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Heart attack

Introduction 

Video: heart attack

A consultant cardiologist explains what a heart attack is, the symptoms, surgical treatments and why it's important for coronary heart disease patients to reduce their risk factors.

A heart attack is a serious medical emergency in which the supply of blood to the heart is suddenly blocked, usually by a blood clot. The lack of blood to the heart can seriously damage the heart muscles. If left untreated, the muscles will begin to die. The medical term for a heart attack is myocardial infarction.

Symptoms of a heart attack include:

  • chest pain: the chest can feel like it is being pressed or squeezed by a heavy object, and the pain can radiate from the chest to the jaw, neck, arms and back
  • shortness of breath
  • overwhelming feeling of anxiety

Heart attacks and coronary heart disease

Most heart attacks occur in people with coronary heat disease, which is caused by atherosclerosis. Atherosclerosis is a serious condition where the arteries become narrowed and hardened by the build-up of clumps of cholesterol, called plaques.

The two arteries that supply the heart are called the coronary arteries. People with hardened and narrowed coronary arteries are said to have coronary heart disease (CHD).

Risk factors for CHD include:

How common are heart attacks?

Heart attacks are very common and are one of the leading causes of death in England. Each year in England, an estimated 111,000 people have a heart attack. Many heart attacks that lead to death are preventable. This is because most of the risk factors that are listed above can also be prevented.

Most heart attacks occur in people who are over 45 years of age. Men are two to three times more likely to have a heart attack than women.

Over the last decade, death rates from heart attacks in England have fallen by around 25%. This may be related to an associated decrease in the number of people smoking cigarettes. However, the number of deaths is still higher than in many other western European countries. It is thought that this is because England has higher rates of obesity, diabetes and physical inactivity (people not exercising enough) than in other countries.

Treatment options for a heart attack can involve using medication to dissolve any blood clots and surgery to widen the coronary artery.

Outlook

The outlook for people who have a heart attack is highly variable and is dependent on two important factors:

  • how quickly they receive treatment after the onset of the heart attack (ideally treatment should begin within 90 minutes of the onset of symptoms)
  • how well they respond to treatment within the first 28 days after the heart attack

Currently, just over half the people who have a heart attack die during the first 28 days after the heart attack. Of these deaths, 75% occur in the first 24 hours and 30% of them occur before the person is admitted to hospital.

If a person survives for 28 days after having a heart attack, their outlook improves dramatically and most people will go on to live for many years.

In those who survive a heart attack, a combination of lifestyle changes and medication is usually recommended to reduce the risk of having another heart attack. See Recovering from a heart attack for more information. 

Last reviewed: 17/03/2010

Next review due: 17/03/2012

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doctor2010 said on 01 June 2009

Both the consultant and the text of this article mislead the audience using the terms "heart attack" and "coronary thrombosis/clot" synonymously.
Firstly, a complete occlusion of a coronary artery is not required to starve the heart muscle of oxygen. Chronic high-grade stenosis is a major cause of "heart attacks" and sudden death due to coronary artery disease.
Secondly, a clot or thrombus is not necessary to cause a "heart attack" and in a significant number of cases at postmortem the only finding is significant narrowing of a coronary artery.

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