Heart attack 

Introduction 

Heart attack

A consultant cardiologist explains what a heart attack is, the symptoms, surgical treatments and why it's important for coronary heart disease patients to reduce their risk factors.

Media last reviewed: 02/10/2013

Next review due: 20/10/2015

Reducing your risk of a heart attack

There are five main steps you can take to reduce your risk of having a heart attack (or having another heart attack):

  • smokers should quit smoking
  • lose weight if you are overweight or obese
  • take regular exercise – adults should do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity each week, unless advised otherwise by the doctor in charge of your care
  • eat a low-fat, high-fibre diet, including whole grains and plenty of fresh fruit and vegetables (at least five portions a day)
  • moderate your alcohol consumption – read more about the alcohol units

Find out how to prevent a heart attack.

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A heart attack is a serious medical emergency in which the supply of blood to the heart is suddenly blocked, usually by a blood clot. Lack of blood to the heart can seriously damage the heart muscle.

A heart attack is known medically as a myocardial infarction or MI.

Symptoms can include:

  • chest pain  the chest can feel like it is being pressed or squeezed by a heavy object, and pain can radiate from the chest to the jaw, neck, arms and back
  • shortness of breath
  • feeling weak and/or lightheaded
  • overwhelming feeling of anxiety

It is important to stress that not everyone experiences severe chest pain; the pain can often be mild and mistaken for indigestion.

It is the combination of symptoms that is important in determining whether a person is having a heart attack, and not the severity of chest pain.

Read more about the symptoms of a heart attack.

Treating heart attacks

A heart attack is a medical emergency. Dial 999 and ask for an ambulance if you think you or someone you know is having a heart attack.

If the casualty is not allergic to aspirin and it’s easily available, give them a tablet (ideally 300mg) to slowly chew and then swallow while waiting for the ambulance to arrive.

The aspirin will help to thin the blood and reduce the risk of a heart attack.

Treatment for a heart attack will depend on how serious it is. Two main treatments are:

  • using medication to dissolve blood clots
  • surgery to help restore blood to the heart

Read more about treating heart attacks.

What causes a heart attack?

Coronary heart disease (CHD) is the leading cause of heart attacks. CHD is a condition in which coronary arteries (the major blood vessels that supply blood to the heart) get clogged up with deposits of cholesterol. These deposits are called plaques.

Before a heart attack, one of the plaques ruptures (bursts), causing a blood clot to develop at the site of the rupture. The clot may then block the supply of blood running through the coronary artery, triggering a heart attack.

Your risk of developing CHD is increased by:

Read more about the causes of heart attacks.

Recovery

The time it takes to recover from a heart attack will depend on the amount of damage to the heart muscle. Some people are well enough to return to work after two weeks. Other people may take several months to recover. The recovery process aims to:

  • reduce your risk of another heart attack through a combination of lifestyle changes, such as eating a healthy diet, and medications, such as statins (which help lower blood cholesterol levels)
  • gradually restore your physical fitness so you can resume normal activities (known as cardiac rehabilitation)

Most people can return to work after having a heart attack, but how quickly will depend on your health, the state of your heart and the type of work you do.

Read more about recovering from a heart attack.

Who is affected

Heart attacks are one of the most common reasons why a person requires emergency medical treatment.

Men are more likely to have a heart attack than women. The British Heart Foundation estimates that around 50,000 men and 32,000 women have a heart attack each year in England.

Most heart attacks occur in people aged over 45.

Complications

Complications of heart attacks can be serious and possibly life-threatening. These include:

  • arrhythmia – this is an abnormal heartbeat, where the heart begins beating faster and faster, then stops beating (cardiac arrest)
  • cardiogenic shock – where the heart's muscles are severely damaged and can no longer contract properly to supply enough blood to maintain many body functions
  • heart rupture – where the heart’s muscles, walls or valves split apart (rupture)

These complications can occur quickly after a heart attack and are a leading cause of death.

Many people will die suddenly from a complication of a heart attack before reaching hospital.

Read more about the complications of a heart attack.

Outlook

The outlook for people who have had a heart attack can be highly variable, depending on:

  • their age – the older you are, the more likely you are to experience serious complications
  • the severity of the heart attack – specifically, how much of the heart's muscle has been damaged during the attack
  • how long it took before a person received treatment – the longer the delay, the worse the outlook tends to be

In general, around one third of people who have a heart attack die as a result. These deaths often occur before a person reaches hospital or, alternatively, within the first 28 days after the heart attack.

If a person survives for 28 days after having a heart attack, their outlook improves dramatically and most people will go on to live for many years.




Page last reviewed: 13/06/2014

Next review due: 13/06/2016

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Comments

The 5 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Ukuk_Hai said on 01 July 2012

TBH I have found that this complete site does not give accurate information. It is very disappointing. There are better sites out there offering accurate, up to date health information and not the outdated, unsatisfactory advice provided here. A massive disappointment. NHS you can and must do better than this.

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doncross said on 20 December 2011

I have learned,that there are many types of heart attack,but it is SO important to get help asap,,my heart attack,5years ago,was not a massive pain,collapse,I had holiday vaccinations in my left arm,went to bed,and was awakened by pain in my left arm,mild pain,like an ache one would get after inoculations,it got a bit more painful,so I took a 300ml aspirin,no better,I phoned the out of hours doctor,who asked me if the pain was going into the jaw, along with questions about my age etc,62,at the time.
He said,much to my objection,that he would send a paramedic,who arrived 5 minutes later,he wired me up,and stated that I was having a heart attack,he treated me on the spot,and I was then rushed into hospital,for further treatment,and went onto a Quad Heart By-Pass,3 months later.I now spend 2hrs a day in the gym,and I am as fit as a pork butchers dog.
But my message is,if you have chest pain,and it does not go after a short time,take an aspirin,and get help. Please.

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helenherbert said on 31 October 2011

Hi. My 78 year old mother had a heart attack 7 days ago and since I have done a lot of reading about heart attacks. PLEASE PLEASE beware of so called "typical symptoms" listed by syrasen as above. My mum had NO pain at all, anywhere. She did sweat and was struggling for breath. She has COPD and asthma and we thought it was an asthma attack. Numerous hospital tests showed it was a heart attack. People need to be aware that many people (especially older women) do not get crushing chest pain or pain in their arm or any pain at all. This is a very misleading belief and actually leads to many people not even calling the emergency services.

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syrasen said on 26 October 2010

The typical symptoms of a heart attack are similar to those of angina, but more severe and longer lasting. The victim feels a pain that is usually squeezing or burning or feels a terrible pressure in the middle of chest. This pain may also travel up to the neck, jaw, or shoulder or down the arm and into the back.Sweating, dizziness, weakness, and shortness of breath often accompany the pain of a heart attack. If you have chest pain that lasts longer than 15 minutes and is not relieved by rest (or by a dose of nitroglycerin), get immediate medical attention.Immediately after you call for medical help, chew and swallow an aspirin and drink a glass of water. (Don't take aspirin if you are allergic to aspirin.) Aspirin is known to thin the blood, which helps the heart get more blood if you are, indeed, having a heart attack.In some cases, a heart attack may cause a sensation that feels like indigestion: you get a sick, aching feeling high in the middle of your abdomen. It can cause a feeling of great weakness, or a sense that you are about to faint. (Many of the people who had heart attacks thought that they had intestinal problem instead of associating it with a heart attack.)
http://www.insideheart.com/heart-attacks-in-women.html

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doctor2010 said on 01 June 2009

Both the consultant and the text of this article mislead the audience using the terms "heart attack" and "coronary thrombosis/clot" synonymously.
Firstly, a complete occlusion of a coronary artery is not required to starve the heart muscle of oxygen. Chronic high-grade stenosis is a major cause of "heart attacks" and sudden death due to coronary artery disease.
Secondly, a clot or thrombus is not necessary to cause a "heart attack" and in a significant number of cases at postmortem the only finding is significant narrowing of a coronary artery.

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