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:
STEMI—A major artery is fully blocked. This is a more serious type of heart attack
NSTEMI—Partial block of an artery. The block may also allow periods of some blood flow.
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:
Narrowing of the coronary arteries due to one or more of following:
Thickening of the artery walls (common aging process)
Build-up of fatty plaques inside the arteries
Spasm of the coronary arteries
Development of a blood clot in the arteries
Embolism—a blood clot that travels to the heart from other areas of the body
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:
The first goal of treatment is to improve blood flow and get oxygen to your heart as quickly as possible. Treatment includes:
Aspirin and other antiplatelet agents—to break up clots in the blood and improve blood flow. It works best when given within the first 6 hours after symptoms appear.
Oxygen therapy—to increase oxygen to the heart.
Nitrate medications—to quickly open blood vessels and improve blood flow to heart muscle.
and/or angiotensin-converting enzyme (ACE) inhibitors—to decrease the workload on the heart.
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:
Balloon angioplasty—A wire is passed through blood vessels to the heart. A balloon is inflated to press open the blocked artery. A mesh device called a stent may also be placed. It will help prop the area open.
Coronary artery bypass grafting
(CABG)—Part of a blood vessel from another area of the body will be taken. It will be attached above and below the blocked area to create blood flow around the blockage.
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
after having a heart attack. Therapy and medicine can help to manage these challenges.
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.
About heart attacks. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/AboutHeartAttacks/About-Heart-Attacks_UCM_002038_Article.jsp#.WbhYX7KGNQI. 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 http://www.dynamed.com/topics/dmp~AN~T233244/Testosterone: 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.
EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
To send comments or feedback to our Editorial Team regarding the content please email us at email@example.com. Our Health Library Support team will respond to your email request within 2 business days.