General Health Tips & News

Understanding Heart Attacks/Myocardial Infarction (MI): Causes, Symptoms, and Diagnosis & Treatment Options

By A.S. (staff writer) , published on February 08, 2024

Medicine Telehealth Health



A heart attack, or myocardial infarction, occurs when there is a loss of blood supply to a part of the heart muscle, usually due to a blockage in a nearby artery, ultimately leading to the death of heart muscle tissue. It is a severe medical emergency that demands immediate hospital treatment. This article delves into the symptoms, treatment options, potential complications, and preventive measures associated with heart attacks.



Heart Attack Mechanism

A heart attack is initiated by the blockage of blood and oxygen flow to the heart, resulting in the death of heart muscle tissue. The term "infarction" signifies tissue death due to the lack of blood supply. This blockage can cause lasting damage to the heart muscle, impacting its ability to function effectively.



Symptoms of a Heart Attack

Symptoms of a heart attack are diverse and may vary among individuals. Common indicators include discomfort, pressure, or pain in the chest, arms, or below the breastbone. Additional symptoms encompass discomfort in the back, jaw, throat, or arm, sweating, nausea, vomiting, weakness, anxiety, fatigue, and shortness of breath. Women and individuals assigned female at birth may experience atypical symptoms such as unusual fatigue, shortness of breath, and discomfort in the neck, shoulder, or upper back.



Recognizing a Heart Attack

A heart attack often manifests as intense chest pain, described as someone squeezing the chest or the sensation of carrying a heavy weight. Weakness, dizziness, sweating, mild pain in the jaw, neck, back, or arms, and difficulty breathing may accompany the chest pain. It's crucial to note that some heart attacks, termed "silent" myocardial infarctions, occur without obvious symptoms, particularly in individuals with diabetes.



Types of Heart Attacks

Understanding the types of heart attacks is essential for appropriate medical response. Three primary categories include:

  1. STEMI (ST-Elevation Myocardial Infarction):

    • Complete coronary artery blockage.

  2. NSTEMI (Non-ST-Elevation Myocardial Infarction):

    • Partial coronary artery blockage.

  3. MINOCA (Myocardial Infarction with Nonobstructive Coronary Arteries):

    • Heart attack with no visible blockages in the main coronary arteries.

Distinguishing between heart attacks, cardiac arrest, and angina is vital as they involve different mechanisms and necessitate distinct interventions.



Causes of Heart Attacks

The predominant cause of heart attacks is coronary artery disease, where plaques made of fat, calcium, proteins, and inflammatory cells narrow the arteries. Plaque rupture can lead to blood clot formation, blocking the artery and causing heart muscle damage. Other causes include coronary artery spasm, anomalous coronary arteries, tears or injuries to arteries, spontaneous coronary artery dissection (SCAD), and coronary artery embolism.



Risk Factors for Heart Attacks

Numerous factors increase the risk of heart attacks, including:

  • Lifestyle Choices:

    • Smoking, alcohol use, lack of exercise.

  • Age:

    • Increased risk with age, generally rising at age 45 for men and age 50 or menopause for women.

  • Illness:

    • Hypertension, diabetes, high cholesterol, and obesity.

  • Family History:

    • Increased risk if parents or siblings experienced a heart attack, especially at a younger age.

  • Overweight or Obesity:

    • Carrying excess weight is a risk factor.

  • Ethnicity:

    • Background may play a role, with some ethnicities having a higher predisposition.

  • Pregnancy:

    • Pregnancy, especially with associated factors like age and obesity, can elevate the risk.

  • Stress:

    • Chronic stress, leading to hormonal changes and unhealthy lifestyle choices, can increase the risk.



Immediate Response to a Heart Attack

Immediate response is crucial during a heart attack:

  • Emergency Services:

    • Call 911 promptly.

  • Aspirin:

    • Chewing aspirin (325 mg) while awaiting emergency services helps inhibit blood clot formation, reducing the risk of death.

Assisting Someone Else Having a Heart Attack

In the case of cardiac arrest:

  • Call 911:

    • Summon emergency help.

  • CPR and AED:

    • Perform CPR and use an automated external defibrillator (AED) if available.


Heart Attack Diagnosis

Emergency medical workers employ various tests for diagnosis:

  • EKG (Electrocardiogram):

    • Records the heart's electrical activity, indicating the extent of muscle damage.

  • Blood Tests:

    • Measure cardiac enzymes and troponin levels to assess heart muscle damage. Tests can also measure troponin levels. Troponins are proteins inside heart cells that are released when the cells are damaged by the lack of blood supply to your heart.

  • Echocardiography:

    • Uses ultrasound to visualize the heart's pumping function and detect injuries.

  • Cardiac Catheterization:

    • Provides images of blocked arteries to guide treatment decisions.

  • Stress Testing, Angiogram, CT Scan, MRI, Nuclear Heart Scans:

    • Further diagnostic tools to evaluate heart function and identify potential risks.

Understanding heart attacks, their symptoms, and risk factors is essential for timely intervention, which significantly influences the prognosis and recovery of individuals experiencing this medical emergency.



Prevention of Heart Attacks

Several measures can lower the risk of a heart attack:

  • Avoiding or quitting smoking

  • Adopting a balanced, healthful diet

  • Managing conditions like diabetes, high cholesterol, and high blood pressure

  • Limiting alcohol intake

  • Maintaining a healthy body weight

  • Stress management

Awareness of heart attack symptoms facilitates prompt treatment, increasing the chances of a positive outcome.


Diagnosis and Recovery

In the hospital, doctors consider age, overall health, medical and family history, and conduct tests such as imaging, electrocardiography, blood tests, and cardiac catheterization to diagnose a heart attack. Recovery time varies based on severity and factors like cardiac rehabilitation, physical activity resumption, return to work, and resuming daily activities.


Treatment for a Heart Attack

Emergency Department Interventions

The goal of treatment is to:

  • Relieve pain.

  • Preserve heart muscle function.

  • Prevent death.


Interventions may include:

  • Intravenous therapy (nitroglycerin and morphine).

  • Continuous monitoring of the heart and vital signs.

  • Oxygen therapy to improve oxygenation to the damaged heart muscle.

  • Pain medicine to decrease workload and oxygen demand of the heart.

  • Cardiac medicine (beta-blockers) to promote blood flow, prevent arrhythmias, and decrease heart rate and blood pressure.

  • Fibrinolytic therapy to dissolve blood clots.

  • Antithrombin or antiplatelet therapy (aspirin or clopidogrel) to prevent further blood clotting.

  • Antihyperlipidemics to lower lipids (fats) in the blood, including statins.



Additional Procedures for Blood Flow Restoration

Coronary Angioplasty

This procedure involves using a balloon to create a larger opening in the vessel to increase blood flow. It may be followed by inserting a stent into the coronary artery to keep it open.


Coronary Artery Bypass Surgery (CABG)

Commonly known as bypass surgery, CABG is performed in individuals with chest pain and coronary artery disease. The surgeon grafts a piece of a vein above and below the blocked area, allowing blood to flow around the blockage. Veins from the leg or arteries from the chest or arm may be used.

In some cases, more than one bypass surgery may be necessary to restore blood flow to all areas of the heart.



Understanding the causes, symptoms, and treatment options for heart attacks is crucial for individuals to recognize and respond promptly to this life-threatening condition. Implementing preventive measures and seeking medical attention in case of symptoms are essential components of heart health.





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