Heart Attack (Myocardial Infarction)

A heart attack, also called a myocardial infarction, is painful blockage of an artery that supplies blood to the heart. It is a medical emergency that requires immediate treatment.

Max's Story

Fourteen-year-old Max and his grandfather, Harry, often shared a Saturday morning ritual: breakfast at their favorite diner, followed by a brisk game of tennis. On this occasion, they both ordered the special: two fried eggs, four strips of bacon, hotcakes, and a side of hash browns. Plates cleared, they hit the tennis courts, but only 10 minutes into their game, Harry, breathing hard and sweating heavily, stopped and complained of a squeezing pain in his chest. Although his grandfather protested that it was most likely indigestion, Max went for help. At the emergency room, his grandfather was given aspirin and placed on a heart monitor that showed he had experienced a heart attack. A nurse told Max that his quick action had probably saved his grandfather's life.




During a heart attack, the flow of blood to the heart is blocked by atherosclerotic plaque or clots, causing tissue death in the areas deprived of oxygen.





During a heart attack, the flow of blood to the heart is blocked by atherosclerotic plaque or clots, causing tissue death in the areas deprived of oxygen.
Illustration by Frank Forney. © 2016 Cengage Learning®.

What Is a Heart Attack (Myocardial Infarction)?

Myocardial infarction is the medical term for a heart attack. Myo means “muscle” and cardio means “heart”. An infarction is the obstruction of the blood supply. Therefore, myocardial infarction means that the blood supply to the heart muscle has been obstructed. Blood is supplied to the heart muscle through the coronary arteries * . When the blood supply is reduced or stopped, the heart muscle is damaged and begins to die. The heart cannot perform its major function, which is to pump blood containing oxygen to the rest of the body.

How Common Are Heart Attacks?

Heart disease, including heart attack, is the leading cause of death in the United States and around the world. According to the American Heart Association, in the United States every year approximately 635,000 people have a first heart attack, and nearly 300,000 people have their second heart attack.

What Are the Causes of Heart Attack?

Most heart attacks are caused by an obstruction to or narrowing of one or more of the coronary arteries. The obstruction or narrowing of the artery is caused by a buildup of plaque * as seen with atherosclerosis * . Plaque is made up of cholesterol * and other substances. An obstruction can also be caused by a clot that blocks the artery. The clot is made up of plaque that has torn away from the wall of the artery. This is the most common cause of a heart attack.

Famous People Who Had Heart Attacks

Some famous people who have had a heart attack (for some it resulted in death):

Who Is at Risk for Heart Attack?

There are many risk factors associated with heart disease. If heart disease is not corrected it can result in myocardial infarction or heart attack. The risk factors for heart disease include:

In 2016 the Cleveland Clinic reported that people who have the most severe types of heart attacks are on average younger than people who had such attacks 20 years ago. Still, the average age is 60 years old.

What Are the Signs of a Heart Attack?

The most common sign of a heart attack is chest pain. The pain may move toward the jaw, the arms and shoulders, the belly, or to the back. Sometimes people describe the pain as indigestion or stomach upset. Some people describe the pain as a heavy pressure, or crushing, as if someone is sitting on their chest. Others describe the pain as feeling like a band is being pulled tightly around the chest.

Other signs that accompany the chest pain include:

What Is the Treatment for Heart Attack?

Diagnosis

The healthcare provider obtains a health history asking questions specific to heart disease. A physical examination is done including checking heart rate (pulse) and blood pressure. An electrocardiogram * (ECG or EKG) examines the electrical conductivity of the heart. An ECG can also show electrical indicators consistent with a myocardial infarction. Blood samples are drawn to determine the presence of proteins that are released into the blood when a heart attack occurs. People having a heart attack or at risk for one are most often treated by a physician who has specialized knowledge and experience in treating heart problems, called a cardiologist.

Treatment

It is essential that anyone having a heart attack receive treatment as soon as possible. Anyone experiencing symptoms that might indicate a heart attack should call 9-1-1 immediately. There are several treatments that are implemented to treat the heart attack and its symptoms. Oxygen is given by mask to increase the oxygen supply to the blood and the tissues. Oxygen also relieves the shortness of breath, which decreases anxiety. Aspirin is given to thin the blood and prevent any further clotting. Nitroglycerin is often given to improve blood supply through the coronary arteries and reduce the workload of the heart. Medication can reduce chest pain, which helps reduce anxiety, thereby decreasing the stress on the heart.

Once initial treatment has begun, the doctor will determine treatments to restore blood flow to the heart and prevent the problem from recurring. There are two treatments that may be done.

  1. Percutaneous coronary intervention, also called angioplasty and stent placement. In this procedure a needle is inserted through the skin (percutaneous). A wire with a tiny balloon is inserted to open the artery. A stent (hollow tube) can be inserted through the needle to the coronary artery. The hollow tube (stent) presses against the wall of the coronary artery to prevent clotting and keep the artery open to improve blood supply. The needle and the insertion wire are removed and the stent is left in place.
  2. Coronary artery bypass grafting. This is a surgical procedure that involves taking a healthy artery or vein from another part of the body, connecting it to the coronary artery beyond the area of blockage. The healthy artery provides a new path for blood supply to the heart muscle.
Preventive Measures

Strategies to prevent heart disease include:

Can Heart Attack Be Prevented?

Eating a nutritious diet, getting sufficient exercise, and managing stress are some ways to prevent heart attacks and heart disease. People have a better chance of surviving a heart attack if they are aware of the warning signs and immediately seek emergency medical help if warning signs appear.

See also Arteriosclerosis/Atherosclerosis • Heart Disease: Overview • Hypertension

Resources

Books and Articles

Kennedy, John M. The Heart Health Bible: The 5-Step Plan to Prevent and Reverse Heart Disease. Boston: Da Capo Press, 2014.

Websites

American Heart Association. “Recommendations for Physical Activity in Adults.” August 17, 2015. http://www.heart.org/HEARTORG/GettingHealthy/PhysicalActivity/FitnessBasics/American-Heart-Association-Recommendations-for-Physical-Activity-in-Adults_UCM_307976_Article.jsp (accessed March 24, 2016).

American Heart Association. “What Is a Heart Attack?” http://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300314.pdf (accessed March 24, 2016).

American Heart Association/American Stroke Association. “Heart Disease and Stroke Statistics—At-a-Glance.” http://www.heart.org/idc/groups/ahamah-public/@wcm/@sop/@smd/documents/downloadable/ucm_470704.pdf (accessed March 24, 2016).

Centers for Disease Control and Prevention. “Heart Attack.” CDC.gov . http://www.cdc.gov/heartdisease/heart_attack.htm (accessed March 24, 2016).

MedlinePlus. “Heart Attack.” U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000195.htm (accessed August 14, 2015).

MedlinePlus. “Heart Disease: Risk Factors.” U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000106.htm (accessed March 24, 2016).

PubMed Health. “Heart Attack (Myocardial Infarction).” http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0021982/ (accessed March 24, 2016).

Welch, Ashley. “Study: Heart Attack Patients Getting Younger, Fatter.” CBS News, March 24, 2016. http://www.cbsnews.com/news/heart-attack-patients-getting-younger-more-obese/ (accessed March 25, 2016).

Organizations

American Heart Association. 7272 Greenville Ave., Dallas, TX 75231. Toll-free: 800-242-8721. Website: http://www.heart.org (accessed March 24, 2016).

Centers for Disease Control and Prevention. 1600 Clifton Rd., Atlanta, GA 30329-4027. Toll-free: 800-232-4636. Website: http://www.cdc.gov (accessed March 14, 2016).

* coronary arteries (KOR-uh-nairee ar-TER-ees) are the arteries that supply oxygenated blood to the heart muscle.

* plaque (PLAK) are fatty deposits that line the arterial wall, causing narrowing of the blood vessel.

* atherosclerosis (athuh-ro-skluh- RO-suhs) is a disease of the blood vessels in which plaque (PLAK) builds up in the arteries. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood.

* cholesterol (ko-LES-ter-ol) is a fatlike substance found in the blood and body tissues.

* menopause (MEN-o-pawz) is the end of menstruation.

* electrocardiogram (e-lek-tro- KAR-dee-o-gram) is a test that records and displays the electrical activity of the heart. Also known as ECG or EKG.

Disclaimer:   This information is not a tool for self-diagnosis or a substitute for professional care.

(MLA 8th Edition)