Heart Attack (Myocardial Infarction) – Cleveland Clinic

Overview A blocked coronary artery prevents blood from reaching your heart muscle and causes a heart attack. What is a heart attack?

A myocardial infarction (commonly called a heart attack) is an extremely dangerous condition that happens because of a lack of blood flow to your heart 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 hearts arteries. Without blood flow, the affected heart muscle will begin to die. If blood flow isnt restored quickly, a heart attack can cause permanent heart damage and death.

A heart attack is a life-threatening emergency. If you suspect you or someone youre with is having a heart attack, call 911 (or your local emergency services phone number). Time is critical in treating a heart attack, and a delay of even a few minutes can result in permanent heart damage or death.

When a heart attack happens, blood flow to a part of your heart stops or is far below normal, which causes injury or death to that part of your heart muscle. When a part of your heart cant pump because its dying from lack of blood flow, it can disrupt the pumping sequence for your entire heart. That reduces or even stops blood flow to the rest of your body, which can be deadly if it isnt corrected quickly.

Heart attacks can have a number of symptoms, some of which are more common than others. Men and people assigned male at birth (AMAB) are likely to have different heart attack symptoms than women and people assigned female at birth (AFAB).

Symptoms of a heart attack that people describe most often include:

Medical research in recent years has shown that women and people AFAB are less likely to have chest pain or discomfort that feels like indigestion. Theyre more likely to have shortness of breath, fatigue and insomnia that started before the heart attack. They also have nausea and vomiting or pain in the back, shoulders, neck, arms or abdomen.

The vast majority of heart attacks occur because of a blockage in one of the blood vessels that supplies your heart. This most often happens because of plaque, a sticky substance that can 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 break open or rupture, and a blood clot can get stuck where the rupture happened. If the clot blocks the artery, this can deprive the heart muscle of blood and cause a heart attack.

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

Several key factors affect your risk of having a heart attack. Unfortunately, some of these heart attack risk factors arent things you can control.

Men and people AMAB: The risk of heart attack increases greatly at age 45.

Women and people AFAB: The risk of heart attack increases greatly at age 50 or after menopause.

Your risk increases if:

Your father or a brother received a heart disease diagnosis at age 55 or younger.

Your mother or a sister received a heart disease diagnosis at age 65 or younger.

These increase your risk of heart attack:

Lack of physical activity.

A diet high in sodium, sugar and fat.

Smoking or tobacco use (including smokeless or chewing tobacco and vaping).

Drinking too much alcohol.

Drug use (especially in younger people).

Having these health conditions can increase your risk of heart attack:

Diabetes.

Obesity.

High blood pressure (hypertension).

High cholesterol (hyperlipidemia).

History of preeclampsia during pregnancy.

Eating disorders (especially in younger people).

Healthcare providers usually diagnose heart attacks in an emergency room setting. Anyone with heart attack symptoms should undergo a physical examination, including checking pulse, blood oxygen levels and blood pressure and listening to heart and lung sounds.

A healthcare provider will diagnose a heart attack using the following:

Treating a heart attack means restoring blood flow to the affected heart muscle as soon as possible. This can happen in a variety of ways, ranging from medication to surgery. Its extremely likely that treatment will use several of the following methods.

People having trouble breathing or with low blood oxygen levels often receive supplementary oxygen along with other heart attack treatments. You can breathe the oxygen either through a tube that sits just below your nose or a mask that fits over your nose and mouth. This increases the amount of oxygen circulating in the blood and reduces the strain on your heart.

Providers restore circulation to your affected heart muscle with a procedure called percutaneous coronary intervention (PCI). This uses a catheter-based device inserted into a major blood vessel (usually one near your upper thigh or your wrist).

PCI is a critical tool in restoring blood flow, and the sooner that happens, the better the chance of a good outcome. Hospitals use a metric called door-to-balloon time to measure their ability to treat a heart attack. This is the average time it takes for people to undergo PCI after they first come into the Emergency Room. PCI often includes the placement of a stent at the site of the blockage to help hold the artery open so another blockage doesnt happen in the same spot.

People 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 using a blood vessel from elsewhere in your body (usually your chest, arm or leg) to construct a detour for blood. This reroutes blood around one or more blocked artery sections and brings blood to your heart muscle.

In general, there are many things that you can do that may prevent a heart attack. However, some factors beyond your control especially your family history can still lead to a heart attack despite your best efforts. Still, reducing your risk can postpone when you have a heart attack and reduce the severity if you have one.

Although there are several risk factors that you cant control, there are many ways you can help yourself and reduce your risk of a heart attack. These include:

Being an active contributor to your health doesnt mean you have to make lifestyle changes all on your own. Ask your primary care provider and other providers on your healthcare team for help. They can provide the information and resources you need.

If youve already had a heart attack, your healthcare provider will recommend a cardiac rehabilitation program. This programs goals are to reduce your chance of a second heart attack. These medically supervised programs provide counseling and focus on the same healthy living goals listed above.

After youve had a heart attack, youre at a higher risk of a similar occurrence. Your healthcare provider will likely recommend follow-up monitoring, testing and care to avoid future heart attacks. Some of these include:

Additionally, youll continue to take medicines some of the ones you received for immediate treatment of your heart attack long-term. These include:

In general, your heart attack symptoms should decrease as you receive treatment. Youll likely have some lingering weakness and fatigue during your hospital stay and for several days after. Your healthcare provider will give you guidance on rest, medications to take, etc.

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

Recovery from a heart attack after leaving the hospital depends on the severity of the heart attack, how soon treatment began, the methods used and the health conditions you had if any before your heart attack. Your healthcare provider can explain the next steps for your recovery and what you can expect. In general, most people can return to work or resume their usual activities anywhere between two weeks to three months after their heart attack. Cardiac rehab can help people gradually and safely increase their physical activity back to its prior level.

Complications associated with heart attacks include:

Younger women (pre-menopause) and people AFAB under age 45 have a better outcome than men and people AMAB of a similar age. Scientists believe this is because of estrogens heart-protective effects. However, after menopause ends the protective benefits of estrogen, women fare worse than men. More specifically:

If you have any symptoms of a heart attack, its best to call 911 for multiple reasons:

New heart attacks happen to about 635,000 people in the U.S. each year. About 300,000 people a year have a second heart attack. About 1 in 7 deaths in the U.S. is due to coronary heart disease, which includes heart attacks.

A note from Cleveland Clinic

A blocked artery needs immediate care to prevent permanent heart damage. You may think that if your symptoms arent intense and severe, youre not having a heart attack. However, its best to get your symptoms checked. Calling 911, rather than driving yourself or having someone else drive you, can be even more life-saving than you think. Time saved is a heart muscle saved, and that means you have a better chance of a good outcome.

Last reviewed by a Cleveland Clinic medical professional on 10/30/2022.

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Heart Attack (Myocardial Infarction) - Cleveland Clinic