Conditions: Heart Attack
Alternative names:
Myocardial Infarction
What is a heart attack?
What are the signs of a heart attack?
What causes a heart attack?
How does my doctor tell if I have a heart attack?
How is a heart attack treated?
What is a heart attack?
A heart attack (myocardial infarction) happens when fatty buildup or a blood clot blocks the flow of blood and oxygen to the heart muscle. This permanent damage to the heart can kill or disable a person. About one-quarter of heart attacks are fatal.
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What are the signs of a heart attack?
The chest pain of a heart attack usually lasts longer than 20 minutes and isn't made better by rest or angina medications. Heart attack pain can range from mild to extremely intense. One patient may think it's only bad indigestion, while another may feel as if an elephant is sitting on his or her chest.
Other symptoms may include:
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Shortness of breath |
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Lightheadedness or dizziness |
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Fainting (syncope) |
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Sweating |
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Feeling sick to your stomach |
Heart attack symptoms in women may be different from those in men.
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What causes a heart attack?
Most heart attacks are caused by a blood clot that blocks an artery bringing blood and oxygen to the heart. As you age, these arteries can become clogged from a buildup of fats, cholesterol, and other substances, reducing their ability to carry blood. The buildup inside the artery may eventually trigger the formation of a clot, which completely blocks blood flow in the artery. Without blood and oxygen, the heart cells in the muscle begin to die.
Occasionally, a severe artery spasm can narrow the artery and cause a heart attack, as can sudden, overwhelming stress.
A number of factors contribute to heart attacks:
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Smoking |
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High blood pressure (hypertension) |
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A diet high in saturated fat |
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High cholesterol levels |
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Diabetes |
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Being overweight |
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Aging |
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A family history of heart attacks |
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How does my doctor tell if I had a heart attack?
It's important to get immediate medical attention if you think you are having, or had, a heart attack. Emergency room staff will usually do these tests:
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An electrocardiogram (ECG or EKG) to monitor your heart and see which of your coronary arteries is blocked |
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A blood test to find if enzymes have leaked from your heart muscle into your bloodstream. This shows the extent of your heart damage. |
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A chest X-ray to see if your heart is enlarged or if your lungs have filled with fluid |
Doctors may order more tests once your condition has stabilized:
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An echocardiogram uses sound waves to make a picture of your heart. Your doctor sees this image on a television monitor, and can examine how well your heart works, and see how much the heart has been damaged by your heart attack. The test takes about 45 minutes, and is painless. |
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An angiography, in which the doctor injects dye into the heart arteries and measures the blood flow and blood pressure in the heart chambers |
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How is a heart attack treated?
| Non-surgical |
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Medicines |
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Immediately after a heart attack, you'll be given oxygen, even if your blood oxygen levels are normal. This reduces the load on your heart. You may also be given several medicines to return blood flow to your heart muscle, bring back a regular heartbeat, and give your heart time to recover. |
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"Clot busters," or thrombolytic agents, can break up a clot within minutes and restore blood flow |
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Aspirin and other blood-thinning medicines (anticoagulants) will keep clots from forming or growing in size |
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Painkillers may be used to reduce your discomfort |
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Some patients are given medicines to slow their heart rate, open and relax their blood vessels, and reduce the heart's workload |
| Surgical |
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Angioplasty uses a tiny balloon, laser, or blade to widen the artery to improve blood flow. Usually a stent—a small metal tube—is implanted to prevent an artery from re-narrowing. With the patient awake and under local pain medicine a thin, flexible tube (catheter) is inserted in an artery (usually near the groin). Most patients are home within a day or two, and back to work within a few days. |
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In coronary artery bypass graft surgery, a segment of vein from the leg or a natural artery from the chest wall is used to route blood around a narrowed heart artery. Bypass surgery usually involves a hospitalization of about a week and a month-long recovery period. Most patients do not return to work until two to three months after surgery. |
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