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About Heart Attacks
A heart attack, also called a myocardial infarction (MI), occurs when a part of the heart muscle becomes damaged or dies due to a sudden loss of blood flow, known as acute coronary syndrome (ACS). The longer the heart goes without blood, the greater the damage to the heart.
Heart attacks are medical emergencies that require immediate care. Do not hesitate to call 911, even if you are unsure of the severity of your symptoms. Emergency Medical Services can begin treatment immediately and communicate with the nearest hospital.
Types of Heart Attacks
There are two main types of heart attacks:
- STEMI (ST-Elevation Myocardial Infarction): Occurs when a coronary artery is completely blocked, causing a portion of the heart muscle to stop getting blood. STEMIs get their name by changing the look of the heart's rhythm wave on an electrocardiogram (EKG or ECG). The "ST segment" of the wave rises much higher than normal, creating a recognizable pattern.
- NSTEMI (non-ST-elevation myocardial infarction): Occurs when an artery is partially blocked and the heart muscles demand for oxygen is not met due to the blockage. There is a different pattern of the heart's rhythm wave in the ST segment which is more subtle. Most heart attacks in the United States are NSTEMIs.
Symptoms of Heart Attacks
Recognizing the symptoms of a heart attack is crucial, as they can vary, especially between men and women. Common signs and symptoms include:
- Chest discomfort including pressure, tightness, pain, squeezing or aching
- Discomfort or pain in the shoulder, arm, back, neck, jaw, teeth or sometimes the upper belly
- Cold sweat
- Fatigue
- Heartburn or indigestion-like feeling
- Lightheadedness or sudden dizziness
- Nausea or vomiting
- Shortness of breath
While the most common sign of a heart attack is chest discomfort or pain, studies show that some women may not experience chest pain at all. Studies show that women also tend to experience subtler symptoms up to a month before the actual heart attack occurs. Some women may also experience sharp pains in their neck, jaw, arm or back.
If you're experiencing pressure, heaviness or pain in the chest, arm or below the breastbone alone or in combination with sweating, nausea, extreme shortness of breath or irregular heartbeats, you may be having a heart attack. Call 911 immediately.
Causes and Risk Factors
Common causes include:
- Coronary artery disease: This is the most common cause of heart disease and occurs when plaque builds up on artery, causing them to narrow or close.
- Coronary thrombosis: Occurs when a blood clot forms at the site of plaque rupture which blocks blood flow to the heart muscle.
- Coronary artery spasms: These sudden contractions (spasms) of a coronary artery can severely narrow the artery temporarily and often occur at rest.
- Spontaneous coronary artery dissection: Occurs when the internal lining of an artery suddenly tears away from the outside lining and blocks blood flow to the heart.
There are a variety of risk factors associated with heart disease and heart attacks.
Common risk factors you can control include:
- High Blood Pressure: Talk with your doctor about blood pressure and check it often. Take any blood pressure medications as directed.
- Tobacco use: Tobacco use, and smoking can damage the lining of your blood vessels, leading to potential plaque buildup and artery narrowing
- High cholesterol: Monitoring cholesterol levels and taking prescribed medications can help prevent plaque buildup.
- Physical inactivity: A lack of movement or exercise can lead to fat and plaque buildup in your arteries.
- Diabetes: High blood sugar can damage your blood vessels and weaken your heart.
- Obesity: Excess weight forces the heart to work harder and raises the risk of coronary artery disease.
Some risk factors cannot be changed, and knowing them can help you understand your risk of a heart attack:
- Age: Women are at a higher risk of dying from a heart attack shortly after it occurs, particularly as they age.
- Gender: Men are at greater risk and tend to experience heart attacks at younger ages.
- Race: African Americans and Mexican Americans are at higher risk for heart disease and blood pressure compared to Caucasians.
- Heredity: A family history of heart disease at an early age increases the risk of developing heart disease and having a heart attack.
Diagnosing a Heart Attack
During a heart attack, doctors and emergency room staff may use several tests to confirm the diagnosis:
- A blood test is a reliable and quick way to diagnose a heart attack. This test checks for a protein called troponin, which rises in the blood during a heart attack.
- Electrocardiogram (EKG or ECG) is a test that shows your heart's rhythm in a wave-like form and can help health care personnel determine if a heart attack is occurring and which type.
- Echocardiogram (or echo) is an ultrasound that shows the function of heart muscle so we can identify where the blood flow is being restricted during a heart attack.
- Cardiac catheterization and coronary angiogram are part of a minimally invasive procedure that uses x-rays and dye (contrast) to look for blockages that may be causing a heart attack so that doctors can open blocked blood vessels.
- Heart computed tomography (CT scan) uses ionizing radiation to take detailed scans of the heart and blood vessels including any plaque or blockages causing a heart attack.
- Heart MRI (magnetic resonance imaging) is a non-radiation option to collect detailed images of the heart and blood flow.
Treatment Options
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Medications
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Percutaneous Coronary Intervention
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Open Heart Surgery
- Aspirin: This common medicine reduces the blood's ability to clot.
- Thrombolytics: These medications help break up blood clots that may be blocking an artery. These are sometimes referred to as "clot busting" drugs.
- Heparin: This is a medication given by intravenous injection (IV) that reduces the stickiness of blood.
- Nitroglycerin: This medication helps to widen arteries and improve blood flow. It can be given as a pill or an injection.
- Beta blockers: These medications slow down the heart rate and lower blood pressure.
- Morphine: This medication is typically used to treat chest pain that may occur with a heart attack.
PCI is a procedure used to open a blocked artery and restore blood flow to the heart. During the procedure, a doctor uses a small tube (catheter) and X-rays to find the blockage. Once found, this doctor inflates a balloon and/or inserts a stent (a small, thin metal mesh tube) to keep open the blocked artery causing the heart attack. For people with STEMI heart attacks, the goal is to open the blocked artery within 90 minutes (about 1.5 hours) of arriving at the hospital. The following BayCare hospitals perform both emergency and scheduled PCIs:
Coronary artery bypass grafting (CABG) is an open-heart surgery that can be done in an emergency or a few days after a heart attack. During this surgery, a healthy blood vessel from another part of the body is used to "bypass" blocked, narrowed, or damaged vessels to restore blood flow to the heart. BayCare has three top-rated open-heart surgery programs:
After a Heart Attack
If you do not already have a cardiologist, it is crucial to find one and begin having regular check-ups after a heart attack. Your cardiologist will monitor your heart for risks like developing arrhythmia, heart failure, heart valve issues, stroke and more. They will also guide you on lifestyle adjustments like a healthier diet, physical activity, and may prescribe long-term medications related to the underlying cause of your heart attack to decrease the risk of another heart attack. These include cholesterol lowering medications and plaque stabilizing medications.
You may also be prescribed cardiac rehabilitation. This program involves a multidisciplinary team of experts that provide supervised physical exercise and heart-health education (including nutrition) to improve cardiovascular health in those who have had a heart attack or another cardiac event. Cardiac rehabilitation is offered at the following BayCare locations:
- Mease Countryside Hospital
- Morton Plant Hospital
- Morton Plant North Bay Hospital
- South Florida Baptist Hospital
- St. Anthony's Hospital
- St. Joseph's Hospital
- Winter Haven Hospital
Additional Resources
Frequently Asked Questions
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Are heart attacks common?
Heart attacks are common in the United States (U.S.), affecting more than 800,000 people each year. According to the Centers for Disease Control, someone in the U.S. has a heart attack every 40 seconds, and 1 in 5 heart attacks are silent with no symptoms. Silent cases are often diagnosed weeks or even months later through physical exams or routine ECG performed by your primary care doctor or cardiologist. This is why it is important to know the causes and address the controllable risk factors for heart attacks. -
What does a heart attack feel like?What a heart attack feels like can vary for different people, but most describe feeling several of the symptoms together that do not get better with rest. The most common feelings include chest discomfort (pain, squeezing or fullness), pain in other areas close to the chest like the belly, arm, shoulder or neck, nausea, and shortness of breath. Even if you are not sure you or a loved one is having a heart attack, it is better to get checked out. Call 911 and wait for EMS.
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After a heart attack, is my heart muscle permanently damaged?Depending on the severity of your heart attack, some heart muscles may heal by forming scar tissue after several weeks. While scar tissue may affect how the heart pumps, the rest of the undamaged heart muscle keeps working. However, once a part of heart muscle dies, it does not recover.
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What is the difference between a heart attack and sudden cardiac arrest?A heart attack is a result of blood flow being blocked and is a “circulation” issue affecting blood flow. Sudden cardiac arrest (SCA) is when the heart rhythm changes suddenly and the heart stops pumping blood to the body. A heart attack can lead to SCA, but other conditions can also cause it including heart rhythm disorders, structural defects, and infections.
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How long does a heart attack last?The length of time a heart attack "lasts" or happens depends on several factors, such as the severity of the blockage of blood flow and its underlying cause. It is an instantaneous event. Heart attacks can last several minutes to a few hours or more. Some people experience symptoms that come and go for minutes at a time. It is crucial to recognize the signs of heart attack early and seek immediate medical treatment to prevent permanent damage or death.
Find a Location
BayCare hospitals’ emergency departments have expert teams specializing in treating heart attacks.