(Acute Myocardial Infarction [AMI]; Myocardial Infarction [MI]; ST-Segment-Elevation MI [STEMI]; Transmural Myocardial infarction)
by Rosalyn Carson-DeWitt, MD
A heart attack is due to a blockage of blood flow to an area of the heart. The heart tissue becomes damaged or dies within a short time after blood flow is stopped. If a large or vital area is affected the damage may stop the heart.
The coronary arteries bring blood and oxygen to the heart muscle. A heart attacks occurs when one or more of these arteries is blocked. Blockage may occur because of one or more of the following:
There are two main coronary arteries. They split off into smaller branches that spread out over the heart. The severity of the heart attack will depend on where the blockage happens:
Blockages may only last a short time and then allow some blood flow. Others may last longer, and lead to more damage.
The risk of heart attack is greater in males and older adults.
You have a higher risk of a heart attack if you do not have healthy blood vessels. This may be due to:
Symptoms can differ from person to person. Common ones are:
Unusual symptoms of heart attack—more common in women:
Call for emergency services right away if you think you may be having a heart attack. Early care can stop further damage.
If the doctor suspects a heart attack it may be confirmed with:
Other test will be based on your specific needs but may include:
The first goal of treatment is to improve blood flow and get oxygen to your heart as quick as possible. Treatment includes:
Medicine may be given to try to break up blood clots. The sooner these medicines are given the better the outcome will be. It works best when given within the first 6 hours after symptoms appear.
Surgery may be needed for:
Severe blockages may need to be treated right away. Surgery may be delayed for a few days if there is enough blood flow to the heart. Surgical options include:
Cardiac rehabilitation can help after a heart attack. It may include:
A heart attack can be a major life event. It is common for people to experience depression after having a heart attack. Therapy and medicine can help to manage these challenges.
Many lifestyle habits influence the health of the blood vessels and heart. Healthy heart habits include:
Small daily doses of aspirin may help some people decrease their risk. This should only be done with your doctor’s approval. Aspirin can have side effects like bleeding in the stomach. Aspirin may also cause problems with other medicine.
American Heart Association
National Stroke Association
Heart and Stroke Foundation of Canada
The College of Family Physicians of Canada
About heart attacks. American Heart Association website. Available at:
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Updated January 27, 2017. Accessed September 12, 2017.
Antithrombotic Trialists' (ATT) Collaboration, Baigent C, Blackwell L, et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet. 2009;373:1849-1860.
Explore heart attack. National Heart Lung and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health/health-topics/topics/heartattack. Updated January 27, 2015. Accessed September 29, 2014.
ST-elevation myocardial infarction (STEMI). EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated June 12, 2017. Accessed September 12, 2017.
2/3/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T233244/Testosterone : Finkle W, Greenland S, Ridgeway GK, et al. Increased risk of non-fatal myocardial infarction following testosterone therapy prescription in men. PLoS One. 2014;9(1):e85805.
7/17/2017 DynaMed Plus Systematic Literature Surveillance http://www.dynamed... : Bally M, Dendukuri N, Rich B, et al. Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data. BMJ. 2017;357:j1909.
Last reviewed September 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC
Last Updated: 5/24/2018
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