Overview

A heart attack, also known as a Myocardial Infarction (MI), occurs when the blood flow to a section of the heart is blocked by the occlusion of the artery that supplies blood to the heart muscle,  depriving that muscle of oxygen. If blood flow is not restored quickly, the affected heart tissue will become damaged or die. This is a medical emergency requiring immediate attention. Most heart attacks are caused by Coronary Artery Disease (CAD), where plaque buildup in the arteries leads to sudden blockage.

Risk Factors

Several factors contribute to the development of a heart attack, including:

  • Coronary Artery Disease (CAD): The most common cause, where plaque buildup narrows or blocks the coronary arteries that supply blood to the heart
  • Blood Clots: A clot can form and obstruct blood flow to the heart, usually on top of an existing plaque.
  • Spasm of Coronary Arteries: Sudden narrowing of arteries, often triggered by smoking, stress, or drug use.
  • High Blood Pressure: High blood pressure increases plaque formation and arterial stiffness and narrowing.
  • Cholesterol: High cholesterol levels are a major contributor to the formation of the plaque which is primarily formed from lipids/ fats, and to the rupture of the plaque which can lead to a blood clot and heart attack as described above.
  • Diabetes: Uncontrolled blood sugar levels can damage blood vessels. Please refer to the article on Diabetes
  • Smoking & Alcohol: Both can contribute to arterial damage and clot formation.
  • Obesity & Sedentary Lifestyle: Lack of physical activity and unhealthy diet increase cardiovascular risk.

Symptoms

Heart Attack symptoms can vary between individuals but often include:

  • Chest Pain or Discomfort, referred to as Angina: feeling of pressure, squeezing, or fullness in the chest that lasts for minutes or even hours.
  • Shortness of Breath: Difficulty breathing, even at rest.
  • Pain Radiating to Other Areas: Discomfort may spread to the arms, neck, jaw, back, or stomach.
  • Cold Sweats & Dizziness: A heart attack may cause sudden sweating, nausea, and dizziness.
  • Fatigue & Weakness: Some people, particularly women, experience extreme tiredness before a heart attack.

Treatment

The treatment for a heart attack focuses on restoring blood flow and preventing further damage:

Emergency Treatments

  • Medications:
    • Thrombolytics (Clot Busters): Dissolve the clot blocking the artery.
    • Antiplatelets & Anticoagulants: To help dissolve the clot and prevent a new clot from forming.
    • Pain Relievers & Beta-Blockers: Help reduce the heart’s workload and pain.
  • Interventional Procedures:
    • Coronary Angioplasty & Stenting: This is the most effective treatment of a heart attack in the acute setting. A catheter with a balloon is inserted to reopen the blocked artery and restore blood flow, and a stent is placed to keep it open.
    • Coronary Artery Bypass Grafting (CABG): In rare cases, bypass surgery is performed to create a new route for blood flow.
  • Post-Heart Attack Care:
    • Cardiac Rehabilitation: A supervised program that includes lifestyle changes, exercise, and education to prevent future heart issues.
    • Long-Term Medication Management: Includes anti platelet medications, cholesterol-lowering drugs, and medications for other risk factors and conditions.

Early recognition and immediate medical intervention are critical in improving survival rates and reducing long-term complications.