What is a Heart Attack?
Let’s start with the basics. Imagine your heart as a hardworking pump, beating over 100,000 times a day to keep you alive. But what happens if this pump suddenly loses its fuel? That’s essentially what a heart attack is—a sudden blockage of blood flow to the heart muscle.
In medical terms, a heart attack is called a myocardial infarction. Simply put, it means part of the heart muscle isn’t getting enough oxygen-rich blood, usually due to a blocked artery. Sounds scary, right? It is. Globally, heart attacks are a leading cause of death, affecting millions each year. In fact, according to the World Health Organization, cardiovascular diseases (including heart attacks) kill an estimated 17.9 million people annually, making up about 32% of all deaths worldwide .
But how common is it? In the United States alone, someone has a heart attack every 40 seconds .
How Does a Heart Attack Occur?
Ever seen a pipe get clogged with debris? Picture the arteries supplying blood to your heart as pipes. Over time, fatty deposits (think cholesterol, but stickier) build up on the walls of these pipes. If a piece of this buildup—called plaque—suddenly breaks off, a blood clot forms around it, blocking the artery.
No blood flow means no oxygen, and the heart muscle starts to suffocate—literally. If not fixed quickly, part of the heart muscle can die. Imagine trying to water your garden with a blocked hose; your plants will wilt. The heart works the same way.
What Are the Causes of Heart Attack?
Wondering what actually triggers a heart attack? Here are the main culprits:
- Coronary artery disease (CAD) is responsible for up to 95% of heart attacks. It’s mainly caused by atherosclerosis—the build-up of plaque in the coronary arteries.
- Spasm of a coronary artery (vasospasm) accounts for around 2-3% of heart attacks. This is when the artery temporarily tightens, restricting blood flow.
- Other causes are rare but can include a tear in the artery wall (spontaneous coronary artery dissection), drug use (like cocaine), or trauma to the chest .
So, the vast majority (about 95%) are due to those nasty cholesterol plaques.
Risk Factors: Who’s at Risk?
Not everyone has the same risk. Let’s talk about who’s more likely to have a heart attack. You might wonder: “Am I at risk?” Here’s what matters most:
Age and gender: Heart attacks become more common after age 45 for men and 55 for women. Men are at higher risk, but after menopause, women catch up quickly.
Family history: Got close relatives who had heart attacks? Your risk is higher.
Lifestyle: Smoking, poor diet, lack of exercise, and being overweight are big factors.
Other health conditions: High blood pressure, high cholesterol, diabetes, and stress all play a role.
Of all these, smoking and high cholesterol are among the most significant modifiable risk factors. Quitting smoking and managing cholesterol can cut your risk dramatically .
Symptoms of Heart Attack: What Should You Look For?
So, what does a heart attack actually feel like? Here’s where it gets interesting—it isn’t always dramatic. Most people expect a crushing chest pain, and yes, that’s classic. But sometimes, it’s milder, or the symptoms are easy to brush off.
Typical symptoms include:
- Chest pain or discomfort: Often described as pressure, squeezing, fullness, or pain. It may last more than a few minutes or go away and return.
- Pain in other areas: The pain can radiate to your arms (especially the left), back, neck, jaw, or stomach.
- Shortness of breath: This can occur with or without chest discomfort.
- Other signs: Breaking out in a cold sweat, nausea, light-headedness, or fatigue.
But why do these symptoms occur? When the heart muscle lacks oxygen, it “cries out” through pain (angina) and stops pumping as effectively, causing breathlessness and dizziness.
Did you know? Women and older adults sometimes have less typical symptoms—like indigestion or just extreme fatigue.
Differential Diagnosis: What Else Could It Be?
A heart attack isn’t the only reason for chest pain or similar symptoms. So, what else might it be?
It could be:
- Angina (stable or unstable): Similar chest pain, but usually brought on by exertion and relieved by rest.
- Gastroesophageal reflux disease (GERD): “Heartburn” pain can mimic a heart attack.
- Anxiety or panic attacks: Can cause chest pain and palpitations.
- Pulmonary embolism: A blood clot in the lungs can cause sudden chest pain and breathlessness.
- Musculoskeletal pain: Like a pulled muscle in your chest wall.
All these conditions can “trick” even doctors, which is why hospital tests are vital .
How to Diagnose a Heart Attack?
You might wonder—how do doctors know for sure it’s a heart attack? The gold standard for diagnosing a heart attack includes:
- Electrocardiogram (ECG or EKG): Quick, painless, and tells if your heart is in trouble by checking its electrical activity.
- Blood tests: Especially for troponin, a heart muscle protein released when damage occurs.
- Coronary angiography: If needed, this test uses dye and X-rays to show if your arteries are blocked.
If you come to the hospital with chest pain, expect an ECG and blood tests right away. If a heart attack is suspected, you’ll get treated immediately—time is muscle!
Treatment of Heart Attack: What Can Be Done?
Treating a heart attack is all about speed. The quicker blood flow is restored, the more heart muscle is saved.
The gold standard treatment:
- Primary percutaneous coronary intervention (PCI): This is a type of angioplasty—doctors use a small balloon to open the blocked artery and may place a stent to keep it open.
- Thrombolytic therapy: If PCI isn’t available quickly, “clot-busting” drugs can be given.
Other treatments include:
- Medications: Aspirin, antiplatelets (like clopidogrel), beta-blockers, ACE inhibitors, and statins.
- Lifestyle changes: Stopping smoking, eating healthy, exercising, and managing stress.
- Cardiac rehabilitation: A structured program to help you recover and reduce your future risk.
If PCI and clot-busting drugs aren’t possible, surgery such as coronary artery bypass grafting (CABG) might be needed.
References
- World Health Organization. Cardiovascular diseases (CVDs) factsheet. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
- CDC. Heart Disease Facts. https://www.cdc.gov/heartdisease/facts.htm
- Mayo Clinic. Heart Attack – Symptoms and Causes. https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106
- American Heart Association. Heart Attack Risk Factors. https://www.heart.org/en/health-topics/heart-attack/heart-attack-risk-factors
- Johns Hopkins Medicine. Chest Pain: How a Doctor Evaluates Chest Pain. https://www.hopkinsmedicine.org/health/conditions-and-diseases/chest-pain