Heart Attack
Also known as Myocardial infarction, MI
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is heart attack?
A heart attack happens when a coronary artery becomes blocked, usually by a clot forming on fatty plaque, starving part of the heart muscle of oxygen. Muscle begins dying within minutes, so reopening the artery quickly preserves heart function and saves lives. Symptoms are often less dramatic than films suggest, particularly in women, older people and those with diabetes.
Causes
- Rupture of atherosclerotic plaque with clot formation
- Gradual narrowing of coronary arteries
- Coronary artery spasm
- Spontaneous coronary artery dissection, more common in younger women
- Severe anaemia or arrhythmia reducing supply
Symptoms
- Central chest pain, pressure, tightness or heaviness
- Pain spreading to the arm, neck, jaw, back or stomach
- Shortness of breath
- Sweating, often cold and clammy
- Nausea or vomiting
- Light headedness or feeling faint
- Overwhelming anxiety or a sense of doom
- Indigestion like discomfort that does not settle
Risk factors
- Smoking
- High blood pressure
- High cholesterol
- Diabetes
- Family history of early heart disease
- Obesity and physical inactivity
- Age, and male sex at younger ages
- Chronic kidney disease and inflammatory conditions
Diagnosis
- ECG performed within minutes of arrival
- Troponin blood test, usually repeated after a few hours
- Coronary angiography to locate the blockage
- Echocardiogram to assess heart muscle damage
- Chest X-ray and blood tests to exclude other causes
Treatment
- Call emergency services immediately, do not drive yourself
- Aspirin 300mg chewed unless allergic, if advised
- Primary angioplasty with stent to reopen the artery
- Thrombolysis where angioplasty is not quickly available
- Antiplatelet medicines, statin, beta blocker and ACE inhibitor
- Cardiac rehabilitation, which reduces further events
- Coronary artery bypass surgery in selected patients
Self care
- Take secondary prevention medicines every day without gaps
- Attend cardiac rehabilitation, which is as valuable as the medicines
- Stop smoking completely
- Build up activity gradually under guidance
- Adopt a Mediterranean style diet low in salt
- Know your own warning symptoms and act on them early
- Manage stress and treat low mood, which is common afterwards
When to see a doctor
Book an appointment if:
- Chest discomfort on exertion that settles with rest
- Reduced exercise tolerance or new breathlessness
- Palpitations or blackouts
- Side effects from heart medicines rather than stopping them
- Low mood or anxiety after a cardiac event
- To have blood pressure, cholesterol and glucose reviewed
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Stop smoking, the single largest modifiable risk
- Control blood pressure, cholesterol and diabetes
- Stay physically active most days
- Keep to a healthy weight and limit alcohol
- Eat a diet high in vegetables, fibre and unsaturated fats
- Attend cardiovascular risk checks when invited
Outlook
Outcomes have improved dramatically where treatment is fast. Reopening the artery within a couple of hours preserves most heart muscle and many people return to full activity. Delay leads to permanent muscle loss and raises the risk of heart failure and dangerous rhythms. Secondary prevention medicines and cardiac rehabilitation substantially reduce the chance of a further event.
Common questions
Do heart attacks always cause crushing chest pain?
No. Many present with breathlessness, nausea, sweating, jaw or back discomfort, or vague indigestion. Women, older adults and people with diabetes are more likely to have these atypical patterns, which contributes to dangerous delays.
Should I drive to hospital or call an ambulance?
Always call an ambulance. Paramedics can record an ECG, give treatment on the way and restart the heart if it stops. Driving risks collapse at the wheel and wastes time on arrival.
What is the difference between angina and a heart attack?
Angina is chest discomfort from a narrowed artery that comes on with exertion and settles with rest. A heart attack is a complete blockage; the pain occurs at rest, lasts longer and does not ease, and it damages heart muscle.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.