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A heart attack is a frightening experience. If you have had a heart attack, or are close with someone who has, you are not alone: tens of thousands of Americans survive.
As you work toward recovery, please use the following questions and answers to better understand what has happened to you and how you can help your heart heal so you can live a healthier, longer life:
See how coronary artery damage leads to a heart attack.
What is a heart attack?
Your heart muscle needs oxygen to survive. A heart attack occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely (View an animation of blood flow). This happens because coronary arteries that supply the heart muscle with blood flow can slowly become narrow from a buildup of fat, cholesterol and other substances that together are called plaque. This slow process is known as atherosclerosis. When a plaque in a heart artery breaks, a blood clot forms around the plaque. This blood clot can block the blood flow through the heart muscle. When the heart muscle is starved for oxygen and nutrients, it is called ischemia. When damage or death of part of the heart muscle occurs as a result of ischemia, it is called a heart attack or myocardial infarction (MI). About every 43 seconds, someone in the United States has a myocardial infarction (heart attack)?
Why didn't I have any warning?
The process of Atherosclerosis has no symptoms. One reason there may be no warning signs is that sometimes when a coronary artery becomes narrowed, other nearby vessels that also bring blood to the heart sometimes expand to help compensate. The network of expanded vessels is called collateral circulation and helps protect some people from heart attacks by getting needed blood to the heart. Collateral circulation can also develop after a heart attack to help the heart muscle recover.
Is my heart permanently damaged?
When a heart attack occurs, the heart muscle that has lost blood supply begins to suffer injury. The amount of damage to the heart muscle depends on the size of the area supplied by the blocked artery and the time between injury and treatment. Damage to the heart muscle from a heart attack heals by forming scar tissue. It usually takes several weeks for your heart muscle to heal. The length of time depends on the extent of your injury and your own rate of healing. The heart is a very tough organ. Even though a part of it may have been severely injured, the rest keeps working. But because your heart has been damaged, it may be weaker and can't pump as much blood as usual. However, with proper treatment after a heart attack and lifestyle changes, further damage can be limited or prevented. Learn more about heart damage detection
Will I recover from my heart attack?
The answer is most likely yes. The heart muscle begins to heal soon after a heart attack and usually takes about eight weeks. Scar tissue may form in the damaged area, and that scar tissue does not contract or pump as well as healthy muscle tissue. That means that extent of damage to the heart muscle can impact how well the heart pumps blood throughout the body. The degree of loss of function depends on the size and location of the scar tissue. Most heart attack survivors have some degree of coronary artery disease (CAD) and will have to make important lifestyle changes and possibly take medication to prevent a future heart attack and lead a full, productive life
Is all chest pain a heart attack?
No. One very common type of chest pain is called angina, or angina pectoris. It's a recurring discomfort that usually lasts only a few minutes. Angina occurs when your heart muscle doesn't get the blood supply and oxygen that it needs. The difference between angina and a heart attack is that angina attacks don't permanently damage the heart muscle. Often angina occurs during exercise or emotional stress when your heart rate and blood pressure increase and your heart muscle needs more oxygen. Learn about unstable angina.
What are the different medical terms for a heart attack?
- Acute Coronary Syndrome (ACS): An umbrella term for situations where the blood supplied to the heart muscle is suddenly blocked.
- STEMI: A common name for ST-elevation myocardial infarction, a type of heart attack caused by a complete blockage in a coronary artery.
- NSTEMI: A non-ST-elevated myocardial infarction, a type of heart attack in which an artery is partially blocked and severely reducing blood flow.
- Myocardial infarction: The damaging or death of an area of the heart muscle (myocardium) resulting from a blocked blood supply to that area; medical term for a heart attack.
- Coronary thrombosis: Formation of a clot in one of the arteries that conduct blood to the heart muscle. Also called coronary occlusion.
- Coronary occlusion: An obstruction of a coronary artery that hinders blood flow to some part of the heart muscle. A cause of heart attack.
What is acute coronary syndrome (ACS)?
You have learned about heart attacks, but maybe you happened to hear a medical professional use the term "acute coronary syndrome" or "ACS" and wondered what that meant. ACS is an umbrella term for situations where the blood supplied to the heart muscle is suddenly blocked. Heart attack is to ACS what Red Delicious is to "apple". Find out more here.
Are there other causes of heart attack?
Sometimes a coronary artery temporarily contracts or goes into spasm. When this happens the artery narrows and blood flow to part of the heart muscle decreases or stops. We're not sure what causes a spasm. A spasm can occur in normal-appearing blood vessels as well as in vessels partly blocked by atherosclerosis. A severe spasm can cause a heart attack.
Another cause (rare) may be Spontaneous coronary artery dissection. It is the result of spontaneous tearing in the coronary artery wall.
How is a heart attack different from cardiac arrest?
People often use these terms interchangeably, but they are not synonyms. A heart attack is when blood flow to the heart is blocked, and sudden cardiac arrest is when the heart malfunctions and suddenly stops beating unexpectedly. A heart attack is a circulation problem and sudden cardiac arrest is an electrical problem. A heart attack can cause a cardiac arrest. In cardiac arrest (also called sudden cardiac death or SCD), death results when the heart suddenly stops working properly. This is caused by abnormal, or irregular, heart rhythms (called arrhythmias). The most common arrhythmia in cardiac arrest is ventricular fibrillation. This is when the heart's lower chambers suddenly start beating chaotically and don't pump blood. Death occurs within minutes after the heart stops. Cardiac arrest may be reversed if CPR (cardiopulmonary resuscitation) is performed and a defibrillator is used to shock the heart and restore a normal heart rhythm within a few minutes.
Read an article highlighting the differences between heart attack and cardiac arrest.
Why do I have to submit to a bunch of tests?
Tests help the doctor determine if a heart attack occurred, how much your heart was damaged and what degree of coronary artery disease (CAD) you might have. The tests screen your heart and help the doctor determine what treatment and lifestyle changes will keep your heart healthy and prevent serious future medical events.
What is the difference between "invasive" and "non-invasive" tests? Non-invasive cardiac tests measure your heart activity through external imaging and electrocardiography. Invasive tests include drawing and testing samples of your blood, and inserting and threading a thin hollow tube called a catheter into a blood vessel to get an inside view.
Where can I see the big picture? How does all this fit together for me?
See Diagnostic Tests and Procedures At-A-Glance to better understand the tests you may have to undergo to find out if you had a heart attack, how much damage was done and what degree of coronary artery disease (CAD) you have.
What types of treatment will I get after the hospital diagnoses my heart attack?
See our Treatment of Heart Attack page. If you've had a heart attack, you may have already had certain procedures to help you survive your heart attack and diagnose your condition:
- Thrombolysis: Many heart attack patients have undergone thrombolysis, a procedure that involves injecting a clot-dissolving agent to restore blood flow in a coronary artery. This procedure is administered within a few (usually three) hours of a heart attack.
- Coronary Angioplasty/Coronary artery bypass graft surgery (CABG): If thrombolysis treatment isn't done
immediately after a heart attack, many patients will need to undergo coronary angioplasty or coronary artery bypass graft surgery (CABG) later to improve blood supply to the heart muscle.
Learn More Here
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A myocardial infarction, which is commonly referred to as a heart attack, is a life threatening event that can happen to anyone. It is typically associated with some form of underlying heart disease that disrupts the flow of blood to the heart. Heart disease can also be the culprit in other deadly conditions such as stroke. In the US, approximately 400,000 people die annually from coronary heart disease and related problems.
The symptoms of a myocardial infarction include, but are not limited to, epigastralgia, which is an oppressive pain in the upper abdomen, pain in the left arm, jaw, and back.
Shortness of breath, profuse sweating and feeling of "dying" are also very common.
Can Heart Disease be Prevented?
Heart disease and heart attack can be prevented or delayed. In order to do this, we must know the risk factors so that we can recognize them and take preventive steps to correct them.
Risk Factors for a Heart Attack
Everyone should take steps to prevent heart disease. However, certain people are at a greater risk than others.
Risk factors for heart attack and stroke depend on one's lifestyle, habits, and health conditions. For example, obesity increases the risk of a heart attack.
People who are obese often develop conditions such as high blood pressure and type 2 diabetes. Both of these conditions can cause heart problems.
Being overweight or obese can lead to coronary heart disease even if diabetes or high blood pressure are not present. Lifestyle habits can also affect your heart. Smoking, for example, can damage arteries, elevate blood pressure, limit the amount of oxygen delivered to body tissues, and increase the risk of blood clots.
Lack of exercise or physical activity and a poor diet can contribute to heart disease.
People who eat unhealthy foods may have elevated cholesterol levels that can lead to heart and vessel problems.
Physical activity can counter the ill effects of other conditions such as obesity, high blood pressure, and diabetes.
Other risk factors for a heart attack include age, a family history of heart disease, and stress.
Regarding age, men 45 years or older and women who are older than 55 are at the greatest risk.
The risk is also increased if a family member such as a parent, grandparent, or a sibling has had a heart attack.
Excessive stress, and how a person's body responds to it, is another factor.
Steps to Eliminate Risk Factors
Recognizing the risk factors for heart disease is half the battle when it comes to avoiding a heart attack.
The next thing to do, is to take steps to eliminate those risk factors. Since many of the risk factors stem from how people live their lives, they must be willing to make some significant lifestyle changes.
For example, quitting smoking, increasing physical activity, losing weight, and eating heart-healthy foods.
A healthy diet consists of vegetables, lean meats, fish, poultry, fruits, nuts, and beans.
In addition to watching what one eats, a person should contact their healthcare provider to discuss an effective weight loss plan.
Exercise, even half an hour of walking, should become a part of one's daily routine.
Reducing the amount of stress in life is also an important change to make, but not always an easy or doable one.
Even if people are unable to resolve all issues that cause stress in their lives, they should learn methods to better cope with it
The greater the number of risk factors an individual has, the greater their chances of having a heart attack.
This makes it crucial that these factors are promptly identified and managed.
Regular checkups with a medical professional are important in detecting and controlling such risk factors.
Checkups can also reveal any underlying conditions that are otherwise not symptomatic yet. Any such conditions should be treated accordingly.
A heart attack is a critical event and just the thought of having one can be quite frightening.
Fortunately, there are ways that people can lower or eliminate their risk of ever suffering one.
The first step is to recognize what risk factors are associated with heart disease and heart attack.
If you believe you are in a high risk group, making the necessary lifestyle changes can enable you to live a long and heart healthy life.
The American Heart Association's Diet and Lifestyle Recommendations
A healthy diet and lifestyle are your best weapons to fight cardiovascular disease. It's not as hard as you may think!
Remember, it's the overall pattern of your choices that counts.
Make the simple steps below part of your life for long-term benefits to your health and your heart. Use up at least as many calories as you take in.
Start by knowing how many calories you should be eating and drinking to maintain your weight. Nutrition and calorie information on food labels is typically based on a 2,000 calorie diet.
You may need fewer or more calories depending on several factors including age, gender, and level of physical activity.
If you are trying not to gain weight, don't eat more calories than you know you can burn up every day.
Increase the amount and intensity of your physical activity to match the number of calories you take in.
Regular physical activity can help you maintain your weight, keep off weight that you lose and help you reach physical and cardiovascular fitness.
If it's hard to schedule regular exercise sessions, try aiming for sessions of at last 10 minutes spread throughout the week.
If you would benefit from lowering your blood pressure or cholesterol, the American Heart Association recommends 40 minutes of aerobic exercise of moderate to vigorous intensity three to four times a week.
Eat a variety of nutritious foods from all the food groups.
You may be eating plenty of food, but your body may not be getting the nutrients it needs to be healthy.
Nutrient rich foods have minerals, protein, whole grains and other nutrients but are lower in calories.
They may help you control your weight, cholesterol and blood pressure.
Eat an overall healthy dietary pattern that emphasizes:
Limit saturated fat, trans fat, sodium, red meat, sweets and sugar sweetened beverages.
If you choose to eat red meat, compare labels and select the leanest cuts available.
One of the diets that fits this pattern is the DASH (Dietary Approaches to Stop Hypertension) eating plan.
Most healthy eating patterns can be adapted based on calorie requirements and personal and cultural food preferences.
Eat less of the nutrient poor foods.
The right number of calories to eat each day is based on your age and physical activity level and whether you're trying to gain, lose or maintain your weight.
You could use your daily allotment of calories on a few high calorie foods and beverages, but you probably wouldn't get the nutrients your body needs to be healthy. Limit foods and beverages high in calories but low in nutrients. Also limit the amount of saturated fat, trans fat and sodium you eat. Read Nutrition Facts labels carefully the Nutrition Facts panel tells you the amount of healthy and unhealthy nutrients in a food or beverage.
As you make daily food choices, base your eating pattern on these recommendations:
Choose fiber-rich whole grains for most grain servings.
Choose poultry and fish without skin and prepare them in healthy ways without added saturated and trans fat. If you choose to eat meat, look for the leanest cuts available and prepare them in healthy and delicious ways.
Select fat-free (skim) and low-fat (1%) dairy products.
Avoid foods containing partially hydrogenated vegetable oils to reduce trans fat in your diet.
Limit saturated fat and trans fat and replace them with the better fats, monounsaturated and polyunsaturated. If you need to lower your blood cholesterol, reduce saturated fat to no more than 5 to 6 percent of total calories. For someone eating 2,000 calories a day, that's about 13 grams of saturated fat.
Cut back on beverages and foods with added sugars.
Choose foods with less sodium and prepare foods with little or no salt. To lower blood pressure, aim to eat no more than 2,400 milligrams of sodium per day.
Reducing daily intake to 1,500 mg is desirable because it can lower blood pressure even further. If you can't meet these goals right now, even reducing sodium intake by 1,000 mg per day can benefit blood pressure.
If you drink alcohol, drink in moderation. That means no more than one drink per day if you're a woman and no more than two drinks per day if you're a man.
Follow the American Heart Association recommendations when you eat out, and keep an eye on your portion sizes.
Also, don't smoke tobacco and avoid secondhand smoke.
Learn more about quitting smoking.
For more information on the American Heart Association Diet and Lifestyle Recommendations:
All health and health related information contained within the Your Heart and Health Medical Information Website is intended to be general in nature and should not be used as a substitute for a visit with a health care professional. The advice is intended to offer only a general basis for individuals to discuss their medical condition with their health care provider. Your health care provider should be consulted regarding matters concerning the medical condition, treatment and needs of you and your family.
For medical matters, please contact your doctor’s office by telephone, in emergency situations, call 911.
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