BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuHeart attackMyocardial infarction; MI; Acute MI; ST-elevation myocardial infarction; Non-ST-elevation myocardial infarction; NSTEMI; CAD - heart attack; Coronary artery disease - heart attackMost heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. If the blood flow is blocked, the heart is starved of oxygen and heart cells die.The medical term for this is myocardial infarction.Previous imagePlay SlideshowStop SlideshowNext image / Causes A substance called plaque can build up in the walls of your coronary arteries. This plaque is made up of cholesterol and other cells.A heart attack may occur when:A disruption in the plaque occurs. This triggers blood platelets and other substances to form a blood clot at the site that blocks most or all of the oxygen-carrying blood from flowing to a part of the heart muscle. This is the most common cause of heart attack.The cause of heart attack is not always known, but there are well known risk factors.Previous imagePlay SlideshowStop SlideshowNext image / Heart attack may occur:When you are resting or asleep After a sudden increase in physical activity When you are active outside in cold weather After sudden, severe emotional or physical stress, including an illness Many risk factors may lead to the development of plaque buildup and a heart attack.Risk factors may lead to the developmen...Coronary heart disease (CHD) is a narrowing of the blood vessels that supply blood and oxygen to the heart. CHD is also called coronary artery disea...Read Article Now Book Mark Article Related video goes here for no-HTML5 browsersAre You At Risk For a Heart Attack?What causes a heart attack? A. Too much cholesterol that can clog your arteries B. A blood clot that blocks blood flow to the heart C. A spasm in an artery that supplies blood to the heart (coronary artery) D. All of the above Correct Answer The correct answer is all of the above. Heart disease can lead to a heart attack when plaque builds up in the arteries that supply blood to the heart. If a blood clot forms, it can block blood flow to the heart. This causes a heart attack. Less often, a heart attack occurs due to a spasm in an artery that supplies blood to the heart.What are risk factors for heart disease and heart attack that you can control? A. Smoking B. High blood pressure C. High cholesterol D. Not exercising E. Being overweight or having obesity F. Diabetes G. All of the above Correct Answer The correct answer is all of the above. Not smoking is the best thing you can do for your heart. You can also lower your risk by staying at a healthy weight, eating a low-fat diet, and getting regular exercise (talk to your doctor before starting to exercise). Taking your medicine for high blood pressure and diabetes also lowers your risk.What are the risk factors you can't control? A. Age B. Sex C. Family history D. Race E. All of the above Correct Answer The correct answer is all of the above. Men are more at risk for heart attacks than women, but a woman's risk increases after menopause. African-Americans, Mexican-Americans, American Indians, Hawaiians, and some Asian-Americans have a higher risk for heart problems. If your parents have heart disease, you are also at risk.Stress can add to your risk of heart disease. A. True B. False Correct Answer The correct answer is true. Some studies have found a link between stress and heart disease. How you deal with stress can also have an effect. If you overeat, drink alcohol to excess, or smoke in response to stress, your risk goes up.Drinking red wine is a good way to lower my risk for heart disease. A. True B. False Correct Answer The correct answer is false. While some studies show that alcohol may have small heart benefits, it also increases the risk of alcoholism, high blood pressure, obesity, and breast cancer. So if you don't drink, don't start. If you do drink, limit it to no more than one drink a day for women and two drinks a day for men.You can't miss signs of a heart attack. A. True B. False Correct Answer The correct answer is false. Not everyone has the classic sign of a heart attack: sudden, intense chest pain. Chest pain may be mild or feel more like pressure or fullness. Not everyone has the same symptoms, so you should know all the signs of a heart attack.What are the warning signs of a heart attack? A. Chest pain or discomfort such as pressure, squeezing, or fullness B. Discomfort or pain in one or both arms, the jaw, neck, back, or stomach C. Shortness of breath D. Cold sweats, nausea, or feeling light-headed E. All of the above Correct Answer The correct answer is all of the above. While chest pain or discomfort is the most common symptom, symptoms can be less obvious, and you may not know what's going on. The more symptoms you have, the more likely you are having a heart attack.Women have different heart attack symptoms than men. A. True B. False Correct Answer The correct answer is false. Men and women can have all the same warning signs. However, women are more likely to have shortness of breath, back or jaw pain, nausea, or feel light-headed. These symptoms may occur without chest pressure or pain.If you think you are having a heart attack, you should: A. Drive yourself to the nearest hospital B. Wait until the pain goes away, then call your doctor C. Call 911 right away D. Take an aspirin and see if it helps Correct Answer The correct answer is call 911 right away. Minutes count during a heart attack. The sooner you get help, the less damage to your heart. Aspirin can be harmful for some people, so don't take it unless told to do so by emergency or medical personnel.You can prevent a heart attack. A. True B. False Correct Answer The correct answer is true. The American Heart Association recommends the ABCs for heart attack prevention: Avoid tobacco. Become more active. Choose good nutrition. Symptoms A heart attack is a medical emergency. If you have symptoms of a heart attack, call 911 or your local emergency number right away.DO NOT try to drive yourself to the hospital. DO NOT WAIT. You are at greatest risk for sudden death in the early hours of a heart attack.Chest pain is the most common symptom of a heart attack.Chest painChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.ImageRead Article Now Book Mark Article You may feel the pain in only one part of your body OR Pain may move from your chest to your arms, shoulder, neck, teeth, jaw, belly area, or backPrevious imagePlay SlideshowStop SlideshowNext image / The pain can be severe or mild. It can feel like:A tight band around the chest Bad indigestion Bad indigestionIndigestion (dyspepsia) is a mild discomfort in the upper belly or abdomen. It often occurs during or right after eating. It may feel like:Heat, bu...ImageRead Article Now Book Mark Article Something heavy sitting on your chest Squeezing or heavy pressureThe pain most often lasts longer than 20 minutes. Rest and a medicine to relax the blood vessels (called nitroglycerin) may not completely relieve the pain of a heart attack. Symptoms may also go away and come back.Other symptoms of a heart attack can include:Anxiety AnxietyStress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...ImageRead Article Now Book Mark Article Cough CoughCoughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder. Some coughs are d...ImageRead Article Now Book Mark Article Fainting FaintingFainting is a brief loss of consciousness due to a drop in blood flow to the brain. The episode most often lasts less than a couple of minutes and y...Read Article Now Book Mark Article Lightheadedness, dizziness Lightheadedness, dizzinessDizziness is a term that is often used to describe 2 different symptoms: lightheadedness and vertigo. Lightheadedness is a feeling that you might fai...ImageRead Article Now Book Mark Article Nausea and vomiting Nausea and vomitingNausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up forces the contents of the stomach up t...ImageRead Article Now Book Mark Article Palpitations (feeling like your heart is beating too fast or irregularly) Palpitations (feeling like your heart i...Palpitations are feelings or sensations that your heart is pounding or racing. They can be felt in your chest, throat, or neck. You may:Have an unpl...ImageRead Article Now Book Mark Article Shortness of breath Shortness of breathBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Sweating, which may be very heavySweatingSweating is the release of liquid from the body's sweat glands. This liquid contains salt. This process is also called perspiration. Sweating helps...ImageRead Article Now Book Mark Article Some people (including older adults, people with diabetes, and women) may have little or no chest pain. Or, they may have atypical symptoms such as shortness of breath, fatigue, and weakness. A "silent heart attack," which can also occur, is a heart attack with no symptoms. Exams and Tests Your health care provider will perform a physical exam and listen to your chest using a stethoscope.Your provider may hear abnormal sounds in your lungs (called crackles), a heart murmur, or other abnormal sounds. Heart murmurA heart murmur is a blowing, whooshing, or rasping sound heard during a heartbeat. The sound is caused by turbulent (rough) blood flow through the h...ImageRead Article Now Book Mark Article You may have a fast or uneven pulse. Your blood pressure may be normal, high, or low.You will have an electrocardiogram (ECG) to look for heart damage. Often, certain changes on the ECG indicate you are having a heart attack, although a heart attack can also occur without ECG changes.Electrocardiogram (ECG)An electrocardiogram (ECG) is a test that records the electrical activity of the heart.ImageRead Article Now Book Mark Article A blood test can show if you have heart tissue damage. This test can confirm that you are having a heart attack. The test is often repeated over time.Blood testA troponin test measures the levels of troponin T or troponin I proteins in the blood. These proteins are released when the heart muscle has been da...Read Article Now Book Mark Article Coronary angiography may be done right away or later in the course of illness.Coronary angiographyCoronary angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the arteries in your heart....ImageRead Article Now Book Mark Article This test uses a special dye and x-rays to see how blood flows through your heart. It can help your provider decide which treatments you need next.Other tests to look at your heart that may be done while you are in the hospital:Echocardiography with or with stress testing EchocardiographyAn echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...ImageRead Article Now Book Mark Article Exercise stress test Exercise stress testAn exercise stress test is used to measure the effect of exercise on your heart.ImageRead Article Now Book Mark Article Nuclear stress test Nuclear stress testNuclear stress test is an imaging method that uses radioactive material to show how well blood flows into the heart muscle, both at rest and during a...ImageRead Article Now Book Mark Article Heart CT scan or heart MRIHeart CT scanA computed tomography (CT) scan of the heart is an imaging method that uses x-rays to create detailed pictures of the heart and its blood vessels. Th...ImageRead Article Now Book Mark Article Heart MRIHeart magnetic resonance imaging is an imaging method that uses powerful magnets and radio waves to create pictures of the heart. It does not use ra...ImageRead Article Now Book Mark Article Treatment IMMEDIATE TREATMENTYou will be hooked up to a heart monitor, so the health care team can see how regularly your heart is beating. You will receive oxygen. An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV. You may get nitroglycerin and morphine to help reduce chest pain. You may receive aspirin, unless it would not be safe for you. In that case, you will be given another medicine that prevents blood clots. Dangerous abnormal heartbeats (arrhythmias) may be treated with medicine or electric shocks.ArrhythmiasAn arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...ImageRead Article Now Book Mark Article EMERGENCY PROCEDURESAngioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart.AngioplastyAngioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. These blood vessels are called the coronary art...ImageRead Article Now Book Mark Article Angioplasty is often the first choice of treatment. It should be done within 90 minutes after you get to the hospital, and usually no later than 12 hours after a heart attack. A stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is usually placed right after or during angioplasty. It helps prevent the artery from closing up again.You may be given drugs to break up the clot. This is called thrombolytic therapy. It is best if these drugs are given soon after the onset of symptoms, usually no later than 12 hours after it and ideally within 30 minutes of arriving at the hospital.Thrombolytic therapySmall blood vessels called coronary arteries supply oxygen carrying blood to the heart muscle. A heart attack can occur if a blood clot stops the flo...Read Article Now Book Mark Article Some people may also have heart bypass surgery to open narrowed or blocked blood vessels that supply blood to the heart. This procedure is also called coronary artery bypass grafting or open heart surgery.Open heart surgeryHeart surgery is any surgery done on the heart muscle, valves, arteries, or the aorta and other large arteries connected to the heart. The term "ope...Read Article Now Book Mark Article TREATMENT AFTER A HEART ATTACKAfter several days, you will be discharged from the hospital.Discharged from the hospitalA heart attack occurs when blood flow to a part of your heart is blocked long enough that part of the heart muscle is damaged or dies. This article ...ImageRead Article Now Book Mark Article You will likely need to take medicines, some for the rest of your life. Always talk to your provider before stopping or changing how you take any medicines. Stopping certain medicines can be deadly.While under the care of your health care team, you will learn:How to take medicines to treat your heart problem and prevent more heart attacks How to eat a heart-healthy diet Heart-healthy dietA heart-healthy diet is low in saturated fat. Saturated fat can increase your bad cholesterol and clog your arteries. A heart-healthy diet also lim...Read Article Now Book Mark Article How to be active and exercise safely Active and exercise safelyA heart attack occurs when blood flow to a part of your heart is blocked long enough that part of the heart muscle is damaged or dies. Starting a re...ImageRead Article Now Book Mark Article What to do when you have chest pain How to stop smokingStop smokingThere are many ways to quit smoking. There are also resources to help you. Family members, friends, and co-workers may be supportive. But to be su...ImageRead Article Now Book Mark Article Strong emotions are common after a heart attack.You may feel sad You may feel anxious and worry about being careful about everything you doAll of these feelings are normal. They go away for most people after 2 or 3 weeks.You may also feel tired when you leave the hospital to go home.Most people who have had a heart attack take part in a cardiac rehabilitation program. Support Groups Many people benefit from taking part in support groups for people with heart disease.Support groups for people with heart di...The following organizations are good resources for information on heart disease:American Heart Association -- www. heart. orgCenters for Disease Cont...ImageRead Article Now Book Mark Article Outlook (Prognosis) After a heart attack, you have a higher chance of having another heart attack.How well you do after a heart attack depends on several factors such as:The amount of damage to your heart muscle and heart valves Where that damage is located Your medical care after the heart attackIf your heart can no longer pump blood out to your body as well as it used to, you may develop heart failure. Abnormal heart rhythms can occur, and they can be life threatening.Heart failureHeart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...ImageRead Article Now Book Mark Article Most people can slowly go back to normal activities after a heart attack. This includes sexual activity. Talk to your provider about how much activity is good for you.Open ReferencesReferencesArnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140(11):e596-e646. PMID: 30879355 pubmed.ncbi.nlm.nih.gov/30879355/.Bohula EA, Morrow DA. ST-elevation myocardial infarction: management. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 38.Giugliano RP, Braunwald E. Non-ST elevation acute coronary syndromes. In: Libby P, Bonow RO, Mann DL, Tomaselli, GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 39.Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the evaluation and diagnosis of chest pain: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021;144: ):e455. PMID: 34709879 pubmed.ncbi.nlm.nih.gov/34709879/.Scirica BM, Libby P, Morrow DA. ST-elevation myocardial infarction: pathophysiology and clinical evolution. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 37.Tamis-Holland JE, Jneid H, Reynolds HR, et al. Contemporary diagnosis and management of patients with myocardial infarction in the absence of obstructive coronary artery disease: a scientific statement from the American Heart Association. Circulation. 2019;139(18):e891-e908. PMID: 30913893 pubmed.ncbi.nlm.nih.gov/30913893/.AllVideoImagesTogHeart attackAnimation Related video goes here for no-HTML5 browsersHeart attack - Animation You feel a tight band of pain around your chest. The pain moves from your chest to your arms, shoulder, and neck. What could your pain mean? Could it be a heart attack, could it be the big one? Heart attacks are caused by interruption of blood supply to part of the heart. If the blood flow is blocked, your heart is starved of oxygen and heart cells die. A hard substance called plaque can build up in the walls of your coronary arteries. This plaque is made up of cholesterol and other cells. A heart attack can occur as a result of plaque buildup or the rupture of one of these plaques. We're not sure why heart attacks occur when they do. You may have a heart attack when you are resting or asleep, or after a sudden increase in physical activity, when you are outside in cold weather, or after a sudden, severe emotional or physical stress, including an illness. So, how is a heart attack treated? If you go to the hospital for a suspected heart attack, a doctor or nurse will listen to your chest with a stethoscope. You will have a blood test to look for heart damage. A coronary angiography test can show your doctor how well blood is moving through your heart. If blood moves slowly, or not at all through your coronary arteries, you have either a narrowed, or blocked artery. Other tests can look at the valves and chambers of your heart and check for abnormal heart rhythms. If you've had a heart attack, doctors can do an emergency procedure called angioplasty. This surgery or procedure can open narrowed or blocked blood vessels. Usually they'll place a small, metal mesh tube, called a stent, in your artery to help keep it open. You may also receive drugs to break up the clot in your artery. Sometimes, doctors will do heart bypass surgery to get blood flowing to your heart muscle again. After you are treated in the hospital for a heart attack, you may need to take medicines to thin your blood, to protect your heart, or to improve your cholesterol levels. You may need to take these medicines for the rest of your life. Most people who have had a heart attack also need cardiac rehabilitation. This will help you slowly increase your exercise level and learn how to follow a healthy lifestyle. After you have a heart attack, your chance of another is higher. How well you do after a heart attack depends on the damage to your heart and where the damage is, and what steps you take to prevent another one. If your heart can no longer pump blood to your body as well as it used to, you may have heart failure and will need lifelong treatment. Usually a person who has had a heart attack can slowly go back to normal activities, but you will need to take steps to prevent another heart attack.Heart - section through the middle - illustration The interior of the heart is composed of valves, chambers, and associated vessels.Heart - section through the middleillustrationHeart - front view - illustration The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide.Heart - front viewillustrationProgressive build-up of plaque in coronary artery - illustration Plaque may build-up in a coronary artery at the site of a tear in the lining of the vessel.Progressive build-up of plaque in coronary arteryillustrationAcute MI - illustration A heart attack or acute myocardial infarction (MI) occurs when one of the arteries that supplies the heart muscle becomes blocked. Blockage may be caused by spasm of the artery or by atherosclerosis with acute clot formation. The blockage results in damaged tissue and a permanent loss of contraction of this portion of the heart muscle.Acute MIillustrationPost myocardial infarction ECG wave tracings - illustration Various phases can be seen through ECG wave tracings following a heart attack. Hyperacute phase begins immediately after a heart attack. Fully evolved phase starts a few hours to days after a heart attack. Resolution phase appears a few weeks after a heart attack. Stabilized chronic phase is the last phase and typically has permanent pathological changes compared to a normal ECG tracing.Post myocardial infarction ECG wave tracingsillustrationPosterior heart arteries - illustration The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.Posterior heart arteriesillustrationAnterior heart arteries - illustration The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.Anterior heart arteriesillustrationHeart attack symptoms - illustration Symptoms of a possible heart attack include chest pain and pain that radiates down the shoulder and arm. Some people (older adults, people with diabetes, and women) may have little or no chest pain. Or, they may experience unusual symptoms (shortness of breath, fatigue, weakness). Women are more likely than men to have symptoms of nausea, vomiting, back or jaw pain, and shortness of breath with chest pain. Heart attack symptomsillustrationJaw pain and heart attacks - illustration Pain from a heart attack may sometimes radiate to the jaw and teeth. Chest pain is a major symptom of heart attack, but other symptoms such as weakness, shortness of breath, nausea, or vomiting may also occur.Jaw pain and heart attacksillustrationHeart bypass surgery - seriesPresentation Heart attackAnimation Related video goes here for no-HTML5 browsersHeart attack - Animation You feel a tight band of pain around your chest. The pain moves from your chest to your arms, shoulder, and neck. What could your pain mean? Could it be a heart attack, could it be the big one? Heart attacks are caused by interruption of blood supply to part of the heart. If the blood flow is blocked, your heart is starved of oxygen and heart cells die. A hard substance called plaque can build up in the walls of your coronary arteries. This plaque is made up of cholesterol and other cells. A heart attack can occur as a result of plaque buildup or the rupture of one of these plaques. We're not sure why heart attacks occur when they do. You may have a heart attack when you are resting or asleep, or after a sudden increase in physical activity, when you are outside in cold weather, or after a sudden, severe emotional or physical stress, including an illness. So, how is a heart attack treated? If you go to the hospital for a suspected heart attack, a doctor or nurse will listen to your chest with a stethoscope. You will have a blood test to look for heart damage. A coronary angiography test can show your doctor how well blood is moving through your heart. If blood moves slowly, or not at all through your coronary arteries, you have either a narrowed, or blocked artery. Other tests can look at the valves and chambers of your heart and check for abnormal heart rhythms. If you've had a heart attack, doctors can do an emergency procedure called angioplasty. This surgery or procedure can open narrowed or blocked blood vessels. Usually they'll place a small, metal mesh tube, called a stent, in your artery to help keep it open. You may also receive drugs to break up the clot in your artery. Sometimes, doctors will do heart bypass surgery to get blood flowing to your heart muscle again. After you are treated in the hospital for a heart attack, you may need to take medicines to thin your blood, to protect your heart, or to improve your cholesterol levels. You may need to take these medicines for the rest of your life. Most people who have had a heart attack also need cardiac rehabilitation. This will help you slowly increase your exercise level and learn how to follow a healthy lifestyle. After you have a heart attack, your chance of another is higher. How well you do after a heart attack depends on the damage to your heart and where the damage is, and what steps you take to prevent another one. If your heart can no longer pump blood to your body as well as it used to, you may have heart failure and will need lifelong treatment. Usually a person who has had a heart attack can slowly go back to normal activities, but you will need to take steps to prevent another heart attack.Heart - section through the middle - illustration The interior of the heart is composed of valves, chambers, and associated vessels.Heart - section through the middleillustrationHeart - front view - illustration The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide.Heart - front viewillustrationProgressive build-up of plaque in coronary artery - illustration Plaque may build-up in a coronary artery at the site of a tear in the lining of the vessel.Progressive build-up of plaque in coronary arteryillustrationAcute MI - illustration A heart attack or acute myocardial infarction (MI) occurs when one of the arteries that supplies the heart muscle becomes blocked. Blockage may be caused by spasm of the artery or by atherosclerosis with acute clot formation. The blockage results in damaged tissue and a permanent loss of contraction of this portion of the heart muscle.Acute MIillustrationPost myocardial infarction ECG wave tracings - illustration Various phases can be seen through ECG wave tracings following a heart attack. Hyperacute phase begins immediately after a heart attack. Fully evolved phase starts a few hours to days after a heart attack. Resolution phase appears a few weeks after a heart attack. Stabilized chronic phase is the last phase and typically has permanent pathological changes compared to a normal ECG tracing.Post myocardial infarction ECG wave tracingsillustrationPosterior heart arteries - illustration The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.Posterior heart arteriesillustrationAnterior heart arteries - illustration The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.Anterior heart arteriesillustrationHeart attack symptoms - illustration Symptoms of a possible heart attack include chest pain and pain that radiates down the shoulder and arm. Some people (older adults, people with diabetes, and women) may have little or no chest pain. Or, they may experience unusual symptoms (shortness of breath, fatigue, weakness). Women are more likely than men to have symptoms of nausea, vomiting, back or jaw pain, and shortness of breath with chest pain. Heart attack symptomsillustrationJaw pain and heart attacks - illustration Pain from a heart attack may sometimes radiate to the jaw and teeth. Chest pain is a major symptom of heart attack, but other symptoms such as weakness, shortness of breath, nausea, or vomiting may also occur.Jaw pain and heart attacksillustrationHeart bypass surgery - seriesPresentation A Closer Look Heart attack and acute coronary syndrome - InDepth(In-Depth)Talking to your MD Heart attack - what to ask your providerSelf Care Diabetes - preventing heart attack and strokeBeing active after your heart attackCardiac rehabilitationWarning signs and symptoms of heart diseaseAngina - when you have chest painRelated Information Atherosclerosis(Condition)Stress and your health(Symptoms)Risks of tobacco(Special Topic)High blood pressure in adults – hypertension(Condition)Diabetes(Condition)Arrhythmias(Condition)Ventricular tachycardia(Condition)Heart failure(Condition)Cardiogenic shock(Condition)Pericarditis(Condition)Cholesterol - what to ask your doctor (Doctor Questions)Heart failure - what to ask your doctor (Doctor Questions)High blood pressure - what to ask your doctor (Doctor Questions)Heart attack - what to ask your provider(Doctor Questions)Taking warfarin (Coumadin, Jantoven) - what to ask your doctor(Doctor Questions)Taking warfarin (Coumadin)(Self-Care)Cholesterol - drug treatment(Self-Care)Heart attack – discharge(Discharge)Angioplasty and stent - heart - discharge (Discharge)Heart attack and acute coronary syndrome - InDepth(In-Depth)Anxiety disorders - InDepth(In-Depth)Smoking - InDepth(In-Depth) Review Date: 10/5/2022 Reviewed By: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Internal review and update on 07/23/2023 by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
Heart attackMyocardial infarction; MI; Acute MI; ST-elevation myocardial infarction; Non-ST-elevation myocardial infarction; NSTEMI; CAD - heart attack; Coronary artery disease - heart attackMost heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. If the blood flow is blocked, the heart is starved of oxygen and heart cells die.The medical term for this is myocardial infarction.Previous imagePlay SlideshowStop SlideshowNext image / Causes A substance called plaque can build up in the walls of your coronary arteries. This plaque is made up of cholesterol and other cells.A heart attack may occur when:A disruption in the plaque occurs. This triggers blood platelets and other substances to form a blood clot at the site that blocks most or all of the oxygen-carrying blood from flowing to a part of the heart muscle. This is the most common cause of heart attack.The cause of heart attack is not always known, but there are well known risk factors.Previous imagePlay SlideshowStop SlideshowNext image / Heart attack may occur:When you are resting or asleep After a sudden increase in physical activity When you are active outside in cold weather After sudden, severe emotional or physical stress, including an illness Many risk factors may lead to the development of plaque buildup and a heart attack.Risk factors may lead to the developmen...Coronary heart disease (CHD) is a narrowing of the blood vessels that supply blood and oxygen to the heart. CHD is also called coronary artery disea...Read Article Now Book Mark Article Related video goes here for no-HTML5 browsersAre You At Risk For a Heart Attack?What causes a heart attack? A. Too much cholesterol that can clog your arteries B. A blood clot that blocks blood flow to the heart C. A spasm in an artery that supplies blood to the heart (coronary artery) D. All of the above Correct Answer The correct answer is all of the above. Heart disease can lead to a heart attack when plaque builds up in the arteries that supply blood to the heart. If a blood clot forms, it can block blood flow to the heart. This causes a heart attack. Less often, a heart attack occurs due to a spasm in an artery that supplies blood to the heart.What are risk factors for heart disease and heart attack that you can control? A. Smoking B. High blood pressure C. High cholesterol D. Not exercising E. Being overweight or having obesity F. Diabetes G. All of the above Correct Answer The correct answer is all of the above. Not smoking is the best thing you can do for your heart. You can also lower your risk by staying at a healthy weight, eating a low-fat diet, and getting regular exercise (talk to your doctor before starting to exercise). Taking your medicine for high blood pressure and diabetes also lowers your risk.What are the risk factors you can't control? A. Age B. Sex C. Family history D. Race E. All of the above Correct Answer The correct answer is all of the above. Men are more at risk for heart attacks than women, but a woman's risk increases after menopause. African-Americans, Mexican-Americans, American Indians, Hawaiians, and some Asian-Americans have a higher risk for heart problems. If your parents have heart disease, you are also at risk.Stress can add to your risk of heart disease. A. True B. False Correct Answer The correct answer is true. Some studies have found a link between stress and heart disease. How you deal with stress can also have an effect. If you overeat, drink alcohol to excess, or smoke in response to stress, your risk goes up.Drinking red wine is a good way to lower my risk for heart disease. A. True B. False Correct Answer The correct answer is false. While some studies show that alcohol may have small heart benefits, it also increases the risk of alcoholism, high blood pressure, obesity, and breast cancer. So if you don't drink, don't start. If you do drink, limit it to no more than one drink a day for women and two drinks a day for men.You can't miss signs of a heart attack. A. True B. False Correct Answer The correct answer is false. Not everyone has the classic sign of a heart attack: sudden, intense chest pain. Chest pain may be mild or feel more like pressure or fullness. Not everyone has the same symptoms, so you should know all the signs of a heart attack.What are the warning signs of a heart attack? A. Chest pain or discomfort such as pressure, squeezing, or fullness B. Discomfort or pain in one or both arms, the jaw, neck, back, or stomach C. Shortness of breath D. Cold sweats, nausea, or feeling light-headed E. All of the above Correct Answer The correct answer is all of the above. While chest pain or discomfort is the most common symptom, symptoms can be less obvious, and you may not know what's going on. The more symptoms you have, the more likely you are having a heart attack.Women have different heart attack symptoms than men. A. True B. False Correct Answer The correct answer is false. Men and women can have all the same warning signs. However, women are more likely to have shortness of breath, back or jaw pain, nausea, or feel light-headed. These symptoms may occur without chest pressure or pain.If you think you are having a heart attack, you should: A. Drive yourself to the nearest hospital B. Wait until the pain goes away, then call your doctor C. Call 911 right away D. Take an aspirin and see if it helps Correct Answer The correct answer is call 911 right away. Minutes count during a heart attack. The sooner you get help, the less damage to your heart. Aspirin can be harmful for some people, so don't take it unless told to do so by emergency or medical personnel.You can prevent a heart attack. A. True B. False Correct Answer The correct answer is true. The American Heart Association recommends the ABCs for heart attack prevention: Avoid tobacco. Become more active. Choose good nutrition. Symptoms A heart attack is a medical emergency. If you have symptoms of a heart attack, call 911 or your local emergency number right away.DO NOT try to drive yourself to the hospital. DO NOT WAIT. You are at greatest risk for sudden death in the early hours of a heart attack.Chest pain is the most common symptom of a heart attack.Chest painChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.ImageRead Article Now Book Mark Article You may feel the pain in only one part of your body OR Pain may move from your chest to your arms, shoulder, neck, teeth, jaw, belly area, or backPrevious imagePlay SlideshowStop SlideshowNext image / The pain can be severe or mild. It can feel like:A tight band around the chest Bad indigestion Bad indigestionIndigestion (dyspepsia) is a mild discomfort in the upper belly or abdomen. It often occurs during or right after eating. It may feel like:Heat, bu...ImageRead Article Now Book Mark Article Something heavy sitting on your chest Squeezing or heavy pressureThe pain most often lasts longer than 20 minutes. Rest and a medicine to relax the blood vessels (called nitroglycerin) may not completely relieve the pain of a heart attack. Symptoms may also go away and come back.Other symptoms of a heart attack can include:Anxiety AnxietyStress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...ImageRead Article Now Book Mark Article Cough CoughCoughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder. Some coughs are d...ImageRead Article Now Book Mark Article Fainting FaintingFainting is a brief loss of consciousness due to a drop in blood flow to the brain. The episode most often lasts less than a couple of minutes and y...Read Article Now Book Mark Article Lightheadedness, dizziness Lightheadedness, dizzinessDizziness is a term that is often used to describe 2 different symptoms: lightheadedness and vertigo. Lightheadedness is a feeling that you might fai...ImageRead Article Now Book Mark Article Nausea and vomiting Nausea and vomitingNausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up forces the contents of the stomach up t...ImageRead Article Now Book Mark Article Palpitations (feeling like your heart is beating too fast or irregularly) Palpitations (feeling like your heart i...Palpitations are feelings or sensations that your heart is pounding or racing. They can be felt in your chest, throat, or neck. You may:Have an unpl...ImageRead Article Now Book Mark Article Shortness of breath Shortness of breathBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Sweating, which may be very heavySweatingSweating is the release of liquid from the body's sweat glands. This liquid contains salt. This process is also called perspiration. Sweating helps...ImageRead Article Now Book Mark Article Some people (including older adults, people with diabetes, and women) may have little or no chest pain. Or, they may have atypical symptoms such as shortness of breath, fatigue, and weakness. A "silent heart attack," which can also occur, is a heart attack with no symptoms. Exams and Tests Your health care provider will perform a physical exam and listen to your chest using a stethoscope.Your provider may hear abnormal sounds in your lungs (called crackles), a heart murmur, or other abnormal sounds. Heart murmurA heart murmur is a blowing, whooshing, or rasping sound heard during a heartbeat. The sound is caused by turbulent (rough) blood flow through the h...ImageRead Article Now Book Mark Article You may have a fast or uneven pulse. Your blood pressure may be normal, high, or low.You will have an electrocardiogram (ECG) to look for heart damage. Often, certain changes on the ECG indicate you are having a heart attack, although a heart attack can also occur without ECG changes.Electrocardiogram (ECG)An electrocardiogram (ECG) is a test that records the electrical activity of the heart.ImageRead Article Now Book Mark Article A blood test can show if you have heart tissue damage. This test can confirm that you are having a heart attack. The test is often repeated over time.Blood testA troponin test measures the levels of troponin T or troponin I proteins in the blood. These proteins are released when the heart muscle has been da...Read Article Now Book Mark Article Coronary angiography may be done right away or later in the course of illness.Coronary angiographyCoronary angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the arteries in your heart....ImageRead Article Now Book Mark Article This test uses a special dye and x-rays to see how blood flows through your heart. It can help your provider decide which treatments you need next.Other tests to look at your heart that may be done while you are in the hospital:Echocardiography with or with stress testing EchocardiographyAn echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...ImageRead Article Now Book Mark Article Exercise stress test Exercise stress testAn exercise stress test is used to measure the effect of exercise on your heart.ImageRead Article Now Book Mark Article Nuclear stress test Nuclear stress testNuclear stress test is an imaging method that uses radioactive material to show how well blood flows into the heart muscle, both at rest and during a...ImageRead Article Now Book Mark Article Heart CT scan or heart MRIHeart CT scanA computed tomography (CT) scan of the heart is an imaging method that uses x-rays to create detailed pictures of the heart and its blood vessels. Th...ImageRead Article Now Book Mark Article Heart MRIHeart magnetic resonance imaging is an imaging method that uses powerful magnets and radio waves to create pictures of the heart. It does not use ra...ImageRead Article Now Book Mark Article Treatment IMMEDIATE TREATMENTYou will be hooked up to a heart monitor, so the health care team can see how regularly your heart is beating. You will receive oxygen. An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV. You may get nitroglycerin and morphine to help reduce chest pain. You may receive aspirin, unless it would not be safe for you. In that case, you will be given another medicine that prevents blood clots. Dangerous abnormal heartbeats (arrhythmias) may be treated with medicine or electric shocks.ArrhythmiasAn arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...ImageRead Article Now Book Mark Article EMERGENCY PROCEDURESAngioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart.AngioplastyAngioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. These blood vessels are called the coronary art...ImageRead Article Now Book Mark Article Angioplasty is often the first choice of treatment. It should be done within 90 minutes after you get to the hospital, and usually no later than 12 hours after a heart attack. A stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is usually placed right after or during angioplasty. It helps prevent the artery from closing up again.You may be given drugs to break up the clot. This is called thrombolytic therapy. It is best if these drugs are given soon after the onset of symptoms, usually no later than 12 hours after it and ideally within 30 minutes of arriving at the hospital.Thrombolytic therapySmall blood vessels called coronary arteries supply oxygen carrying blood to the heart muscle. A heart attack can occur if a blood clot stops the flo...Read Article Now Book Mark Article Some people may also have heart bypass surgery to open narrowed or blocked blood vessels that supply blood to the heart. This procedure is also called coronary artery bypass grafting or open heart surgery.Open heart surgeryHeart surgery is any surgery done on the heart muscle, valves, arteries, or the aorta and other large arteries connected to the heart. The term "ope...Read Article Now Book Mark Article TREATMENT AFTER A HEART ATTACKAfter several days, you will be discharged from the hospital.Discharged from the hospitalA heart attack occurs when blood flow to a part of your heart is blocked long enough that part of the heart muscle is damaged or dies. This article ...ImageRead Article Now Book Mark Article You will likely need to take medicines, some for the rest of your life. Always talk to your provider before stopping or changing how you take any medicines. Stopping certain medicines can be deadly.While under the care of your health care team, you will learn:How to take medicines to treat your heart problem and prevent more heart attacks How to eat a heart-healthy diet Heart-healthy dietA heart-healthy diet is low in saturated fat. Saturated fat can increase your bad cholesterol and clog your arteries. A heart-healthy diet also lim...Read Article Now Book Mark Article How to be active and exercise safely Active and exercise safelyA heart attack occurs when blood flow to a part of your heart is blocked long enough that part of the heart muscle is damaged or dies. Starting a re...ImageRead Article Now Book Mark Article What to do when you have chest pain How to stop smokingStop smokingThere are many ways to quit smoking. There are also resources to help you. Family members, friends, and co-workers may be supportive. But to be su...ImageRead Article Now Book Mark Article Strong emotions are common after a heart attack.You may feel sad You may feel anxious and worry about being careful about everything you doAll of these feelings are normal. They go away for most people after 2 or 3 weeks.You may also feel tired when you leave the hospital to go home.Most people who have had a heart attack take part in a cardiac rehabilitation program. Support Groups Many people benefit from taking part in support groups for people with heart disease.Support groups for people with heart di...The following organizations are good resources for information on heart disease:American Heart Association -- www. heart. orgCenters for Disease Cont...ImageRead Article Now Book Mark Article Outlook (Prognosis) After a heart attack, you have a higher chance of having another heart attack.How well you do after a heart attack depends on several factors such as:The amount of damage to your heart muscle and heart valves Where that damage is located Your medical care after the heart attackIf your heart can no longer pump blood out to your body as well as it used to, you may develop heart failure. Abnormal heart rhythms can occur, and they can be life threatening.Heart failureHeart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...ImageRead Article Now Book Mark Article Most people can slowly go back to normal activities after a heart attack. This includes sexual activity. Talk to your provider about how much activity is good for you.Open ReferencesReferencesArnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140(11):e596-e646. PMID: 30879355 pubmed.ncbi.nlm.nih.gov/30879355/.Bohula EA, Morrow DA. ST-elevation myocardial infarction: management. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 38.Giugliano RP, Braunwald E. Non-ST elevation acute coronary syndromes. In: Libby P, Bonow RO, Mann DL, Tomaselli, GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 39.Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the evaluation and diagnosis of chest pain: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021;144: ):e455. PMID: 34709879 pubmed.ncbi.nlm.nih.gov/34709879/.Scirica BM, Libby P, Morrow DA. ST-elevation myocardial infarction: pathophysiology and clinical evolution. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 37.Tamis-Holland JE, Jneid H, Reynolds HR, et al. Contemporary diagnosis and management of patients with myocardial infarction in the absence of obstructive coronary artery disease: a scientific statement from the American Heart Association. Circulation. 2019;139(18):e891-e908. PMID: 30913893 pubmed.ncbi.nlm.nih.gov/30913893/.