Heart Attack

A heart attack, known medically as a myocardial infarction, happens when the flow of blood to part of the heart muscle is suddenly blocked. Without its blood supply, that part of the heart is starved of oxygen and begins to be damaged, which is why treatment to restore blood flow quickly is so important.

It is different from a cardiac arrest, in which the heart stops pumping altogether — although a heart attack can sometimes trigger a cardiac arrest. A heart attack is always a medical emergency that needs immediate help.

The most common symptom is chest pain or discomfort — often described as tightness, heaviness, pressure, or squeezing in the center of the chest. The pain may spread to one or both arms, the jaw, neck, back, or stomach.

Other symptoms include shortness of breath, breaking out in a cold sweat, feeling sick or being sick, light-headedness, and a feeling of anxiety or dread. Not everyone has severe chest pain; symptoms can be milder or unusual, particularly in women, older adults, and people with diabetes. If you or someone else may be having a heart attack, treat it as an emergency and call for help straight away — do not wait to see whether the symptoms pass.

Most heart attacks are caused by coronary artery disease, in which the arteries supplying the heart become narrowed by fatty deposits over many years. A heart attack usually occurs when one of these deposits ruptures and a blood clot forms, suddenly blocking the artery.

Risk is increased by smoking, high blood pressure, high cholesterol, diabetes, being overweight, physical inactivity, and a family history of heart disease. Managing these factors lowers the risk.

When someone arrives at hospital with suspected heart attack, an electrocardiogram (ECG) is done immediately to check the heart's electrical activity, along with blood tests that detect proteins released when heart muscle is damaged.

These tests confirm the diagnosis and show the type of heart attack, which guides urgent treatment. Further tests such as coronary angiography show which artery is blocked so it can be reopened.

The priority is to restore blood flow to the heart as quickly as possible. The main treatment is emergency coronary angioplasty (primary PCI), in which the blocked artery is reopened with a balloon and usually held open with a stent. Where this is not immediately available, clot-dissolving medicines may be used. Medicines to thin the blood and protect the heart are started straight away.

After the emergency is over, treatment focuses on recovery and preventing another heart attack. This includes medicines, cardiac rehabilitation — a supervised program of exercise and education — and lifestyle changes. Some people need further procedures such as bypass surgery. This longer-term care can be planned and supported over time, including for international patients.

Many heart attacks can be prevented by reducing the risk factors for coronary artery disease: not smoking, keeping blood pressure and cholesterol controlled, managing diabetes, staying active, eating well, and maintaining a healthy weight. If you have already had a heart attack, taking prescribed medicines and completing cardiac rehabilitation greatly lowers the risk of another.

The outlook has improved considerably with fast emergency treatment. How well the heart recovers depends on how much muscle was affected and how quickly blood flow was restored — which is exactly why getting emergency help without delay matters so much.