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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. Your doctor calls this a 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 can occur as a result of plaque buildup.
The cause of heart attacks is not always known. Heart attacks may occur:
See: Coronary artery disease to learn about risk factors
Cardiogenic shock is a state in which the heart has been damaged so much that it cannot supply enough blood to the organs of the body. This condition is a medical emergency.
A heart attack is a medical emergency. If you have symptoms of a heart attack, call 911 or your local emergency number right away.
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 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, 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.
A troponin blood test can show if you have heart tissue damage. This test can confirm that you are having a heart attack.Coronary angiography is often done right away or when you are more stable. You may also have tests such as an electrocardiogram (ECG).
Other tests to look at your heart that may be done while you are in the hospital:
You will most likely first be treated in the emergency room.
Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. Usually a small, metal mesh tube called a stent is placed at the same time.
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
The following drugs are given to most people after they have a heart attack. These drugs can help prevent another heart attack. Ask your doctor or nurse about these drugs:
You may need to take some of these medicines for the rest of your life. Always talk to your health care provider before stopping or changing how you take any medicines. Any changes may be life threatening.
After a heart attack, you may feel sad. You may feel anxious and worry about being careful in 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. While under the care of a doctor and nurses, you will:
LIVING A HEALTHY LIFESTYLE
To prevent another heart attack:
After a heart attack, your chance of having another one is higher.
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 have 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.
Immediately call your local emergency number (such as 911) if you have symptoms of a heart attack.
Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr., et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am coll Cardiol. 2007;50:e1-e157.
Kushner FG, Hand M, Smith SC Jr, King SB 3rd, Anderson JL, Antman EM, et al. 2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients WithST-Elevation Myocardial Infarction (updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention(updating the 2005 Guideline and 2007 Focused Update): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2009 Dec 1;120(22):2271-306. Epub 2009 Nov 18.
Antman EM. ST-segment elevation myocardial infarction: pathology, pathophysiology, and clinical features. 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 54.
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.