Every 40 seconds a heart attack occurs. Every year, 790,000 Americans suffer a heart attack.[1] One in five of these will be silent. The damage is done, and the individual will not even know that a heart attack occurred.[3]

What is a heart attack?

A heart attack (also known as a myocardial infarction) occurs when the heart muscle is damaged due to lack of blood flow. The longer the blood flow is restricted, the greater the damage to the heart muscle. Once the heart tissue is deprived of oxygen it begins to deteriorate and die. Once it dies, it cannot be restored.[6]

What causes heart attacks?

Coronary Heart Disease

Coronary heart disease (CHD) is the number one cause of heart attacks in most individuals. When the flow of blood suddenly becomes blocked and the heart can’t get enough oxygen, a section of heart muscle begins to quickly die. This occurs when sticky plaque builds up in the coronary arteries, leading to “atherosclerosis”. This eventually causes a blood clot to form that blocks blood flow through a coronary artery. Without treatment, healthy heart tissue may die and be replaced with scarring.[6]

What causes a heart attack?—Other Factors

Coronary Artery Spasm

A less frequent cause of heart attacks, stems, from a severe tightening or spasm of a coronary artery that cuts off blood flow through the artery. This can occur in arteries not affected by atherosclerosis.

While the exact cause for this is not known, spasms may be related to:

• Drugs, such as cocaine
• Stress, emotional pain
• Extreme cold
• Smoking[5]

Symptoms of a Heart Attack

While most people associate heart attack symptoms with sudden, crushing, chest pain, some individuals report feeling no pain in the chest at all. In fact, symptoms do vary from person to person, between men and women, and whether or not other medical conditions exist.

Common Heart Attack Signs

Common heart attack signs can be mild and intermittent, causing only slight discomfort, or more sudden and intense.

Individuals with diabetes often suffer only mild heart attack symptoms, or not symptoms at all.

Chest pain is the most common sign of heart attack for both men and women. This involves pressure, fullness, or pain in the center or left side of the chest. It can also feel like indigestion or heartburn and may be mild or severe.

Angina is a symptom of chest pain that can mimic that of a heart attack and sometimes occurs in individuals with coronary heart disease during periods of activity. Pain usually only lasts a few minutes and subsides with rest, however.

Shortness of breath may occur along with chest pain, or alone, while at rest, or engaged in physical activity

Upset stomach, vomiting and fatigue may also signify a heart attack.

Other common signs and symptoms include:

• Cold sweat
• Unusual fatigue
• Nausea, vomiting
• Intensifying of symptoms
• Dizziness/lightheadedness
• Changes in patterns of symptoms[5]

Prevent Heart Attack Damage—Every Minute Counts

According to the American Heart Association and the American College of Cardiology, there are several steps to take when the first symptoms of a heart attack appear. Every minute counts. As oxygen is deprived from the heart muscle, tissue begins to deteriorate and quickly dies.

Signs may develop slowly, over the course of several hours, days; even weeks before an actual heart attack occurs.

When symptoms appear:

Call 9-1-1 immediately, even if you’re not sure if a heart attack is taking place. A 9-1-1 dispatcher can advise you (or another caller) until Emergency Medical Services (EMS) arrives. Transport by ambulance is the fastest way to the hospital, and the quickest way to be seen by hospital emergency room personnel. While en route, EMS personnel will continuously monitor your condition, communicate with the hospital, and be prepared to provide life-saving treatment if necessary.

Chew 1 adult-size (325 mg) non-coated aspirin. This may limit the damage to your heart if you are having a heart attack, and could save your life. Aspirin thins the blood. (Make sure to advise paramedics so they do not administer another aspirin).

Early intervention treatments include:

Percutaneous coronary intervention (PCI) also referred to as angioplasty must be administered within 90 minutes of a STEMI heart attack.

If PCI is not available, fibronolytic (“clot-busting”) therapy should be administered within 30 minutes following a heart attack. Transport to a facility that performs PCI should immediately follow.[2]

Heart Attack Treatment

Medical treatment for a heart attack may include a series of medications including blood thinners, anti-clotting medications, pain relievers, medications to help dilate blood vessels, heart muscle relaxants, and blood pressure reducers.

Medications prescribed include:

Aspirin—This reduces blood clotting and helps maintain blood flow through arteries.

Thrombolytics—These medications help dissolve blood clots and lessen damage to the heart if administered early.

Antiplatelet agents—These minimize the emergence of new blood clots and keep existing clots from growing larger.

Other blood-thinning medications—These medications reduce the ability of the blood to be “sticky” and form clots.

Pain relievers—Pain relief may be offered to ease discomfort.

Nitroglycerin—This medication treats chest pain for those patients who suffer from angina. It helps by improving blood flow to the heart by widening blood vessels

Beta blockers—These medications help relax the heart muscle, slow the heartbeat and decrease blood pressure.

ACE inhibitors—These reduce stress to the heart and lower blood pressure.

Medical/Surgical Procedures

In addition to pharmacological intervention, physicians may perform a number of medical or surgical procedures to treat a heart attack.

Coronary angioplasty and stenting—A physician passes a long, thin catheter through an artery in the leg or groin to a blocked artery in the heart. This is done immediately following a cardiac catheterization, a procedure to locate blockages. The catheter uses an inflated balloon to open a blocked artery. A metal stent may be placed in the artery to hold it open long-term and restore blood flow to the heart. Slow-release medication may also be included with some stents to keep an artery open.

Coronary artery bypass surgery—Emergency bypass surgery may be necessary at the time a heart attack occurs. This may also be done about three to seven days after the initial attack, giving the tissue some time to recover. Bypass surgery essentially “bypasses” blocked or narrowed arteries by sewing veins or arteries in place beyond the damaged areas, restoring blood flow to the heart.[4]

Every year 114,000 Americans die from heart attacks. Many have heart attack symptoms long before the actual cardiac event occurs, without even realizing it. Knowing what signs to look for, and what to do immediately if a heart attack occurs, could not only save your life, but also prevent permanent heart tissue damage for the future.