Heart Attack - At a Glance

Description
What is a heart attack?
A heart attack happens when the blood supply to your heart muscle is blocked and a portion of the heart muscle dies. Learn more.

Causes and Risk Factors
What causes a heart attack?
A heart attack is usually caused by the buildup of plaque in your coronary arteries. The plaque builds up over time to eventually slow or completely block blood flow to the heart muscle. Learn more.

Symptoms
What are symptoms of a heart attack?
Heart attacks may cause sharp pain in the chest, arms, back or jaw, or shortness of breath, nausea, fatigue, and indigestion. Symptoms are different for men and women. Learn more.

Diagnosis
How are heart attacks diagnosed?
A heart attack is diagnosed based on your symptoms, an electrocardiogram (ECG) and the results of your blood studies. Learn more.

Treatment
How are heart attacks treated? 
Heart attack treatment begins with medication immediately to open your coronary arteries. Learn more.

Success Stories
What is it like to have a heart attack?
Patients who have survived a heart attack share their treatment stories. Learn more.

Description
What is a heart attack?
Your heart pumps blood, which carries oxygen to all parts of your body. Your heart, just like every other part of your body, needs oxygen to survive. Special blood vessels on the surface of your heart (coronary arteries) deliver blood and oxygen to your heart muscle. When the blood supply to your heart muscle slows down or is blocked, a portion of the heart muscle to die. This is called a heart attack.

Because a heart attack damages only a small part of your heart muscle, the rest of your heart continues to pump normally. If you have another heart attack, however, more heart tissue may be damaged.

Years ago people often died from heart attacks. If enough muscle is damaged, people can still die from a heart attack. But heart attacks don’t happen in a moment. Rather, they happen over a period of hours, if not longer.

Today with advanced treatments – and immediate medical help – most people having a heart attack survive. Yet after a heart attack, the muscle is no longer as healthy as it once was. So heart attacks can lead to other heart problems such as heart failure or arrhythmias.

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Causes and Risk Factors
What causes a heart attack?
A heart attack is usually caused by the build-up of plaque in your coronary arteries. Plaque is made up of fatty substances, like cholesterol, in your blood. The plaque builds up slowly over time. Eventually plaque can harden and narrow the coronary arteries. Plaque can also slow or completely block blood flow to the heart muscle. When plaque blocks the blood supply to your heart, your heart cannot get the oxygen it needs.

Watch the Video: Heart Attack [00:30]

Atherosclerosis is the general medical term for plaque buildup that clogs arteries. Coronary artery disease (CAD) is the medical term for atherosclerosis in the coronary arteries. So atherosclerosis or CAD—whatever term you use—can cause heart attacks.

For many decades doctors thought that heart attacks—and CAD in general—affected mostly men. Doctors are now realizing that heart disease is just as common in women. As a result, more clinical studies are being done to learn about how heat attacks differ in men and women.

Learn more about women and heart disease:www.bostonscientific.com/closethegap

Risk Factors
The key to preventing a heart attack is managing your risk factors. In particular, the risk factors you can control often make a major difference in how likely you are to have a heart attack. The more risk factors you have, the greater your chances of developing CAD.

Risks Factors that you can change

• Eating high-fat foods
• Lack of exercise
• Smoking
• Stress
• Excess weight

Risk factors you cannot change

• Age—the risk increases as you age
• Gender
• Heredity—the risk increases if there is a family history of heart or blood vessel disease

Other health conditions that can increase your risk

• Diabetes
• High blood pressure

To learn what everyone should know about deart disease, go to Do You Have Heart Disease.

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Symptoms
What are symptoms of a heart attack?
You may know the classic symptom of a heart attack is chest pain (angina) that doesn’t go away when you rest. However, doctors have recently found that this is more likely a common symptom of men than women. Earlier studies of heart attacks focused mostly on men. Now studies are looking at heart attacks in women, too. Your doctor may know that the symptoms for men and women can differ.

The most common symptoms for men and women—just before or during a heart attack—are as follows:

Traditional symptoms (from studies done mostly with men)

• Pain or discomfort in the center of the chest
• Discomfort in the arms, back, neck, jaw or stomach
• Shortness of breath
• A cold sweat
• Nausea or lightheadedness

Women’s symptoms (from newer studies done on women)

• Shortness of breath
• Weakness
• Unusual fatigue
• A cold sweat
• Nausea or dizziness

Men typically have symptoms right before or during a heart attack. But women can have symptoms for weeks before the attack. Here are some of the most common symptoms that women notice for a month or more before a heart attack:

• Unusual fatigue
• Sleep disturbances
• Shortness of breath
• Indigestion
• Anxiety

Some people do not feel symptoms when they have a heart attack. These “silent heart attacks” can do just as much damage to your heart.

Don’t delay getting help
Should any symptoms occur that you believe are related to your heart, get help by calling 9-1-1 right away. Don’t wait to see if the symptoms go away. First responders, emergency medical technicians, and paramedics can begin testing and treatment even before you arrive at the hospital.

Once paramedics arrive, in addition to assessing your condition, they may have you chew an aspirin on the way to the hospital. Quick treatment with special medicals at the hospital can help avoid lasting damage to your heart.

Many people die before they arrive at the hospital because they ignore their symptoms out of fear that something bad is happening.² It is much better to seek care if you are unsure that your symptoms are related to heart disease and find that all is well than to die at home.

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Diagnosis
How is a heart attack diagnosed?
Once the emergency care team sees you at the hospital, they will ask you about your symptoms and begin to evaluate you. A heart attack is diagnosed based on your symptoms, ECG and the results of your blood studies. The goal of treatment is to treat you quickly and limit heart muscle damage.

The healthcare team will ask you many questions about your heart attack to decide the best treatment. Important questions include:

• When did the pain start?
• What were you doing?
• Did you have to stop?
• Did the pain get better with rest?
• Did the pain come back with activity?
• Did the pain stay in your chest or did it move somewhere else, like the jaw, teeth, arm or back?
• Did you get short of breath?
• Did you become nauseous?
• Were you sweating profusely?

The ECG test (also known as an electrocardiogram or EKG) can help to tell what happened to your heart muscle and where it has occurred. In addition, your heart rate and rhythm can be watched. You may also be connected to a bedside monitor with leads (wires) for continuous monitoring of your heart rate and rhythm.

Blood may be drawn to measure levels of biochemicals present. Biochemical markers are found inside your body's cells and are needed for their function. When your heart muscle cells are injured, their contents—including the elements—are released into your bloodstream. By measuring the levels of these elements, the doctor can determine the size of the heart attack and approximately when the heart attack started. Other blood tests may also be performed. Other tests include the following:

• Echocardiogram (Echo)
• Cardiac Catheterization
• Chest X-ray

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Treatment
How are heart attacks treated?
The goal of treatment is to treat you quickly and limit heart muscle damage. Heart attack treatment begins immediately with medication and treatments to open your coronary arteries.

When a heart attack strikes, the key thing to remember is that time equals muscle. The longer the delay in seeking medical care, the more damage can occur to the heart muscle. There is a window of opportunity to restore blood supply to the heart muscle by unblocking the blocked heart artery.

Treatments must be done in a hospital and include administration of clot-busting drugs to dissolve the clot at the site of the ruptured plaque, cardiac catheterization and angioplasty, in which the blood vessel is opened by balloon, often delivering a stent.

Heart attacks can often be prevented. So part of your treatment may include living a healthier lifestyle. If you don’t get enough exercise, for example, your healthcare team might suggest ways you can make exercise a habit.

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Success Stories
What is it like to have a heart attack?
Bob Whitney had his first heart attack when he was 36 years old. The years that followed brought more cardiac events, bypass surgery, and plenty of medication. In 2003, Bob says he was "fortunate enough to be resuscitated" after a cardiac event. What happened next was also very fortunate.

“I was at a Little League meeting, and my heart stopped for about 4 minutes. Fortunately, a doctor and an FBI agent were also at the meeting. The two of them gave me CPR and got my heart started again.”

Bob received in ICD as part of a clinical study called MADIT II. At age 66, between coaching the games and seeing his four grandchildren, he's pretty busy. He also builds dollhouses for charity and does volunteer work. "I'm known here in my home as the Energizer Bunny®," Bob laughs.

Next: Sudden Cardiac Arrest >>