quit smoking immediately. He didn't have much choice. At that time, treatment for a heart attack was total bed rest for 3 weeks.

"That's how they thought the heart would heal in those days—with complete rest, no excitement. Now we know that if you can get up, get up. You have to move around at least a little."

During those weeks in the hospital and the months of recovery that followed, Alan taught himself a lot about heart disease. He read everything on the topic that he could find.

"I learned how to take care of myself. Those lessons have stayed with me."

One of those lessons is the importance of a healthy diet. But putting what he knows into daily practice is an ongoing challenge. Alan leans on his wife, Cloris, for help.

"I've had to work at keeping my weight under control, and that has really helped my cholesterol," he says. "When you have heart disease, you learn to eat better for the rest of your life. And if you don't, you're asking for trouble."

Alan no longer drinks alcohol or eats red meat. His daily meals include fruit and vegetables. Fish is often on the menu at home. The portions are a little smaller than what he'd like. Since his diagnosis of type 2 diabetes a few years ago, he's also had to limit sweets.

"That's a tough one," he says.

Making these changes hasn't prevented the need for major surgeries and other procedures. But they have helped Alan stay active and enjoy life. "Heart care isn't a one-time fix. Exercise, eating, and medical care all have to work together," he says.

Support groups make a difference

As a lifelong athlete, Alan didn't need much coaching to add more exercise to his daily routine. For more than 30 years, he's been an enthusiastic member of a local walking program for people with heart problems.

"It's so easy for cardiac patients to put weight on," Alan says. "And it's so hard to get it off. You need to walk every day or the weight comes right back."

Alan credits Cloris with giving him the help he needs to stay focused on taking care of his heart. But he also relies on a network of friends and support groups. The two belong to the cardiac support group at their local hospital. Alan is also a member of the Ticker Kickers, a group of people who have pacemakers or implantable cardiac defibrillators.

"I couldn't do any of it without my support groups," he says. "The camaraderie of being together and working out together makes such a big difference. We take care of each other."

When newcomers join, Alan and other longtime members of the group share what they know. "We ask them about what they're going through, what medicines they're taking. And we share information about how to get along. It's great for them and for us."

Getting the care you need

After 4 bypass surgeries and 30 angioplasties, Alan has lots of tips about how to work with doctors. He and Cloris track every aspect of his medical care. They keep a printed sheet in the car and bring a copy to every doctor visit. The sheet contains a list of every procedure performed and when, medicines he has taken, names of doctors, and drug allergies.

If you plan to have bypass surgery, ask for the most experienced surgeon, Alan advises. He also tells people to make the most of their office visits and ask a lot of questions.

"We bring a list of questions to every doctor visit," Cloris says. "You can't always remember everything you want to know."

Coping with change after a heart attack

Life wasn't easy after the heart attack. Unable to return to work, Alan sank into depression. Cloris, up until then a full-time homemaker, found a job to support the family, which included two young children.

"That was the most difficult adjustment for Alan," Cloris says. "All of a sudden I was thrown into the workforce, and we didn't have any choice."

"Psychologically, it was tough," Alan says. "But we got used to it. And we kept going."

Working with a counselor or chaplain can be a huge help for people with heart problems and for their families. What is often overlooked in cardiac care is the impact a major heart event can have on the person's family and loved ones.

"When you have a heart attack, you know you have to change your lifestyle," Cloris says. "There's depression. But with all the new medicines and surgeries and procedures, you have to remember that there is so much to hope for."

Keep a positive attitude

Even though Alan stopped working, he has never stopped learning—or helping others learn—about how to cope with heart disease. What has kept him going all these years? A positive attitude.

"You've got to have a sense of humor. Don't take life so seriously," he says.

Staying positive and finding the humor in any situation is a message Alan shares with everyone he talks with about heart disease. He is well known around the local hospital, where he often visits with people scheduled for heart surgery.

At one such visit, a man asked him about the pain after bypass surgery. How bad would it be? How long would it last? "I told him, 'It only hurts when you breathe.' He just looked at me for a minute. And then we both started laughing, and we couldn't stop," Alan says. "Sometimes it just takes someone who can say, 'been there, done that.' A nurse or doctor can tell you what to expect, but they haven't been there."

Alan's story reflects his experiences as told in an interview. The photograph is not of Alan, to protect his privacy.

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