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Heart Attack: When Blood Stops Flowing to the Heart

The information below will help you understand what it means when the blood flow to a section of the heart suddenly stops and why this can happen. If you think you or somebody near you is having a heart attack because they are displaying the below-described symptoms, please call emergency services immediately. 

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Doctors hurrying a patient down a hospital floor

What Is a Heart Attack?

A heart attack or myocardial infarction (MI) is a life-threatening emergency requiring immediate medical care. It happens when the blood flow to a section of the heart suddenly stops and the muscle cells do not receive enough oxygen. Usually, a heart attack is caused by a blockage of one or more coronary arteries. Without a blood supply, the heart cannot work properly. Cardiac function is reduced or even fails completely. In the latter case, death may occur suddenly. If only a small section of the heart’s muscle is affected, the heart may be injured but still able to function at a reduced capacity. The longer the heart’s blood circulation is disturbed, however, the higher the risk that muscle cells will die and be replaced by scar tissue. This scar tissue is not able to perform the tasks of the muscle and the heart will never regain its original power and capacity. Sometimes, scar tissue may cause irregular heartbeats because it cannot conduct the electrical impulses that control the heart’s activity. If the heart is severely damaged, even minor stresses may overstrain its capacity, causing a potentially fatal heart attack. It is therefore crucial to find and treat the blockage of the blood flow as quickly as possible.

What Causes a Heart Attack?

One of the main causes of heart attack is coronary artery disease, which is characterized by a narrowing of the coronary arteries. Generally, coronary artery disease is a result of arteriosclerosis – the thickening and hardening of the walls of the arteries. The heart muscle’s blood circulation can also be disturbed by other blood vessel diseases, scar tissue, heart failure or heart rhythm disorders. 

People at a high risk of myocardial infarction are those with a genetic predisposition, men over 45 and women over 55 years old, as well as patients who have already had bypass surgery. These risk factors cannot be influenced. 

You can reduce or mitigate, however, the following risk factors with appropriate treatment or lifestyle changes: 

  • Hypertension (high blood pressure) 
  • High blood fats, especially "bad" cholesterol (LDL) 
  • Diabetes 
  • Smoking 
  • Excess weight or obesity 
  • Lack of exercise 
  • Stress 

What Are the Symptoms of a Heart Attack?

Usually, a heart attack occurs suddenly and without any warning. The symptoms of a heart attack may vary from person to person. Women and men often experience very different symptoms. In about one-third of heart attacks, because contrary to common belief, a heart attack can also happen without causing significant symptoms. This “silent” myocardial infarction often occurs in people with diabetes. In many cases, it is detected randomly during an electrocardiogram examination. 

Symptoms may include: 

  • Severe and long-lasting chest pain in men 
  • Chest pain spreading to the arms, shoulder, jaw or upper abdomen 
  • Cold sweats 
  • Shortness of breath 
  • Nausea 
  • Fainting 
  • Pain in the upper abdomen combined with nausea and vomiting (women) 

Since all heart attacks can be life-threatening or cause complications, always call emergency services if you suspect that you or someone near you is having a heart attack. 

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Physician's hands with a pen in their hand

How Is a Heart Attack Diagnosed?

The most important examination for quickly diagnosing a heart attack is the electrocardiogram (ECG). If the electrocardiogram findings confirm a heart attack, the heart’s electrical activity will be observed during emergency treatment in order to detect any heart rhythm disorders early. 

As a second step, the medical team has to find out where the affected section of the heart is and which coronary artery is blocked. To do this, they will perform echocardiography – an examination of the heart with ultrasound waves. Coronary arteries are usually examined via a catheter in a hospital’s catheterisation laboratory. The medical team may also run blood tests, which indicate if a heart attack has occurred and how severe it was. Examinations like computed tomography or magnetic resonance imaging may provide additional information. 

 

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Health care professionals checking on a patient in a hospital

How Is a Heart Attack Treated?

The longer you wait to start treatment after a heart attack, the more heart tissue is damaged or dies. The blood flow has to be fixed as soon as possible to restore the oxygen levels in the blood. Usually, the patient will be attached to an oxygen mask or something similar right away. Depending on whether there is a partial or complete blockage, the treatment will vary. 

The following medications might be given to help or fix the blood flow: 

  • Aspirin: reduces blood clotting and helps to keep the blood moving through a narrowed artery.  
  • Clot busters (thrombolytics or fibrinolytics): help to break up any blood clots that are blocking blood flow to the heart. 
  • Other blood-thinning medications. 
  • Nitroglycerin: widens the blood vessels and helps improve blood flow. It also helps with the chest pain associated with heart attacks. 
  • Morphine: relieves chest pain that can’t be treated with nitroglycerin. 
  • Beta blockers: slow the heartbeat and lower blood pressure limiting the damage to the heart muscle. 
  • ACE inhibitors: lower blood pressure and reduce stress on the heart. 
  • Statins:  lower unhealthy cholesterol levels.  

The following surgical procedures might also be necessary: 

  • Coronary angioplasty and stenting: This procedure is done to open clogged heart arteries. 
  • Coronary artery bypass surgery (CABG): This is open-heart surgery. A surgeon takes a healthy blood vessel from another part of the body to create a new path for blood in the heart.

How Can You Prevent a Heart Attack

Prevention is the safest and best protection against a heart attack. By pursuing a healthy lifestyle, some risk factors can already be reduced or completely excluded in advance. A healthy lifestyle includes: 

  • Eat a healthy diet with large portions of vegetables and foods low in sugar and fat 
  • Exercise regularly 
  • Drink enough water, especially if you are older and are not as thirsty anymore 
  • Stop smoking if you do 
  • Avoid stress 
  • Lose weight if you are overweight 
  • Get regular checkups with your doctor 

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