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A heart attack occurs when blood flow to a part of your heart is blocked for a long enough time that part of the heart muscle is damaged or dies. The medical term for this is myocardial infarction.
Myocardial infarction; MI; Acute MI; ST-elevation myocardial infarction; Non-ST-elevation myocardial infarction
Most heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. If the blood flow is blocked, the heart is starved of oxygen and heart cells die.
A hard substance called plaque can build up in the walls of your coronary arteries. This plaque is made up of cholesterol and other cells.
A heart attack may occur when:
The cause of heart attacks is not always known. Heart attacks may occur:
A heart attack is a medical emergency. If you have symptoms of a heart attack, call 911 or your local emergency number quickly.
Chest pain is the most common symptom of a heart attack. You may feel the pain in only one part of your body, or it may move from your chest to your arms, shoulder, neck, teeth, jaw, belly area, or back.
The pain can be severe or mild. It can feel like:
The pain usually lasts longer than 20 minutes. Rest and a medicine called nitroglycerin may not completely relieve the pain of a heart attack. Symptoms may also go away and come back.
Other symptoms of a heart attack can include:
Some people (the elderly, people with diabetes, and women) may have little or no chest pain. Or, they may have unusual symptoms (shortness of breath, fatigue, and weakness). A "silent heart attack" is a heart attack with no symptoms.
A doctor or nurse will perform a physical exam and listen to your chest using a stethoscope.
Other tests to look at your heart that may be done while you are in the hospital:
In the emergency room:
Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart.
You may be given drugs to break up the clot. It is best if these drugs are given within 3 hours of when you first felt the chest pain. This is called thrombolytic therapy.
Some patients may also have heart bypass surgery to open narrowed or blocked blood vessels that supply blood to the heart. This procedure is also called open heart surgery.
AFTER YOUR HEART ATTACK
After several days, you will be discharged from the hospital.
You will likely need to take medicines, possibly for the rest of your life. Always talk to your health care provider before stopping or changing how you take any medicines.
While under the care of your health care team, you will learn:
After a heart attack, you may feel sad. You may feel anxious and worry about being careful about everything you do. All of these feelings are normal. They go away for most people after 2 or 3 weeks. You may also feel tired when you leave the hospital to go home.
Most people who have had a heart attack take part in a cardiac rehab program.
After a heart attack, your chance of having another one is higher than if you never had a heart attack.
How well you do after a heart attack depends on the damage to your heart muscle and heart valves, and where that damage is located.
If your heart can no longer pump blood out to your body as well as it used to, you may develop heart failure. Abnormal heart rhythms can occur, and they can be life threatening.
Usually a person who has had a heart attack can slowly go back to normal activities, including sexual activity. Discuss your activity level with your health care provider.
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Cannon CP, Braunwald E. Unstable angina and non-ST elevation myocardial infarction. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsever; 2011:chap 56.
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Wright RS, Anderson JL, Adams CD, et al. 2011 ACCF/AHA Focused Update of the Guidelines for the Management of Patients with Unstable Angina/Non-ST-Elevation Myocardial Infarction (Updating the 2007 Guideline). A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the American College of Emergency Physicians, Society for Cardiovascular Angiograpy and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2011;57:1920-1959.