Heart Attack (Myocardial Infarction)

A heart attack (myocardial infarction) typically occurs when plaques formed by the fatty deposits in the arteries rupture. This causes a blood clot to form, which may block blood flow to an area of the heart muscle, weakening the heart's pumping ability and often leaving permanent damage. If the damage is significant, it can lead to a weakened heart muscle.[1] The blockage might be complete or partial. A ‘STEMI’ heart attack (ST-elevation myocardial infarction) refers to a complete blockage of a coronary artery. A partial blockage would be an ‘NSTEMI’ heart attack (non-ST-elevation myocardial infarction).[2]

Symptoms

Don’t wait to get help if you experience any of these signs of a heart attack. Although some heart attacks are sudden and intense, most start slowly, with mild pain or discomfort. Call 9-1-1 immediately if you feel: [3]

• Chest pain or discomfort
• Pain or discomfort in other areas of the upper body (in one or both arms, the back, neck, jaw or stomach)
• Shortness of breath, with or without chest discomfort
• Sweating
• Nausea
• Lightheadedness

Treatment

Once a heart attack is diagnosed or strongly suspected, treatment begins immediately. Doctors start treatments promptly to try to restore blood flow through the blood vessels supplying the heart. Treatments used during and shortly after a heart attack may include: [4]

Medications

• Anticlotting medicines (e.g., Aspirin) to prevent further blood clotting
• Anticoagulants, or blood thinners, to prevent blood clots from forming in the arteries, and keep existing clots from getting larger
• ACE inhibitors to lower blood pressure and reduce strain on the heart
• Beta blockers to decrease the heart’s workload
• Statin medicines to control or lower blood cholesterol
• Thrombolytic (clot-busting) medicines to dissolve any blood clots in the heart's arteries

Surgery

• Coronary artery bypass grafting, a procedure used to provide a new route for blood to flow to the heart muscle

Other treatments

• Oxygen therapy to make it easier to breathe and control the heart’s workload[5]
• Percutaneous coronary intervention (or coronary angioplasty), a non-surgical procedure used to open blocked coronary arteries
• Lifestyle changes including heart-healthy eating, aiming for healthy weight, managing stress, physical activity, and quitting smoking [6]