Overview
A heart attack happens when blood flow to part of the heart muscle is suddenly blocked, most often by a blood clot. Starved of oxygen, that part of the muscle begins to be damaged.
It is a medical emergency. The sooner blood flow is restored, the more heart muscle can be saved.
Symptoms
Symptoms can start suddenly or come on slowly. They include:
- Pain, pressure or tightness in the centre or left side of the chest
- Pain spreading to the arms, jaw, neck, back or upper tummy
- Shortness of breath
- Cold sweat
- Nausea or vomiting
- Light-headedness or dizziness
- Unusual tiredness
Not everyone has severe chest pain. Women, older people and people with diabetes are more likely to have milder symptoms, such as breathlessness, tiredness or a feeling like indigestion.
When to see a doctor
If someone collapses and is not breathing normally, call for emergency help and start chest compressions (CPR) if you know how.
Chest pain that comes on with exertion and settles with a few minutes of rest () should be checked by a doctor soon. It can be a warning sign of narrowed heart arteries.
Causes
Most heart attacks are caused by coronary artery disease. Fatty deposits called build up over many years in the arteries that supply the heart. If a plaque breaks open, a blood clot forms on it and can block the artery.
Less often, the cause is a sudden tightening (spasm) of a heart artery, or a tear in the artery wall.
Risk factors
- Smoking and other tobacco use
- High
- High
- Diabetes
- Being overweight or obese
- Lack of physical activity
- An unhealthy diet
- Older age
- A family history of early heart disease
Complications
A heart attack can damage the heart muscle and lead to:
- Abnormal heart rhythms (arrhythmias), which can be life-threatening
- Heart failure, where the weakened heart cannot pump blood well enough
- Cardiac arrest, where the heart stops beating
Quick treatment lowers the chance of these problems.
Prevention
- Not smoking or using tobacco
- Eating more vegetables, fruit and whole grains, and less salt, sugar and fried food
- Being physically active on most days
- Keeping to a healthy weight
- Limiting alcohol
- Keeping , and blood sugar under control
High blood pressure, diabetes and high cholesterol often cause no symptoms, so regular health checks help find them early.
Diagnosis
Tests in hospital may include:
- An electrocardiogram (), which records the heart's electrical activity
- Blood tests for , a protein released when heart muscle is damaged
- An ( scan of the heart)
- , where dye shows blockages in the heart arteries on X-ray
Treatment
Treatment aims to restore blood flow as fast as possible and to stop further clots. It may include:
- Medicines that stop blood clots forming or growing, such as aspirin and other blood-thinning medicines
- Clot-dissolving medicines ()
- Coronary , where a small balloon opens the blocked artery and a mesh tube () keeps it open
- Coronary artery bypass surgery, where a blood vessel from elsewhere in the body carries blood around the blockage
Afterwards, most people take long-term medicines, such as medicines, to lower , and medicines. , a supervised programme of exercise, education and support, helps recovery and lowers the risk of another heart attack.
Myths and facts
Things people often say about this. Open each one to see what is true.
Myth“A heart attack always means sudden, crushing chest pain. If the pain is mild, it cannot be the heart.”What is true?
Fact
Symptoms range from mild to severe, and no two people have exactly the same ones. The chest discomfort can feel like heartburn or indigestion, and some people mainly notice breathlessness or unusual tiredness.
Myth“It is only gas or acidity. Take an antacid and wait and see.”What is true?
Fact
A heart attack can feel like indigestion, so waiting to find out is risky. Emergency help should be called even when you are not sure it is the heart, because treatment works best when it starts early. Do not drive yourself to hospital.
Myth“Heart attacks happen to men. Women do not need to worry about the heart.”What is true?
Fact
Women have heart attacks too, and the symptoms are often not the ones people expect. Feeling tired for no reason, breathless or generally unwell, with or without chest discomfort, can be a warning sign in a woman and needs to be checked urgently.
Myth“It is written in my fate, or it runs in my family, so nothing I do will change it.”What is true?
Fact
Most heart disease can be prevented by acting on the things that are within reach: not using tobacco, eating less salt and more fruit and vegetables, staying active, and keeping blood pressure, blood sugar and cholesterol under control. A family history raises the risk, but it does not settle the outcome.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
Is a heart attack the same as a cardiac arrest?
No. In a heart attack, the blood supply to part of the heart is blocked, and the person is usually awake and breathing. In a cardiac arrest, the heart stops pumping and the person collapses. A heart attack can sometimes trigger a cardiac arrest.
How can I tell a heart attack from acidity or gas?
It can be hard to tell, because a heart attack can feel like indigestion. Chest discomfort that comes with sweating, breathlessness, nausea, or pain spreading to the arm or jaw should be treated as a possible heart attack and needs emergency care.
Can I return to normal life after a heart attack?
Most people gradually return to their usual activities. Cardiac rehabilitation, regular medicines and lifestyle changes all help. The treating doctor can advise on when to resume work, exercise and driving.
