HEART ATTACK

There are two very good reasons you should know how to survive a heart attack. First, odds are very high that either you or someone you love will suffer from a heart attack during your lifetime. And second, whether you survive that heart attack may depend on what you and your doctors do about it during the first few hours.

More than a million Americans have heart attacks each year. A heart attack, or myocardial infarction (MI), is permanent damage to the heart muscle. “Myo” means muscle, “cardial” refers to the heart, and “infarction” means death of tissue due to lack of blood supply.

What Happens During a Heart Attack?

The heart muscle requires a constant supply of oxygen-rich blood to nourish it. The coronary arteries provide the heart with this critical blood supply. If you have coronary artery disease, those arteries become narrow and blood cannot flow as well as they should. Fatty matter, calcium, proteins, and inflammatory cells build up within the arteries to form plaques of different sizes. The plaque deposits are hard on the outside and soft and mushy on the inside.

When the plaque is hard, the outer shell cracks (plaque rupture), platelets (disc-shaped particles in the blood that aid clotting) come to the area, and blood clots form around the plaque. If a blood clot totally blocks the artery, the heart muscle becomes “starved” for oxygen. Within a short time, death of heart muscle cells occurs, causing permanent damage. This is a heart attack.

Symptoms of a heart attack include:

Discomfort, pressure, heaviness, or pain in the chest, arm, or below the breastbone


Discomfort radiating to the back, jaw, throat, or arm


Fullness, indigestion, or choking feeling (may feel like heartburn)


Sweating, nausea, vomiting, or dizziness


Extreme weakness, anxiety, or shortness of breath


Rapid or irregular heartbeats

During a heart attack, symptoms last 30 minutes or longer and are not relieved by rest or nitroglycerin under the tongue.

Some people have a heart attack without having any symptoms (a “silent” myocardial infarction). A silent MI can occur in anyone, but it is more common among people with diabetes.

What Do I Do if I Have a Heart Attack?

At the first signs of a heart attack, call for emergency treatment (usually 911). The best time to treat a heart attack is within one to two hours of the first onset of symptoms. Waiting longer increases the damage to your heart and reduces your chance of survival.

Keep in mind that chest discomfort can be described in many ways. It can occur in the chest or in the arms, back, or jaw. If you have symptoms, take notice. These are your heart disease warning signs. Seek medical care immediately.

Call your doctor if you have symptoms such as chest pain that becomes more frequent, increases in intensity, lasts longer, or spreads to other areas; shortness of breath, especially at rest; dizziness, or irregular heartbeats.

What Is the Treatment for a Heart Attack?

Once heart attack is diagnosed, treatment begins immediately — possibly in the ambulance or emergency room. Drugs and surgical procedures are used to treat a heart attack.

Medications must be given as soon as possible (within one to two hours from the start of your heart attack) to decrease the amount of heart damage. The longer the delay in starting these drugs, the more damage can occur and the less benefit they can provide.

Drugs used during a heart attack may include:

Aspirin to prevent blood clotting that may worsen the heart attack. Other antiplatelets, such as Brilinta, Effient, or Plavix, to prevent blood clotting. Thrombolytic therapy (“clot busters”) to dissolve any blood clots in the heart’s arteries.

Healing of the heart muscle begins soon after a heart attack and takes about eight weeks. Just like a skin wound, the heart’s wound heals and a scar will form in the damaged area. But, the new scar tissue does not contract. So, the heart’s pumping ability is lessened after a heart attack. The amount of lost pumping ability depends on the size and location of the scar.

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