Heart Attacks

A heart attack, also known as a myocardial infarction, occurs when an area of heart muscle dies or is permanently damaged due to an inadequate supply of oxygen to that area.

Warning Signs 

Chest discomfort

Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

Discomfort in other areas of the upper body

Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.

Shortness of breath

May occur with or without chest discomfort.

Other signs

These may include breaking out in a cold sweat, nausea, or lightheadedness.

If you or someone you're with has chest discomfort, especially with one or more of the other signs, don't wait longer than a few minutes (no more than 5) before calling for help. Call 911 or your emergency response number. Get to a hospital right away.

Symptoms

Patients experiencing a heart attack may present with one or several of the following symptoms:

  • chest pain or other pain, which radiates from the chest to arms or shoulder; neck, teeth, or jaw; abdomen or back. the pain can be intense and severe or quite subtle and confusing and can feel like:

    • squeezing or heavy pressure

    • a tight band on the chest

    • "an elephant sitting on [your] chest"

    • bad indigestion

    • anxiety

  • fainting
  • feeling of "impending doom"

  • lightheadedness/dizziness

  • nausea or vomiting

  • shortness of breath

  • sweating, which may be profuse

Diagnostic Tools

Many tests are used to diagnose a heart attack. Usually, more than one test is required before a definitive diagnosis can be made. These tests may include: 

  • physical examination and patient history   

  • electrocardiogram (ECG)  

  • blood tests (cardiac biomarkers)

  • echocardiogram 

  • nuclear imaging study (Myocardial perfusion scan)

  • coronary angiography  

  • left ventriculography

Treatment Options

Both medication and cardiac catheterization with direct angioplasty is considered appropriate treatment for heart attack patients. 

Medications used to stop symptoms of a heart attack, may include:

  • aspirin

  • anticoagulants (heparins)

  • thrombolytic therapy

  • ACE inhibitors  

  • beta blockers  

  • nitrates

In some cases or when medications fail, the best treatment is to complete emergency cardiac catheterization and a mechanical treatment such as balloon angioplasty, stenting or open heart surgery to restore blood flow to the damaged heart muscle.

  • Balloon angioplasty or stent placement coronary artery bypass surgery (CABG) (refer to graphic below)

Important Instructions for Drug–Eluting Stent Patients

  • Notify your doctor immediately if you experience chest discomfort, chest pain, or shortness of breath, particularly if the symptoms are new or worsening.

  • Take your medications as prescribed by your doctor.

  • Report any side effects from your medication immediately. Side effects may include bleeding, easy bruising, nausea, vomiting, headache, or rash.

  • Do not stop any of your medications unless instructed to do so by your doctor.


 

Diagrams:
Click images to enlarge

Modern Treatments for Heart Attack

 

 

Stroke vs. Heart Attack

 

 

Influence of collateral supply on infarct size

 

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