(Acute Myocardial Infarction [AMI]; Myocardial Infarction [MI]; ST-Segment-Elevation MI [STEMI]; Transmural Myocardial infarction)
by Rosalyn Carson-DeWitt, MD
A heart attack is when an area of the heart does not get enough blood flow. The area becomes damaged or dies within a short time after blood flow is stopped. If a large or vital area is affected the heart may stop. A heat attack may be:
The coronary arteries bring blood and oxygen to the heart muscle. A heart attack occurs when one or more of these arteries is blocked. Blockage may occur because of one or more of the following:
There are 2 main coronary arteries. They split off into smaller branches that spread out over the heart. A blockage on larger artery will affect more of the heart. It can cause a severe heart attack. Blockages in the smaller arteries will have a smaller effect.
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. The risk of a heart attack is also higher in those with blood vessel disease or damage. Things that may increase risk of blood vessel disease and heart attacks are:
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.
A heart attack is an emergency. Tests to confirm a heart attack and look for changes in the heart include:
Other tests 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 quickly as possible. Treatment includes:
Surgery may be needed for clots that do not respond to medicine. Some blockages may also be caused by a buildup of plaque in blood vessels. Surgery can help to improve blood flow. Surgical options include:
Cardiac rehabilitation can help after a heart attack. It will teach healthy habits to decrease the risk of another heart attack. The program will also monitor the heart as physical activity is increased. Severe heart attacks can also make the heart weaker. Rehabilitation can help to adjust to changes.
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.
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:
...(Click grey area to select URL)
Accessed September 14, 2020.
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. Accessed September 14, 2020.
ST-elevation myocardial infarction (STEMI). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/st-elevation-myocardial-infarction-stemi. Accessed September 14, 2020.
2/3/2014 DynaMed Systematic Literature Surveillance
...(Click grey area to select URL)
Finkle W, Greenland S, 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 Systematic Literature Surveillance https://www.dynamed.com/condition/acute-coronary-syndromes: Bally M, Dendukuri N, 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 2020 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC
Last Updated: 9/15/2020