Heart Attack at A Glance
Heart Attack at A Glance
Heart Attack at A Glance
Acute myocardial infarction, commonly known as The outward signs and symptoms of a heart attack
heart attack, occurs when the heart is starved of can vary widely from person to person. Many people
oxygen because blood flow through one or more of do not experience the crushing chest pain that has
the coronary arteries — a group of vessels that been dramatized on television and in movies.
surround and supply the heart — is blocked. The lack The most common symptoms include:
of oxygen causes chest pain and results in irreversible
• CHEST PAIN OR DISCOMFORT
damage, eventually leading to the death of heart
Most heart attacks involve discomfort in the center
muscle (called myocardium).
or left side of the chest. It usually lasts for more
Atherosclerosis, the progressive accumulation of fat, than a few minutes or goes away and comes back.
cholesterol, and other substances within the walls of The discomfort can feel like pressure, squeezing,
the coronary arteries, is largely to blame. These waxy fullness, or pain. It also can feel like heartburn or
substances, together known as plaque, build up over indigestion, and can be mild or severe.
time, narrowing the opening of the blood vessels.
• UPPER BODY DISCOMFORT
When a piece of plaque ruptures, a blood clot forms,
Patients experiencing a heart attack may feel pain
completely obstructing blood flow and resulting in a
or discomfort in one or both arms, the back,
heart attack. (This NHLBI video illustrates the biology
shoulders, neck, jaw, or upper part of the stomach
behind a heart attack.)
(above the belly button).
Heart attack is a leading cause of death around the
• SHORTNESS OF BREATH
world. According to the World Health Organization,
This is sometimes a patient’s only symptom, or
cardiovascular disease, including heart attack, is
it may occur before or along with chest pain or
responsible for 10% of the disability-adjusted life
discomfort. It can occur when at rest or with
years lost in low- and middle-income countries, and
mild physical activity.
18% in high-income countries. (Disability-adjusted
life years, or DALYs, combine years of potential life
DIAGNOSIS
lost due to premature death with years of productive
life lost due to disability. They can be thought of as There are several diagnostic tests physicians use to
“healthy years of life lost.”) In the United States, diagnose a heart attack. They include:
someone suffers from a heart attack roughly every
• E KG (ELECTROCARDIOGRAM)
34 seconds.
An EKG is a simple, painless test that detects and
records the heart’s electrical activity. The test shows
how fast the heart is beating and its rhythm. It also
records the strength and timing of electrical signals
as they pass through each part of the heart. An
Office of Communications EKG can detect signs of heart damage due to
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coronary heart disease as well as signs of a
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previous or current heart attack.
• BLOOD TESTS Once the diagnosis of a heart attack is confirmed,
During a heart attack, heart muscle cells die and doctors initiate treatments aimed at promptly
release proteins into the bloodstream. Blood tests restoring blood flow to the heart. The two main
can detect and measure the amount of these treatments are “clot-busting” medicines and percuta-
proteins: higher than normal levels suggest a neous coronary intervention (PCI), sometimes referred
heart attack. Commonly used blood tests include to as coronary angioplasty, a procedure used to open
troponin tests, CK or CK–MB tests, and serum blocked coronary arteries.
myoglobin tests. Blood tests often are repeated
• CLOT-BUSTERS
to check for changes over time.
Thrombolytic medicines, also called “clot busters,”
• CORONARY ANGIOGRAPHY are used to dissolve blood clots that are blocking
Coronary angiography is a test that uses dye and the coronary arteries. To work best, these medicines
special x-rays to highlight the insides of the must be given within several hours of the start of
coronary arteries. This test often is done during a heart attack symptoms. Ideally, the medicine
heart attack to help find blockages in these blood should be given as soon as possible.
vessels. To get the dye into the coronary arteries,
• PERCUTANEOUS CORONARY INTERVENTION
doctors use a procedure called cardiac catheteriza-
Percutaneous coronary intervention (PCI) is a
tion. A thin, flexible tube known as a catheter is
nonsurgical procedure that opens blocked or
put into a blood vessel in the arm, groin (upper
narrowed coronary arteries. This procedure also
thigh), or neck, and then threaded into the
is called coronary angioplasty.
coronary arteries, where the dye is then released
into the bloodstream. Special x-rays are taken A thin, flexible tube with a balloon or other device
while the dye is flowing through the coronary on the end is threaded through a blood vessel,
arteries. The dye lets doctors study the flow of usually in the groin (upper thigh), to the narrowed
blood through the heart and blood vessels. or blocked coronary artery.
• Oxygen therapy
OTHER TRE ATMENT S FOR HE ART AT TACK
• Aspirin to help thin the blood and prevent further
• BETA BLOCKERS
blood clotting
Beta blockers decrease your heart’s workload. These
• Nitroglycerin to reduce the heart’s workload and medicines also are used to relieve chest pain and
improve blood flow through the coronary arteries discomfort and to help prevent repeat heart
attacks. Beta blockers also are used to treat
• Treatment for chest pain
arrhythmias (irregular heartbeats).