What You Should Know About Heart Attacks

By Caroline Pak, Pharm D, Medical Editor-in-Chief  — This post originally appeared on Get Healthy Stay Healthy 

According to the American Heart Association, as of 2016, about every 43 seconds someone in the U.S. experiences a myocardial infarction, otherwise known as a heart attack. Heart attacks occur when blood flow carrying oxygen to the heart becomes very reduced or blocked. When part of the heart muscle does not get the oxygen it needs to survive, it begins to die.

A heart attack is a serious matter as it can lead to death or permanent heart damage. People with symptoms of a heart attack need immediate attention. It’s important to call 9-1-1 right away. Here’s what you should know about heart attacks.

What Causes Heart Attacks?
Most heart attacks are caused as a result of having coronary heart disease. The arteries that supply the heart with blood (also called coronary artery) can become clogged with fat, cholesterol, or other substances—the collection of these materials is called plaque. Plaque can build up over time—this is a condition called atherosclerosis in which often there are no signs or symptoms. When a part of the plaque breaks off, a blood clot can form there. Depending on the size of the blood clot, blood flow in the artery supplying the heart can be partially or completely blocked.

Another cause of heart attack (but less common) is a coronary artery spasm (tightening of the heart artery) which causes the blood flow to the heart to be reduced or cut off. The exact cause of these spasms is not known; however, they may be related to using illicit drugs (such as cocaine), cigarette smoking, and intense emotional stress.

What are the Signs and Symptoms?
You may have seen actors on television portraying heart attacks, dramatically clutching at their heart as a sign of having sudden, intense chest pain. But that’s not the case with all people. Some people will feel mild pain or discomfort at first, and some won’t experience chest pain at all.

Heart attack signs and symptoms may include:

• Chest discomfort, usually occurring in the center of the chest. People may experience an uncomfortable pressure, tightness, squeezing or pain. The feeling can last more than a few minutes and can go away and come back
• Pain and discomfort in the upper body (e.g., arm, back, neck, jaw, stomach)
• Shortness of breath
• Nausea or vomiting
• Lightheadedness
• Cold sweat

Women can have different heart attack symptoms compared to men. In fact, women are more likely than men to experience chest pain without pressure, along with other symptoms such as shortness of breath, weakness, fatigue, indigestion, nausea/vomiting, and palpitations. Pain in the upper back, arm, neck and jaw may occur more often in women than in men as well.

If you, or someone you know, is experiencing symptoms of a possible heart attack, call 9-1-1 immediately.

What are Your Risk Factors?
There are a few things that can contribute to clogged arteries. Increasing age and being male puts a person at a higher risk for a heart disease. Having a family history of heart disease can also increase your risk. Other risk factors also include:

• Smoking
• High cholesterol
• High blood pressure
• Lack of exercise
• Obesity or being overweight
• Diabetes

What Tests Do They Usually Run?
Your healthcare team will diagnose a heart attack after conducting a physical exam and reviewing your signs and symptoms, medical history and test results. Doctors will run tests to determine how much damage there was to the heart and how severe your heart disease is. Some common diagnostic tests include:

• EKG (electrocardiogram), a simple and harmless test that checks the electrical activity of your heart using sticky patches, called electrodes, that are placed on your skin. An EKG can show how fast your heart is beating, whether its rhythm is normal or not, among other things.
• Blood tests, to measure whether there are higher levels than normal of specific proteins that are released into the blood during a heart attack. These blood tests may be done repeatedly to see whether these levels increase or decrease over time.
• Coronary angiography, a special X-ray test to see how blood flows through your heart. This test often is done during a heart attack to help find blockages in the coronary arteries. A thin tube (called a catheter) is passed through an artery (usually in your leg or groin) and a dye is then injected into the catheter to show the flow of blood through the heart and its blood vessels.

Keep in mind that there are many other tests that may be done to also evaluate your heart (e.g., stress tests, CT scan, MRI).

How Is It Treated?
Your treatment will vary depending on the type of heart attack you had (which depends on whether the artery is partially or completely blocked), how much damage the heart suffered, how much time passed since having the heart attack, along with a number of other factors.

There are also many treatments for heart attack, some of which may include the use of clot-busting medications, having an angioplasty (also called PCI [percutaneous coronary intervention]—this is a catheter that is placed inside an artery to restore blood flow to the heart) and heart bypass surgery (to open up blood vessels that have become closed up or narrow).

The heart is one tough muscle and though a part of it may have been injured, the rest of it keeps on working. It usually takes several weeks for the heart to heal after a heart attack, depending on how badly the heart was damaged. It may not pump blood as well as it used to. The damage caused by a heart attack can lead to heart problems such as heart failure, valve problems, and irregular heart rhythm. However, with proper treatment and lifestyle changes, it is possible to limit or prevent further damage. So be sure to see your doctor or cardiologist (doctor who specializes in the heart) regularly.

What You Can Do
Taking steps to help prevent a heart attack is the best thing you can do if you have or are at risk for heart disease. This may involve several key lifestyle changes you can put in place, such as:

• Manage your blood pressure
• Control cholesterol
• Reduce blood sugar
• Get active
• Eat a healthy diet
• Maintain a healthy weight
• Quit smoking
• If you drink alcohol, do it in moderation. If you do not drink alcohol, do not start drinking

If you’ve had a heart attack, taking your medicine as prescribed every day and maintaining healthy lifestyle habits is important. If you are concerned about your risk for a heart attack or for a repeat heart attack, speak with your doctor right away and start a heart healthy plan today.

Caroline Pak is the Medical Editor-in-Chief for Pfizer’s Get Healthy Stay Healthy website.
Reviewed by Lisa Tarasenko, PharmD, MBA, who is a Senior Director on the Medical Affairs team at Pfizer, Inc.

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