Heart Attack

A heart attack or acute myocardial infarction is the damage and death of heart muscle due to blockage in blood flow. Medically speaking, an infarct is dead tissue caused by loss of blood supply, whereas myocardium means to the heart muscle.

Note that a myocardial infarction is different from other acute heart disease, such as a cardiac arrest caused by the failure of the heart's electrical system.

Heart Attack / Myocardial Infarction Symptoms

The symptoms of a heart attack include:

  • Angina or chest pain
    A classic heart attack symptom is crushing pain or squeezing sensation underneath the breast bone or in the left side of the chest.

    This pain is actually caused by lactic acid and waste product in the heart muscle, which build up when the muscle is deprived of oxygen.

    Pain in the chest may precede a heart attack by a period of weeks, months, or even years before an actual attack. It may even develop after the attack.

  • Chest pain that radiates to the arm, neck, throat, and jaw
  • Shortness of breath
  • Sweating and feeling of coldness or clamminess
  • Nausea and light-headedness
  • Feeling of indigestion and vomiting
  • Fearful feeling or sense of impending doom
  • Loss of consciousness or near-fainting


Your doctor would look for the following tests to diagnose a heart attack:

  • Electrocardiogram or ECG
    A heart attack would show a specific pattern in an ECG test.

  • Blood test
    A heart attack would result in elevated levels of heart muscle enzymes, which are released when the heart muscle is damaged.

Causes of Heart Attack

Causes of a myocardial infarction include:

  • Reduced blood flow due to atherosclerotic plaque in the arteries that supply blood to the heart muscle (in a condition called coronary artery disease or atherosclerosis of the heart)

  • Rupture of a plaque, which then lodges downstream to cause a complete blockage of blood supply in the artery.

Treatment for Heart Attack or Myocardial Infarction

If you suspect that you are having a heart attack:

  • Call for medical help immediately.

  • Take nitroglycerine tablet or aspirin
    If you have nitroglycerine tablet, place it under the tongue immediately and repeat every 3 minutes. You can also chew a regular aspirin to help thin the blood and prevent clotting.

If you suspect someone else is having a heart attack, call for medical help immediately. If that person stops breathing or loses consciousness, administer CPR or cardiopulmonary rescue.

Your doctor would administer the following medical treatments:

  • Morphine to help with the pain
  • Oxygen to help breathe
  • Clot-dissolving drugs, such as t-PA or tissue plasminogen activator
  • Streptokinase derivatives to restore blood flow

After the immediate treatment for heart attack, your doctor may prescribe the following medications to reduce the risk of another attack:

  • Anti-coagulants, such as aspirin, dicumarol, heparin, and warfarin, to help prevent blood clotting
  • Beta blockers to reduce the heart's oxygen consumption
  • Digitalis to improve the heart's pumping power
  • ACE inhibitors or angiotensin converting enzyme inhibitors, such as captopril and enalapril to help prevent heart attack and help it recover

Depending on the severity of the heart attack and the condition of the blocked artery, your doctor may perform the following medical procedures:

  • Balloon dilation or coronary angioplasty
    Here, a catheter or tube is threaded into the heart's blood vessel and a baloon is inflated to dilate the artery at the point of atherosclerotic plaque deposit. A wire stent is sometimes then placed to keep the artery open.

  • Coronary bypass grafting or a heart bypass surgery
    A surgeon grafts another blood vessel from the chest or leg and "bypasses" the blocked artery.

Complications of a Heart Attack

In the first week after a heart attack episode, there is a risk of the following medical complications:

  • Weakness in the heart wall and the possibility of rupture
    Although it is rare and occurs in only 1% of heart attacks, rupture of the heart wall is immediately fatal.

  • More heart attack
    In the first two weeks, the risk of repeat heart attack is about 10%.

  • Pericarditis
    Inflammation of the pericardium or tissue covering the heart occurs in about 20% of the patients.


About 20% of heart attack patients die before even reaching the hospital. Early treatment is crucial in saving a heart attack patient's life - it can reduce the death rate by half.

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