What Is a Heart Attack?

A heart attack, or myocardial infarction, occurs when blood flow to the heart is suddenly blocked, usually by a blood clot, cutting off oxygen and damaging the heart muscle. It is a medical emergency that requires immediate treatment. Most heart attacks result from coronary artery disease (CAD) caused by the buildup of plaque inside the coronary arteries.

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Causes of a Heart Attack

The primary cause is atherosclerosis, the accumulation of fat, cholesterol, and other substances that form plaque in the arteries. When the plaque ruptures, it can form a blood clot that blocks blood flow. Other causes include:

  • Coronary artery dissection (artery tear)
  • Coronary embolism (traveling clot or material)
  • Coronary artery spasm, often triggered by drug use (e.g., cocaine)

Symptoms of a Heart Attack

Common symptoms:

  • Chest pain or pressure (fullness, squeezing, or discomfort)
  • Pain in the arms, shoulders, jaw, back, or upper abdomen
  • Shortness of breath
  • Sweating
  • Dizziness or fainting
  • Nausea and vomiting
  • Anxiety

Additional symptoms in women:

  • Heartburn
  • Fatigue
  • Light-headedness
  • Clammy skin
  • Abdominal pain

Some heart attacks occur without symptoms (silent heart attacks), especially in people with diabetes. Warning signs may appear days or weeks before the actual event.

Risk Factors

Modifiable risks:

  • Smoking
  • High blood pressure
  • High cholesterol
  • Obesity
  • Diabetes
  • Sedentary lifestyle
  • Stress
  • Excess alcohol use
  • Illegal drug use (e.g., stimulants)

Non-modifiable risks:

  • Age
  • Family history of heart disease
  • Autoimmune diseases (e.g., lupus, rheumatoid arthritis)

Diagnosis of a Heart Attack

Heart attacks are often diagnosed in emergency settings. Tests include:

  • Electrocardiogram (ECG) – to detect abnormal heart rhythms
  • Blood tests – to detect enzymes that indicate heart muscle damage
  • Chest X-ray
  • Echocardiogram – ultrasound to check heart function
  • Coronary angiography (catheterization) – visualizes blockages
  • CT or MRI – evaluates heart structure and damage

Treatment

Immediate emergency care:

  • Call 911
  • CPR if the patient is unresponsive
  • Aspirin – prevents further clotting
  • Thrombolytics – dissolves blood clots
  • Nitroglycerin – relieves chest pain

Medical or surgical procedures:

  • Angioplasty with stent placement – opens blocked artery
  • Coronary artery bypass surgery – reroutes blood flow around blockage

Prevention

Even after a heart attack, future risk can be reduced through:

  • Quitting smoking
  • Healthy diet (low in saturated fat, high in fiber)
  • Regular physical activity
  • Managing stress
  • Blood pressure and cholesterol control
  • Managing diabetes
  • Medications (blood thinners, beta blockers, ACE inhibitors)
  • Cardiac rehabilitation