Heart Attack
What is a heart attack?
A heart attack (also called myocardial infarction) occurs when an inadequate supply of blood and oxygen causes damage to a part of your heart muscle.
Compared to angina or chest pain, the pain from a heart attack lasts longer and is not responsive to methods of relief that might ease angina. Sometimes the pain is severe; sometimes not. For more information on chest pain or angina, click here .
A heart attack should be considered a warning that you have heart disease and should consider adopting a more heart-healthy lifestyle.
What causes a heart attack?
A major cause of heart attack is atherosclerosis (or hardening of the arteries), the build-up of cholesterol or other fatty substances inside the artery. As atherosclerosis progresses over a long time, sections of your coronary arteries may be narrowed or completely blocked, prohibiting the blood with its oxygen and nutrients from reaching the heart.
Atherosclerosis can be prevented and reduced by adopting a heart-healthy lifestyle that includes a balanced diet low in fats, regular exercise, no smoking and other steps to reduce your particular, modifiable risk factors such as high blood pressure, high cholesterol and excessive weight.
What are the symptoms of heart attack?
- Intense, prolonged chest pain or feeling of pressure
- Prolonged upper abdomen pain
- Shortness of breath
- Pain extending beyond the chest to the left shoulder and arm, back, teeth and jaw
- Fainting, nausea, vomiting, heavy sweating
Heart attacks can occur in different parts of the heart, and don’t always produce the same symptoms. In fact, symptoms may differ between men and women. For example, one classic symptom description is tightness in the chest extending into the arms and jaw. But many women describe having shortness of breath, a sense of anxiety, or different types of chest discomfort such as a heaviness or pressure.
If you experience any of these symptoms, act promptly and seek medical attention by calling 911. Tell them you are having symptoms of a heart attack. Mercy’s Chest Pain ER is only minutes away.
What are the risk factors for heart attack?
There are many risk factors that contribute to the atherosclerosis that causes most heart attacks. These include:
- High blood pressure (hypertension)
- High blood cholesterol levels
- Smoking
- Diabetes
- Obesity
- Lack of physical activity
- Stress
- Excessive use of alcohol
- Family history of heart attack
How is heart attack diagnosed?
Regular physical exams can pinpoint risk factors that could lead to a heart attack. But Mercy's Emergency Department has established a specialized Chest Pain ER to ensure a “rapid response” to rule out heart disorders and quicken treatment for patients with chest pain. A series of tests is done to pinpoint the heart’s condition and nature of the heart attack to determine proper treatment.
Patients with chest pain are given an IV, oxygen and an aspirin. Next comes lab work, an ECG and a chest X-ray to show the heart’s size and shape, and lungs.
If these initial screening tests show evidence of cardiac disease, a cardiac catheterization will be done, and cardiac IV medications started. The catheterization reveals any narrowed or blocked coronary arteries.
If test results are negative or inconclusive, but one or more cardiac risk factors exists (smoking, hypertension, age, diabetes, high cholesterol, family history), you will remain in a special Chest Pain ER observation area. Lab tests and ECGs are repeated within four to six hours after the onset of symptoms to observe any changes due to cardiac distress.
What treatment is available?
It is important during a heart attack to call 911 for emergency medical help immediately. Before the ambulance arrives, if possible, chew one regular strength aspirin to help maintain blood flow.
During recovery from heart attack, stress tests are usually done to measure the effect of exertion on the heart and blood vessels.
At the hospital, you may also be given medications such as:
- IV thrombolytics – also called clot-busters. They help dissolve blood clots blocking coronary arteries.
- IV platelet inhibitors – prevent blood platelets from sticking together to form a clot.
- “Super-aspirins” (platelet inhibitors in tablet form) – stronger than aspirin, this prevents new clot formation.
- Blood-thinning medications – another prevention against clot formation.
- Pain relievers – to ease discomfort due to chest pain (angina).
- Nitroglycerin – temporarily opens narrowed blood vessels to boost blood flow to and from the heart.
- Beta blockers – help relax your heart so its heartbeat slows and it is less stressed.
- Cholesterol-lowering drugs – help lower cholesterol and can improve recovery.
Procedures that may be considered include:
- Coronary angioplasty – opens blocked coronary arteries to allow better blood flow to heart. A catheter is inserted into an artery in your leg to the blocked coronary artery. A balloon is inflated to open the blockage. If necessary, a stent is inserted to hold open the artery for better blood flow.
- Coronary artery bypass surgery – Veins or arteries are sewn in place at a site beyond the blocked or narrowed coronary artery to restore blood flow to the heart.
Physical rehabilitation will help promote your heart’s healing and prevent further heart attacks. Cardiac Rehabilitation programs are available at Mercy’s Fitness Center .
If you think you are experiencing a heart attack, call 911 immediately. Mercy’s Chest Pain ER is only minutes away.
Your heart will heal from a heart attack. But it’s important to work with your physician and Mercy’s Cardiac Rehabilitation staff to address any lifestyle changes you should make to prevent another one, or to ease a heart condition that led to the heart attack.
