What is a Heart Attack?

A heart attack occurs when a blood clot restricts or cuts off oxygenated blood to a portion of the heart’s muscle. Unless blood starts flowing again quickly to that area, the heart muscle begins to die. Most heart attacks are caused by a buildup of plaque inside the coronary arteries. Plaque build-up can rupture an artery and allow a blood clot to form. If the blood clot is large enough, it can block blood flow to the heart.

Heart muscle damage can be limited with immediate emergency treatment. Untreated heart damage can cause ongoing health problems. If heart attack symptoms last longer than 30 minutes or after taking prescribed nitroglycerin, call 9-1-1 immediately. Do not drive to the hospital. Wait for emergency help to arrive.

Baptist Health is an accredited American Association Mission Lifeline Receiving Center, meaning patients being treated will benefit from the most advanced, superior care in the diagnosis, management and treatment of heart attacks. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Symptoms

Conditions develop gradually that can lead to a heart attack, and those conditions may show no symptoms. That’s why regular checkups are important. Heart attack signs and symptoms vary and do not always occur as chest-crushing pressure. Symptoms that last more than 30 minutes can signal a heart attack is occurring, including:

• Pain in the chest or upper body. The pain may be deep, aching, gnawing, and/or throbbing, and may last for hours or days in the center or left side of the chest. It may also occur in the jaw, neck, arms or upper part of the stomach. The pain is generally not affected by movement, although certain positions may be more comfortable than others.
• Shortness of breath
• Pain in the left shoulder or between the shoulder blades
• A cold sweat
• Fatigue
• Dizziness or lightheadedness
• Nausea and vomiting
• Are you reluctant to tell someone of these symptoms?
• Are you reluctant to call because you think your mild symptoms do not warrant doing so?
• If you carry with you nitroglycerin, does the nitroglycerin seem to take away the discomfort within 5 minutes?

How Long Do Heart Attack Symptoms Last?

Heart attack symptoms may last anywhere from a few minutes to several hours. Heart attack symptoms do not last for multiple days and ongoing symptoms may be a sign of a chronic heart condition or another condition. If your symptoms persist, contact your doctor immediately.

Minor heart attack symptoms could indicate that you've experienced a minor heart attack.

Causes

Heart attack causes can include:

• Buildup of plaque – fat, cholesterol and other cellular waste – on artery walls
• Coronary artery spasms caused by drugs, including cocaine; stress, extreme cold and smoking
• Diabetes can cause a “silent” heart attack with no symptoms (myocardial infarction)
• High blood pressure
• High cholesterol
• Heart failure
• Heavy drinking
• Lack of exercise
• Obesity
• Stress
• Tobacco/ drug use

Risk Factors

Heart attack risk factors can include:

Age: Men over 50 with a family of heart disease and women after menopause ends are most commonly diagnosed with heart attack.

Gender: More women than men have heart attacks, and they can occur in younger women.

Family history: People with a family history of heart disease are at higher risk for heart attack.

Infection: Some infections, like syphilis or salmonella, that are untreated can lead to heart attack.

Race and ethnicity: African-Americans have a higher risk of heart disease that can cause a heart attack, due in part to severe high blood pressure, diabetes and obesity.

Prevention

While some risk factors like age and heredity cannot be controlled, there are ways you can help to prevent a heart attack:

Avoid use of tobacco and cocaine: Both have significant risk for causing heart attack.

Control diabetes: Take medications as prescribed and follow your physician’s eating and exercise recommendations.

Eat heart-healthy foods: Limit your salt, sugar and saturated fats intake; and add nuts, green leafy vegetables, fish, beans, bran, fruits, grains, olive oil, canola oil, salmon, tuna, herring and mackerel to your diet.

Exercise: Get aerobic exercise for 30 minutes at least five days a week.

Limit alcohol use: Talk with your physician about the amount and types of alcohol you can consume.

Manage your weight: Eat a heart-healthy diet and exercise to lower the risk of another heart attack.

Manage stress: Take a stress management course, learn about biofeedback, mediate, do yoga or aerobic exercise and discuss with family and friends about problems.

Take your medications as prescribed: If you have high blood pressure, high cholesterol, diabetes, anxiety or depression, be certain to take your prescribed medications as directed.

Diagnosis

An early heart attack diagnosis is critical to limit damage to the heart. Advanced technology is used to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures and tests for heart attacks can include:

Blood test: Blood tests check for proteins and enzymes released into the blood after heart muscle dies. Over time, blood tests are repeated to detect changes. 

Chest X-ray: A common imaging test of the lungs, heart and coronary arteries.

Coronary angiography: This procedure often is done with cardiac catheterization. During the procedure, dye that can be seen on an X-ray is injected into the heart chambers or coronary arteries. The dye lets a physician study blood flow through the heart and blood vessels to detect any blockages.

Echocardiogram: This ultrasound exam uses soundwaves to take moving pictures of the heart’s chambers and valves.

Electrocardiogram (EKG): This test measures the electrical activity of the heart and can help determine if parts of the heart are enlarged, overworked or damaged. The heart’s electrical currents are detected by 12 to 15 electrodes that are attached to the arms, legs and chest via sticky tape.

Radionuclide imaging (thallium stress test): This non-invasive procedure can identify if there is severe heart damage. A radioactive isotope is injected into a vein and a special camera or scanner records how it travels through the heart. Any heart damage can be plotted, locating the damaged area of the heart. This procedure can be done with an electrocardiogram, during both rest an exercise.

Prognosis

Prognosis depends upon how quickly a heart attack is treated. If treatment occurs rapidly when symptoms are first experienced, damage to the heart can be prevented or limited. Recovery is enhanced through a positive outlook, as is taking medications as prescribed and making lifestyle changes.

Treatment and Recovery

Heart attack treatment occurs in two stages. Immediate emergency care is needed when symptoms are first experienced. If you experience symptoms or are not sure if you are having a heart problem, call 9-1-1, and let a physician determine if you are having a heart attack. You will receive immediate treatment if a heart attack is suspected. If you are having a heart attack, secondary treatment can include medications and medical procedures or surgery.

Immediate Medicine for Heart Attacks

Medication is given to prevent blood clots, help blood flow through the coronary arteries and calm the heart, and to reduce pain. Oxygen may be given to make sure your heart, lungs, organs and tissues stay healthy.

Secondary Medicine for Heart Attacks

Medication is given to lower blood pressure, treat pain, dissolve blood clots, control and lower cholesterol and help blood flow through the coronary arteries.

Surgery

Certain surgical procedures may also be done to treat a heart attack, including:

• Percutaneous coronary intervention (PCI): This procedure, commonly known as coronary angioplasty, can open a blocked artery, improve blood flow and diminish chest pain. A stent, which is a small mesh tube, can be inserted to keep the artery open.

• Coronary artery bypass grafting (CABG): This surgery improves blood flow to your heart by creating a bypass around your narrowed coronary arteries by grafting arteries or veins taken from other parts of your body.
• Pacemaker implantation: This device can be implanted during minor surgery to help the right and left ventricle contract normally.

Recovery After Surgery

Depending on how your body heals, you will be in the hospital for a day after your percutaneous coronary intervention and recover well within a week.

• After coronary artery bypass grafting, you will spend one to two days in an intensive care unit, and another three to five days in another unit before you can go home. Full recovery may take 6-12 weeks. Your physician will tell you when you may be physically active again, including going back to work or resuming sexual activity.
• After pacemaker implantation, you may spend one night in the hospital before going home. Full recovery may take up to four weeks. Your physician will tell you when you may be physically active again and about what activities to avoid during recuperation.

Follow-up Care After Surgery

Before leaving the hospital, your physician or nurse will discuss a follow-up plan that will probably include check-ups and tests. To reduce the risk of heart attack complications, it is important for you to follow your specific health plan, including:

• Go to cardiac rehabilitation for medical support to monitor your health, learn about heart-healthy foods and exercises to increase your strength and stamina

• Eat a diet low in fat, cholesterol and salt
• Get exercise daily
• Lose weight
• Avoid tobacco and cocaine use
• Limit alcohol use
• Reduce stress
• Get counseling for depression
• Do not take birth control pills because they can cause blood clots
• Take medicines daily as prescribed for high blood pressure, high cholesterol, diabetes, anxiety and depression
• Learn the difference between chest pain (angina) and heart attack symptoms
• Make an emergency card to hand to emergency workers if you experience heart attack symptoms. It should include:
  • Your medications and any you’re allergic to
  • Your physician’s full name and daytime and after-hours phone numbers
  • A relative or friend’s name, and work, home and mobile numbers.

Complications

If heart attack is not diagnosed and treated, damage to the heart can cause debilitating conditions. Problems also can occur after treatment for a heart attack, especially if medical recovery advice is not followed. Complications can include:

Anxiety and depression: After a heart attack, worrying about health and needing to adopt a new lifestyle can lead to depression, which slows recovery from a heart attack.

Heart attack: If a heart attack has occurred, risk increases for having another heart attack.