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Heart Attack

(Acute Myocardial Infarction [AMI]; Myocardial Infarction [MI]; ST-Segment-Elevation MI [STEMI]; Transmural Myocardial infarction)

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More InDepth Information on this Condition

Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

A heart attack occurs when blood flow to the heart muscle is interrupted. Oxygen cannot get to the heart muscle, causing tissue damage or tissue death.

Heart Attack

Heart Attack
Copyright © Nucleus Medical Media, Inc.

Causes

A heart attack may be caused by:

  • Thickening of the walls of the arteries feeding the heart muscle (coronary arteries)
  • Accumulation of fatty plaques in the coronary arteries
  • Narrowing of the coronary arteries
  • Spasm of the coronary arteries
  • Development of a blood clot in the coronary arteries
  • Embolism that affects the coronary arteries

Risk Factors

These factors increase your chance of developing heart attack. Tell your doctor if you have any of these:

Symptoms

Symptoms include:

  • Squeezing, heavy chest pain behind breastbone, especially with:
    • Exercise or exertion
    • Emotional stress
    • Cold weather
    • A large meal
    • Usually comes on quickly
  • Pain in the left shoulder, left arm, or jaw
  • Shortness of breath
  • Sweating, clammy skin
  • Nausea
  • Weakness
  • Loss of consciousness
  • Anxiety, especially feeling a sense of doom or panic without apparent reason

Unusual symptoms of heart attack (may occur more frequently in women):

  • Stomach pain
  • Back and shoulder pain
  • Confusion
  • Fainting

If you think you are having a heart attack, call for medical help right away.

Diagnosis

Tests may include:

  • Blood tests—To look for certain enzymes found in the blood within hours or days after a heart attack.
  • Urine tests—To look for certain substances found in the urine within hours or days after a heart attack.
  • Electrocardiogram (EKG) —to look for evidence of blockage or damage.
  • Echocardiogram —to examine the size, shape, function, and motion of the heart.
  • Stress test —Records the heart's electrical activity under increased physical stress, usually done days or weeks after the heart attack.
  • Nuclear scanning—show areas of the heart muscle where there is diminished blood flow.
  • Electron-beam computed tomography (EBCT)—to make detailed pictures of the heart, coronary arteries, and surrounding structures.
  • Coronary angiography —Uto look for narrowing or blockage in the coronary arteries.

Treatment

Treatment includes:

  • Aspirin
  • Oxygen
  • Pain-relieving medicine
  • Nitrate medicines
  • Other antiplatelet agents
  • Beta-blockers and/or angiotensin-converting enzyme (ACE) inhibitor medicines
  • Anti-anxiety medicine
  • Cholesterol-lowering medicines (such as statin drugs)

Within the first six hours after a heart attack, you may be given medicines to break up blood clots in the coronary arteries.

If you have severe blockages you may need surgery immediately or after recovery, such as:

During recovery, you may need physical or rehabilitative therapy to help you regain your strength.

You may feel depressed after having a heart attack. Therapy and medicine can help relieve depression.

If you have a heart attack, follow your doctor's instructions .

Prevention

Preventing or treating coronary artery disease may help prevent a heart attack.

RESOURCES:

American Heart Association

http://www.heart.org

Heart and Stroke Foundation

http://www.heartandstroke.com

CANADIAN RESOURCES

College of Family Physicians Canada

http://www.cfpc.ca

Heart and Stroke Foundation

http://www.heartandstroke.com

References:

About heart attacks. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/AboutHeartAttacks/About-Heart-Attacks_UCM_002038_Article.jsp. Accessed August 7, 2012.

ST-elevation myocardial infarction (STEMI). EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated June 7, 2012. Accessed August 7, 2012.

What is a heart attack? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/. Updated march 1, 2011. Accessed August 7, 2011.

7/6/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Antithrombotic Trialists' (ATT) Collaboration, Baigent C, Blackwell L, et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet. 2009;373:1849-1860.

Last reviewed September 2013 by Michael J. Fucci, DO

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.