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.
The medical term for this is myocardial infarction.
A 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:
A tear in the plaque occurs. This triggers blood platelets and other substances to form a blood clot at the site that blocks most or all of the oxygen-carrying blood from flowing to a part of the heart muscle. This is the most common cause of heart attack.
A slow buildup of plaque may narrow one of the coronary arteries so that it is almost blocked.
In either case, there is not enough blood flow to the heart muscle and heart muscle dies.
Coronary heart disease (CHD) is a narrowing of the small blood vessels that supply blood and oxygen to the heart. CHD is also called coronary artery...
The correct answer is all of the above. Heart disease can lead to a heart attack when plaque builds up in the arteries that supply blood to the heart. If a blood clot forms, it can block blood flow to the heart. This causes a heart attack. Less often, a heart attack occurs due to a spasm in an artery that supplies blood to the heart.
What are risk factors for heart disease and heart attack that you can control?
The correct answer is all of the above. Not smoking is the best thing you can do for your heart. You can also lower your risk by staying at a healthy weight, eating a low-fat diet, and getting regular exercise (talk to your doctor before starting to exercise). Taking your medicine for high blood pressure and diabetes also lowers your risk.
The correct answer is all of the above. Men are more at risk for heart attacks than women, but a woman's risk increases after menopause. African-Americans, Mexican-Americans, American Indians, Hawaiians, and some Asian-Americans have a higher risk for heart problems. If your parents have heart disease, you are also at risk.
The correct answer is true. Some studies have found a link between stress and heart disease. How you deal with stress can also have an effect. If you overeat, drink alcohol to excess, or smoke in response to stress, your risk goes up.
Drinking red wine is a good way to lower my risk for heart disease.
The correct answer is false. While some studies show that alcohol may have small heart benefits, it also increases the risk of alcoholism, high blood pressure, obesity, and breast cancer. So if you don't drink, don't start. If you do drink, limit it to no more than one drink a day for women and two drinks a day for men.
The correct answer is false. Not everyone has the classic sign of a heart attack: sudden, intense chest pain. Chest pain may be mild or feel more like pressure or fullness. Not everyone has the same symptoms, so you should know all the signs of a heart attack.
What are the warning signs of a heart attack?
A. Chest pain or discomfort such as pressure, squeezing, or fullness
B. Discomfort or pain in one or both arms, the jaw, neck, back, or stomach
The correct answer is all of the above. While chest pain or discomfort is the most common symptom, symptoms can be less obvious, and you may not know what's going on. The more symptoms you have, the more likely you are having a heart attack.
Women have different heart attack symptoms than men.
The correct answer is false. Men and women can have all the same warning signs. However, women are more likely to have shortness of breath, back or jaw pain, nausea, or feel light-headed. These symptoms may occur without chest pressure or pain.
If you think you are having a heart attack, you should:
A. Drive yourself to the nearest hospital
B. Wait until the pain goes away, then call your doctor
The correct answer is call 9-1-1 right away. Minutes count during a heart attack. The sooner you get help, the less damage to your heart. Aspirin can be harmful for some people, so don't take it unless told to do so by emergency or medical personnel.
The correct answer is true. The American Heart Association recommends the ABCs for heart attack prevention: Avoid tobacco. Become more active. Choose good nutrition.
Symptoms
A heart attack is a medical emergency. If you have symptoms of a heart attack, call 911 or your local emergency number right away.
DO NOT try to drive yourself to the hospital.
DO NOT WAIT. You are at greatest risk of sudden death in the early hours of a heart attack.
Chest pain is the most common symptom of a heart attack.
Chest pain
Chest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.
The pain most often lasts longer than 20 minutes. Rest and a medicine to relax the blood vessels (called nitroglycerin) may not completely relieve the pain of a heart attack. Symptoms may also go away and come back.
Stress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...
Coughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder. Some coughs are d...
Fainting is a brief loss of consciousness due to a drop in blood flow to the brain. The episode most often lasts less than a couple of minutes and y...
Dizziness is a term that is often used to describe 2 different symptoms: lightheadedness and vertigo. Lightheadedness is a feeling that you might fai...
Nausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up is forcing the contents of the stomach ...
Some people (the older adults, people with diabetes, and women) may have little or no chest pain. Or, they may have unusual symptoms such as shortness of breath, fatigue, and weakness. A "silent heart attack" is a heart attack with no symptoms.
Exams and Tests
A health care provider will perform a physical exam and listen to your chest using a stethoscope.
The provider may hear abnormal sounds in your lungs (called crackles), a heart murmur, or other abnormal sounds.
Heart murmur
A heart murmur is a blowing, whooshing, or rasping sound heard during a heartbeat. The sound is caused by turbulent (rough) blood flow through the h...
You will have an electrocardiogram (ECG) to look for heart damage. Most of the time, certain changes on the ECG indicate you are having a heart attack. Sometimes these changes are not present, even though other tests indicate you have had a heart attack. This can be called non-ST elevation myocardial infarction (NSTEMI).
Electrocardiogram (ECG)
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
A blood test can show if you have heart tissue damage. This test can confirm that you are having a heart attack. You will likely have this test 3 times over the first 6 to 12 hours.
Blood test
A troponin test measures the levels troponin T or troponin I proteins in the blood. These proteins are released when the heart muscle has been damag...
Coronary angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the arteries in your heart....
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...
A computed tomography (CT) scan of the heart is an imaging method that uses x-rays to create detailed pictures of the heart and its blood vessels. Th...
Heart magnetic resonance imaging is an imaging method that uses powerful magnets and radio waves to create pictures of the heart. It does not use ra...
You will be hooked up to a heart monitor, so the health care team can see how regularly your heart is beating.
You will receive oxygen so that your heart doesn't have to work as hard.
An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV.
You may get nitroglycerin and morphine to help reduce chest pain.
You may receive aspirin, unless it would not be safe for you. In that case, you will be given another medicine that prevents blood clots.
Dangerous abnormal heartbeats (arrhythmias) may be treated with medicine or electric shocks.
Arrhythmias
An arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...
Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart.
Angioplasty
Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. These blood vessels are called the coronary art...
Angioplasty is often the first choice of treatment. It should be done within 90 minutes after you get to the hospital, and usually no later than 12 hours after a heart attack.
A stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is usually placed after or during angioplasty. It helps prevent the artery from closing up again.
You may be given drugs to break up the clot. This is called thrombolytic therapy. It is best if these drugs are given soon after the onset of symptoms, usually no later than 12 hours after it and ideally within 30 minutes of arriving to the hospital.
Thrombolytic therapy
Small blood vessels called coronary arteries supply blood and oxygen to the heart. A heart attack can occur if a blood clot stops the flow of blood t...
Some people may also have heart bypass surgery to open narrowed or blocked blood vessels that supply blood to the heart. This procedure is also called coronary artery bypass grafting and/or open heart surgery.
Open heart surgery
Heart surgery is any surgery done on the heart muscle, valves, arteries, or the aorta and other large arteries connected to the heart. The term "ope...
A heart attack occurs when blood flow to a part of your heart is blocked long enough that part of the heart muscle is damaged or dies. This article ...
You will likely need to take medicines, some for the rest of your life. Always talk to your provider before stopping or changing how you take any medicines. Stopping certain medicines can be deadly.
While under the care of your health care team, you will learn:
How to take medicines to treat your heart problem and prevent more heart attacks
You had a heart attack and were in the hospital. You may have had angioplasty and a stent placed in an artery to open a blocked artery in your heart...
The following organizations are good resources for information on heart disease:American Heart Association -- www. heart. orgCenters for Disease Cont...
After a heart attack, you have a higher chance of having another heart attack.
How well you do after a heart attack depends on several factors such as:
The amount of damage to your heart muscle and heart valves
Where that damage is located
Your medical care after the heart attack
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.
Heart failure
Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...
Most people can slowly go back to normal activities after a heart attack. This includes sexual activity. Talk to your provider about how much activity is good for you.
Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;64(24):e139-e228. PMID: 25260718 www.ncbi.nlm.nih.gov/pubmed/25260718.
Anderson JL. ST segment elevation acute myocardial infarction and complications of myocardial infarction. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 73.
O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;61(4):485-510. PMID: 23256913 www.ncbi.nlm.nih.gov/pubmed/23256913.
Scirica BM, Morrow DA. ST-elevation myocardial infarction. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 51.
The interior of the heart is composed of valves, chambers, and associated vessels.
Heart, section through t...
illustration
Heart, front view - illustration
The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide.
Heart, front view
illustration
Progressive build-up of plaque in coronary artery - illustration
Plaque may build-up in a coronary artery at the site of a tear in the lining of the vessel.
Progressive build-up of ...
illustration
Acute MI - illustration
A heart attack or acute myocardial infarction (MI) occurs when one of the arteries that supplies the heart muscle becomes blocked. Blockage may be caused by spasm of the artery or by atherosclerosis with acute clot formation. The blockage results in damaged tissue and a permanent loss of contraction of this portion of the heart muscle.
Acute MI
illustration
Post myocardial infarction ECG wave tracings - illustration
Various phases can be seen through ECG wave tracings following a heart attack. Hyperacute phase begins immediately after a heart attack. Fully evolved phase starts a few hours to days after a heart attack. Resolution phase appears a few weeks after a heart attack. Stabilized chronic phase is the last phase and typically has permanent pathological changes compared to a normal ECG tracing.
Post myocardial infarcti...
illustration
Posterior heart arteries - illustration
The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.
Posterior heart arteries
illustration
Anterior heart arteries - illustration
The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.
Anterior heart arteries
illustration
Heart attack symptoms - illustration
Symptoms of a possible heart attack include chest pain and pain that radiates down the shoulder and arm.
Some people (older adults, people with diabetes, and women) may have little or no chest pain. Or, they may experience unusual symptoms (shortness of breath, fatigue, weakness). Women are more likely than men to have symptoms of nausea, vomiting, back or jaw pain, and shortness of breath with chest pain.
Heart attack symptoms
illustration
Jaw pain and heart attacks - illustration
Pain from a heart attack may sometimes radiate to the jaw and teeth. Chest pain is a major symptom of heart attack, but other symptoms such as weakness, shortness of breath, nausea, or vomiting may also occur.
Jaw pain and heart attac...
illustration
Heart, section through the middle - illustration
The interior of the heart is composed of valves, chambers, and associated vessels.
Heart, section through t...
illustration
Heart, front view - illustration
The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide.
Heart, front view
illustration
Acute MI - illustration
A heart attack or acute myocardial infarction (MI) occurs when one of the arteries that supplies the heart muscle becomes blocked. Blockage may be caused by spasm of the artery or by atherosclerosis with acute clot formation. The blockage results in damaged tissue and a permanent loss of contraction of this portion of the heart muscle.
Acute MI
illustration
Post myocardial infarction ECG wave tracings - illustration
Various phases can be seen through ECG wave tracings following a heart attack. Hyperacute phase begins immediately after a heart attack. Fully evolved phase starts a few hours to days after a heart attack. Resolution phase appears a few weeks after a heart attack. Stabilized chronic phase is the last phase and typically has permanent pathological changes compared to a normal ECG tracing.
Post myocardial infarcti...
illustration
Progressive build-up of plaque in coronary artery - illustration
Plaque may build-up in a coronary artery at the site of a tear in the lining of the vessel.
Progressive build-up of ...
illustration
Posterior heart arteries - illustration
The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.
Posterior heart arteries
illustration
Anterior heart arteries - illustration
The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.
Anterior heart arteries
illustration
Jaw pain and heart attacks - illustration
Pain from a heart attack may sometimes radiate to the jaw and teeth. Chest pain is a major symptom of heart attack, but other symptoms such as weakness, shortness of breath, nausea, or vomiting may also occur.
Jaw pain and heart attac...
illustration
Heart attack symptoms - illustration
Symptoms of a possible heart attack include chest pain and pain that radiates down the shoulder and arm.
Some people (older adults, people with diabetes, and women) may have little or no chest pain. Or, they may experience unusual symptoms (shortness of breath, fatigue, weakness). Women are more likely than men to have symptoms of nausea, vomiting, back or jaw pain, and shortness of breath with chest pain.
Heart attack symptoms
illustration
Heart attack
Animation
Heart attack - Animation
Heart, section through the middle - illustration
The interior of the heart is composed of valves, chambers, and associated vessels.
Heart, section through t...
illustration
Heart, front view - illustration
The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide.
Heart, front view
illustration
Progressive build-up of plaque in coronary artery - illustration
Plaque may build-up in a coronary artery at the site of a tear in the lining of the vessel.
Progressive build-up of ...
illustration
Acute MI - illustration
A heart attack or acute myocardial infarction (MI) occurs when one of the arteries that supplies the heart muscle becomes blocked. Blockage may be caused by spasm of the artery or by atherosclerosis with acute clot formation. The blockage results in damaged tissue and a permanent loss of contraction of this portion of the heart muscle.
Acute MI
illustration
Post myocardial infarction ECG wave tracings - illustration
Various phases can be seen through ECG wave tracings following a heart attack. Hyperacute phase begins immediately after a heart attack. Fully evolved phase starts a few hours to days after a heart attack. Resolution phase appears a few weeks after a heart attack. Stabilized chronic phase is the last phase and typically has permanent pathological changes compared to a normal ECG tracing.
Post myocardial infarcti...
illustration
Posterior heart arteries - illustration
The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.
Posterior heart arteries
illustration
Anterior heart arteries - illustration
The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.
Anterior heart arteries
illustration
Heart attack symptoms - illustration
Symptoms of a possible heart attack include chest pain and pain that radiates down the shoulder and arm.
Some people (older adults, people with diabetes, and women) may have little or no chest pain. Or, they may experience unusual symptoms (shortness of breath, fatigue, weakness). Women are more likely than men to have symptoms of nausea, vomiting, back or jaw pain, and shortness of breath with chest pain.
Heart attack symptoms
illustration
Jaw pain and heart attacks - illustration
Pain from a heart attack may sometimes radiate to the jaw and teeth. Chest pain is a major symptom of heart attack, but other symptoms such as weakness, shortness of breath, nausea, or vomiting may also occur.
Jaw pain and heart attac...
illustration
Heart, section through the middle - illustration
The interior of the heart is composed of valves, chambers, and associated vessels.
Heart, section through t...
illustration
Heart, front view - illustration
The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide.
Heart, front view
illustration
Acute MI - illustration
A heart attack or acute myocardial infarction (MI) occurs when one of the arteries that supplies the heart muscle becomes blocked. Blockage may be caused by spasm of the artery or by atherosclerosis with acute clot formation. The blockage results in damaged tissue and a permanent loss of contraction of this portion of the heart muscle.
Acute MI
illustration
Post myocardial infarction ECG wave tracings - illustration
Various phases can be seen through ECG wave tracings following a heart attack. Hyperacute phase begins immediately after a heart attack. Fully evolved phase starts a few hours to days after a heart attack. Resolution phase appears a few weeks after a heart attack. Stabilized chronic phase is the last phase and typically has permanent pathological changes compared to a normal ECG tracing.
Post myocardial infarcti...
illustration
Progressive build-up of plaque in coronary artery - illustration
Plaque may build-up in a coronary artery at the site of a tear in the lining of the vessel.
Progressive build-up of ...
illustration
Posterior heart arteries - illustration
The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.
Posterior heart arteries
illustration
Anterior heart arteries - illustration
The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.
Anterior heart arteries
illustration
Jaw pain and heart attacks - illustration
Pain from a heart attack may sometimes radiate to the jaw and teeth. Chest pain is a major symptom of heart attack, but other symptoms such as weakness, shortness of breath, nausea, or vomiting may also occur.
Jaw pain and heart attac...
illustration
Heart attack symptoms - illustration
Symptoms of a possible heart attack include chest pain and pain that radiates down the shoulder and arm.
Some people (older adults, people with diabetes, and women) may have little or no chest pain. Or, they may experience unusual symptoms (shortness of breath, fatigue, weakness). Women are more likely than men to have symptoms of nausea, vomiting, back or jaw pain, and shortness of breath with chest pain.
Reviewed By:
Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Internal review and update on 09/01/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
