what is happening to the heart during a heart attack

Overview

Blocked artery stopping blood flow to the heart during a heart attack. — How a blocked artery can cause a heart attack.

What is a middle attack?

A myocardial infarction (commonly called a heart assail) is an extremely dangerous condition caused by a lack of blood catamenia to your center muscle. The lack of blood flow can occur because of many different factors but is usually related to a blockage in one or more of your heart's arteries. Without blood flow, the affected heart musculus will begin to dice. If claret flow isn't restored speedily, a heart attack can crusade permanent heart harm and death.

A heart assault is a life-threatening emergency. If you doubtable you lot or someone y'all're with is having a heart assault, do non hesitate to call 911 (or your local emergency services telephone number). Time is disquisitional in treating a heart attack, and a filibuster of even a few minutes tin can result in permanent center damage or death.

How common are heart attacks?

New heart attacks happen to nearly 635,000 people in the U.Southward. each twelvemonth. About 300,000 people a twelvemonth take a second heart attack. Nigh 1 in seven deaths in the U.S. is due to coronary centre disease, which includes heart attacks.

What happens during a heart attack?

When a heart set on happens, blood flow to a part of your heart stops or is far below normal, which causes that part of your eye muscle to dice. When a part of your eye can't pump because it's dying from lack of blood menses, it can disrupt the pumping sequence for the entire eye. That reduces or even stops claret catamenia to the rest of your body, which can exist deadly if it isn't corrected quickly.

Symptoms and Causes

What causes a heart assault?

The vast bulk of centre attacks occur because of a blockage in one of the blood vessels that supply your heart. This nearly often happens because of plaque, a sticky substance that tin build up on the insides of your arteries (similar to how pouring grease down your kitchen sink can clog your home plumbing). That buildup is called atherosclerosis.

Sometimes, plaque deposits inside the coronary (heart) arteries can pause open or rupture, and a blood clot tin can get stuck where the rupture happened. If the jell blocks the avenue, this can deprive the centre muscle of blood and crusade a heart set on.

Heart attacks are possible without a blockage, but this is rare and merely accounts for nearly 5% of all heart attacks. This kind of heart attack tin occur for the following reasons:

Spasm of the avenue: Your claret vessels have a musculus lining that allows them to become wider or narrower equally needed. Those muscles can sometimes twitch or spasm, cutting off blood period to eye musculus.
Rare medical conditions: An example of this would be any affliction that causes unusual narrowing of claret vessels.
Trauma: This includes tears or ruptures in the coronary arteries.
Obstruction that came from elsewhere in the torso: A blood clot or air bubble (embolism) that gets trapped in a coronary avenue.
Electrolyte imbalances: Having too much or too little of fundamental minerals similar potassium in your claret tin can crusade a centre assail.
Eating disorders: Over time, an eating disorder can cause damage to your center and ultimately result in a center attack.

Who is nigh at risk for a heart attack?

Several key factors affect your chance of having a eye attack. Unfortunately, some of these risk factors aren't things you lot can control.

Age and sex.
Family history of eye disease.
History of preeclampsia, a condition that can develop during pregnancy.
Lifestyle.
If yous have certain health conditions or diseases.

Age and sex

Your gamble of heart attack increases as you get older, and your sexual practice as well influences when your risk of a centre attack starts to increase:

Men: The risk of centre attack increases greatly at age 45.
Women: The hazard of heart attack increases greatly at age 50 or after menopause.

Family history

If you lot accept a parent or sibling with a history of heart disease or middle attack — especially at a younger age — your risk is even greater. That chance increases with the following:

Your father or a brother who was diagnosed with heart disease at historic period 55 or younger.
Your mother or a sister who was diagnosed with centre disease at historic period 65 or younger.

Lifestyle

The lifestyle choices you make tin also bear upon your gamble of having a heart attack. The following lifestyle factors increase your risk of centre assault:

Lack of concrete activeness.
A diet high in sodium, sugar and fatty.
Smoking or tobacco use (including smokeless or chewing tobacco and vaping).
Drinking too much alcohol.
Drug abuse (especially in younger individuals).

Other diseases and health conditions

The following health conditions can increase your risk of centre attack:

Diabetes.
Obesity.
High blood pressure (hypertension).
Loftier cholesterol (hyperlipidemia).
Eating disorders (especially in younger individuals).

What are the symptoms of a eye attack?

Heart attacks can have a number of symptoms, some of which are more common than others. The symptoms yous have are also influenced by your sex, every bit with men and women being more probable to take different middle attack symptoms.

Mutual center attack symptoms

Symptoms most frequently described past people having a heart attack:

Chest pain (angina). This symptom can exist mild and experience like discomfort or heaviness, or information technology can exist severe and feel similar crushing pain. Information technology may starting time in your chest and spread (or radiate) to other areas similar your left arm (or both arms), shoulder, cervix, jaw, back or down toward your waist.
Shortness of breath or problem breathing.
Nausea or tum discomfort. Heart attacks can ofttimes be mistaken for indigestion.
Centre palpitations.
Anxiety or a feeling of "impending doom."
Sweating.
Feeling giddy, dizzy or passing out.

Heart assault symptoms in women

Medical enquiry in recent years has shown that women may have the above symptoms, but besides accept a higher chance of experiencing symptoms dissimilar from those listed in a higher place.

Women are less likely to describe the following:

Chest pain, especially in the center of the breast.
Discomfort that feels like indigestion.

Women are more likely to draw the following:

Shortness of jiff, fatigue and insomnia that started before the centre attack.
Pain in the back, shoulders, neck, arms or abdomen.
Nausea and vomiting.

Is acute coronary syndrome the same as a heart attack?

Astute coronary syndrome is a life-threatening condition that requires emergency medical care and can result in a centre assault. Astute coronary syndrome is a proper name given to three types of coronary avenue affliction associated with a sudden rupture of plaque inside the coronary avenue:

Unstable angina.
ST-segment acme myocardial infarction or heart attack (STEMI).*
Non-ST segment elevation myocardial infarction or middle attack (NSTEMI).*

The location of the blockage, the length of time that blood flow is blocked and the amount of damage that occurs determine the type of acute coronary syndrome.

*Run into the Electrocardiogram description in the Diagnosis & Tests department for an explanation of STEMI and non-STEMI heart attacks.

Diagnosis and Tests

How are centre attacks diagnosed?

Heart attacks are usually diagnosed in an emergency room setting. A healthcare provider will diagnose a heart attack using the post-obit:

History and symptoms: The provider will inquire you about the symptoms you experienced. If someone was with you, the provider might as well ask them to describe what happened.
Lab testing: Heart attacks cause a specific chemical mark to show up in your blood.
Heart-specific diagnostic tests: This includes tests that notice and record the electric activity in your center.
Imaging tests: These tests give providers a way to "run into" inside your heart. Many of these tests can as well bear witness the location of a blood menses blockage, which can guide treatment.

What tests will be done to diagnose this condition?

Anyone with heart attack symptoms should undergo a physical exam, including checking pulse, blood oxygen levels, claret pressure, and listening to heart and lung sounds.

Other tests used to diagnose heart attack include:

Electrocardiogram (abbreviated as EKG or ECG): This is i of the kickoff tests done when someone comes to an ER with heart attack symptoms. This exam uses sensors chosen electrodes that attach to the peel of your chest. The electrodes pick upward electrical action in the center and evidence information technology as a wave on a display or printout. By looking at the wave, providers tin see the force and timing of the electrical signal every bit it travels through your heart. When the signal doesn't travel like it should, the shape of the moving ridge changes, which can indicate a centre attack or similar problems. EKG for a heart attack is usually continuous to monitor for changes in heart activity.

STEMI and non-STEMI eye attacks

The wave of your heart'south electrical signal is divided into sections using messages of the alphabet starting at P and ending at U. I particular department of the wave, the ST segment, shows activity in the center'south lower two chambers. Those chambers are the left ventricle and right ventricle.

Ordinarily, the ST segment is very flat, but a heart assail that affects the ventricles will often cause the ST segment to exist much taller than normal. Healthcare professionals call this kind of heart assault an ST-Elevation Myocardial Infarction, or STEMI. Eye attacks, in full general, are broadly split into STEMI and not-STEMI categories, with STEMI heart attacks typically being more than astringent.

Blood tests. During a centre set on, the harm to heart muscle cells almost always causes a chemical marker to appear in your bloodstream. Blood tests that look for that marker are amid the most reliable methods to diagnose a heart attack.

Certain kinds of tests can provide pictures or computer-generated images of the heart. These include:

Echocardiogram: This test uses ultrasound (high-frequency sound waves), similar to how bats use ultrasound like a sonar to encounter obstacles. The ultrasonic waves will travel through and bounciness off unlike parts of your heart at different speeds. An echocardiogram tin can use that information to generate a pic of the within and outside of your heart.
Angiogram: This test involves taking an Ten-ray after injecting a dye-similar substance easily seen on an X-ray into your claret. This allows doctors to see areas with little or no claret flow.
Eye computed tomography (CT) scan: This imaging test uses X-rays and estimator processing to create a highly detailed browse of your center.
Heart MRI: This test uses a powerful magnetic field and calculator processing to create an image of your heart.
Nuclear heart scans: Similar to angiography, these scans employ a radioactive dye injected into your blood. What sets them apart from an angiogram is that they employ computer-enhanced methods like computed tomography (CT) or positron emission tomography (PET) scans.

Management and Treatment

How are eye attacks treated?

Treating a centre attack means restoring blood menstruation to the affected centre muscle as soon as possible. This can happen in a variety of ways, ranging from medication to surgery. It's extremely likely that treatment volition use several of the following methods.

Supplementary oxygen

People having trouble breathing or with low blood oxygen levels will oft receive supplementary oxygen along with other eye set on treatments. You can exhale the oxygen either through a tube that sits but beneath your nose or a mask that fits over your nose and oral fissure. This increases the amount of oxygen circulating in the blood and reduces the strain on your heart.

Medications

Anti-clotting medications: This includes aspirin and other blood-thinning medicines.
Nitroglycerin: This medicine is used to relieve chest hurting. It also is a powerful vasodilator, meaning it causes claret vessels to widen and so blood can pass through more easily.
Thrombolytic (clot-busting) medications: These intravenous (IV) medications cause blood clots to intermission down and dissolve. These medications are usually used only within the first 12 hours after a eye attack.
Anti-arrhythmia medications: Middle attacks can often cause malfunctions in your heart's normal beating rhythm chosen arrhythmias. Some arrhythmias can be life-threatening. Anti-arrhythmia medications tin can stop or foreclose these malfunctions.
Hurting medications: The most mutual pain medication given during heart set on intendance is morphine. This can help convalesce chest pain.

Percutaneous coronary intervention

Restoring apportionment to the afflicted eye muscle is usually washed with a procedure chosen percutaneous coronary intervention. Often called PCI for curt, this process uses a catheter-based device inserted into a major blood vessel (usually one almost your upper thigh).

Once the catheter is inserted into the claret vessel through a small incision, the provider threads it upwards to the blocked artery on your heart. In one case it reaches the location of the blockage, the provider volition inflate a small balloon on the end of the device to widen the blood vessel and articulate the blockage.

PCI is a disquisitional tool in restoring claret flow, and the sooner that happens, the meliorate the hazard of a good outcome. Hospitals use a metric called "door-to-balloon time" to measure their power to treat a centre attack. This is the average time it takes for patients to undergo PCI after they first come into the Emergency Room.

PCI ofttimes includes the placement of a stent at the site of the blockage. Stents are made of metal mesh and look like tube-shaped scaffolds. They assistance concur the artery open then another blockage doesn't happen in the same spot. Some stents are coated with a medication that prevents clotting or tissue growth on the stent itself (either of which could cause another blockage).

Coronary artery bypass grafting

Patients who have severe blockages of their coronary arteries may undergo coronary artery bypass grafting. This surgery is often called open-heart surgery, bypass surgery or CABG (the acronym is pronounced the same as "cabbage").

CABG involves taking a blood vessel from elsewhere in the body (usually your chest, arm or leg) and using information technology to construct a detour for blood to use. This reroutes blood around the blocked artery section (or more 1 avenue; a double bypass goes effectually two arteries, three is a triple, and so on).

Prevention

Can I foreclose having a heart attack?

In general, there are many things that yous can exercise that may forbid a heart assault. However, some factors across your command — peculiarly your family history — can all the same pb to a heart attack despite your best efforts. Still, reducing your risk can postpone when you accept a heart set on and reduce the severity if you accept one.

How tin can I reduce my risk of having a heart attack?

Although there are several risk factors that yous can't control, there are many ways y'all tin help yourself and reduce your chance of a heart attack. These include:

Schedule a checkup: Find a primary intendance provider and see them at least in one case a year for a checkup or wellness visit. An almanac checkup can take hold of many of the early warning signs of heart affliction, including signs that you tin't feel. These include your blood pressure, claret sugar levels, cholesterol levels and more.
Quit tobacco products : This includes smokeless tobacco and all vaping products.
Practise regularly : Aim for 20 to 30 minutes of moderately intense physical action a week.
Eat a healthy diet: Examples include the Mediterranean or Dash diets. A plant-based diet approach is an fantabulous alternative.
Maintain a healthy weight: Your primary care provider can advise yous on a healthy goal weight and provide you lot resources and guidance to help you lot reach that goal.
Manage your existing health conditions: This includes high cholesterol levels, loftier blood pressure and diabetes.
Reduce your stress : Consider techniques such as yoga, deep breathing and meditation.
Take your medications: Don't just take medications when yous remember to or when you lot accept a doctor'south appointment coming upwards.
Keep all your medical appointments: Seeing your healthcare providers regularly tin help uncover heart-related problems or other medical problems yous didn't know you had. This tin besides help treat bug sooner rather than later.

Being an active contributor to your health doesn't hateful yous have to make lifestyle changes all on your own. Ask your master intendance provider and other providers on your healthcare team for help. They can provide the information and resources you demand, and point you to services from which you might do good.

If you've already had a heart attack, your healthcare provider will recommend a cardiac rehabilitation program. This plan's goals are to reduce your chance of a 2nd eye set on. These medically supervised programs provide counseling and focus on the same healthy living goals listed above.

Outlook / Prognosis

What tin I expect if I accept this condition?

After you've had a middle attack, you're at a higher risk of a like occurrence. Your healthcare provider volition likely recommend follow-up monitoring, testing and care to avert hereafter middle attacks. Some of these include:

Centre scans: Similar to the methods used to diagnose a heart attack, these can assess the effects of your heart assail and determine if you have permanent heart damage. They can also look for signs of heart and circulatory problems that increase the chance of futurity heart attacks.
Stress test: Your provider may too recommend that you lot undergo a stress test. These are heart tests and scans that accept identify while y'all're exercising. Stress tests tin show potential problems that stand out simply when your eye is working harder.
Cardiac rehabilitation : Your healthcare provider may recommend that yous get through a cardiac rehabilitation plan during your recovery from a heart assail. These programs are medically supervised and focus on helping y'all improve your overall health and lifestyle, which can prevent another eye attack. Cardiac rehabilitation generally involves a team of providers and experts, including doctors, concrete therapists, nurses, exercise specialists/trainers, dietitians, wellness educators, counselors and more.

How soon later on treatment will I feel ameliorate?

In full general, your heart assail symptoms should subtract every bit y'all receive handling. You lot volition probable have some lingering weakness and fatigue during your hospital stay and for several days afterward. Your healthcare provider will give you guidance on rest, medications to accept, etc.

Recovery from the treatments besides varies, depending on the method of treatment. The average hospital stay for a center attack is between four and five days. In full general, expect to stay in the hospital for the following length of time:

Medication just: Patients treated with medication but have an average hospital stay of approximately six days.
PCI: Recovering from PCI is easier than surgery because information technology's a less invasive method for treating a heart attack. The boilerplate length of stay for PCI is well-nigh four days.
CABG: Recovery from heart bypass surgery takes longer because it is a major surgery. The average length of stay for CABG is about seven days.

When tin I resume my usual activities?

Recovery from a heart set on afterwards you're released from the hospital depends on the severity of the heart attack, how shortly treatment began, methods used and the health conditions you had — if any — before your heart assail. Your healthcare provider can explain the next steps for your recovery and what you tin expect. In general, nigh people can return to piece of work or resume their usual activities anywhere between two weeks to three months after their middle attack.

Living With

What are the complications of a heart set on?

Complications associated with heart attacks include:

Arrhythmias (abnormal center rhythms): Direction options include medication, pacemaker placement, implantable cardioverter defibrillator placement and other options.
Heart failure: If enough heart tissue has died, your heart is now weakened and tin't pump blood effectively, which can lead to heart failure.
Heart valve problems: Depending on the surface area of centre impairment, your middle valves may be affected. Catheter-based procedures or surgery are treatment options for eye valve problems.
Sudden cardiac arrest : This sudden stoppage of your eye tin be caused by arrhythmia.
Low and feet: Talk to your healthcare provider. Management includes medication and counseling. Joining a support group can help.

Do women fare better or worse than men after a center set on?

Younger women (pre-menopause) under age 45 have a meliorate result than men of a similar age. Scientists believe this is because of estrogen's heart-protective furnishings. However, after menopause ends the protective benefits of estrogen, women fare worse than men. More specifically:

Women betwixt the ages of 45 and 65 who've had a heart attack are more than likely to die within a yr of the issue compared with men of this aforementioned age.
Women over age 65 are more than likely to die within weeks of their heart set on than men over age 65.

Oftentimes Asked Questions

Why should I call 911 if I can drive myself to the hospital (or take someone drive me)?

If you lot take any symptoms of a heart set on, it'south best to call 911 for multiple reasons:

Offset responders tin do some of the early testing and treatment for a eye assault on the way to the hospital. This can speed upwards the overall diagnosis and handling procedure.
If you come into the hospital by ambulance, you usually have more immediate access to care. When y'all're having a eye attack, every second matters.
Center attacks can cause your heart to beat irregularly or cease entirely, either of which could crusade you to pass out. If you're in an ambulance when that happens, outset responders tin can react immediately to stabilize y'all. You likewise won't have to worry about passing out behind the wheel and causing a crash that could have devastating consequences for yourself or others.

A note from Cleveland Dispensary

A blocked artery needs immediate care to prevent permanent heart harm. You may remember that if your symptoms are not intense and severe, you're not having a heart attack. Notwithstanding, it's best to get your symptoms checked. Calling 911, rather than driving yourself or having someone else drive y'all, tin can exist fifty-fifty more than life-saving than you think. Fourth dimension saved is center muscle saved, and that ways you have a amend risk of a good outcome.

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Source: https://my.clevelandclinic.org/health/diseases/16818-heart-attack-myocardial-infarction