Understanding Heart Attacks: The Basics Explained

6 hours ago
4 min read

Author: Rushil Dave, MD Student, University of Toronto

What is a Heart Attack?

The heart is responsible for circulating blood, which contains oxygen, throughout our body. A heart attack means that blood flow to the heart itself is reduced or blocked, which means it is not getting enough oxygen [1].

If blood flow is not restored quickly, the heart can become permanently damaged or parts of it can die. Heart attacks are medical emergencies for this reason.

Common Symptoms

The following symptoms are commonly experienced during a heart attack [1]:

Chest pain or tightness that lasts for more than a few minutes: you may feel like your chest is being squeezed, or there is a weight on your chest that you cannot lift off
Pain that spreads to the jaw, left shoulder, stomach, back, or left arm
Shortness of breath
Nausea or vomiting
Excessive sweating
Feeling lightheaded or dizzy
Sudden weakness

Research shows that older people and women are more likely to show different symptoms. Please be aware of the following symptoms which could also mean that a person is having a heart attack [1]:

Stomach pain
Sudden weakness
Confusion
Extreme fatigue
Back pain

What Causes a Heart Attack?

There are many reasons for why the blood vessels that supply your heart become blocked. Here are some of the most common reasons:

Fatty plaques build up in the blood vessels over time and lead to blockage.
An existing plaque breaks open and forms a clot, which blocks blood flow to the heart.
A blood clot from elsewhere in the body ends in vessels to the heart.

Figure 1. A heart attack happens when plaque blocks a coronary artery, stopping blood flow to part of the heart — **Figure 1.** A heart attack happens when plaque blocks a coronary artery, stopping blood flow to part of the heart

Who is at Risk?

Anyone can have a heart attack. However, there are some common things to know about that can increase your risk [1].

Table 1. Risk factors for heart attacks.

Risk Factor	How it Increases Risk of a Heart Attack
Uncontrolled High Blood Pressure	Constant high pressure can damage blood vessel walls. This makes existing fatty plaques more likely to rupture.
High Cholesterol	High cholesterol can contribute to fatty plaque development.
Uncontrolled Diabetes	High levels of blood sugar injures blood vessels, also raising the chances of plaque rupture.
Smoking	The smoke can damage blood vessels throughout the body and lower oxygen delivery to the heart.
Constant high stress	Raises blood pressure and inflammation throughout the body.
Family history of heart disease	Some may be predisposed to developing conditions that raise risk for heart attacks like high cholesterol, diabetes, and high blood pressure.
Older age	Fat accumulates in the arteries over time as you get older.
Obesity	Obesity can cause inflammation and create blood clots in the arteries.

How are Heart Attacks Diagnosed?

The first thing doctors will do is ask you a series of questions based on common symptoms of a heart attack.

If what you are describing sounds like a heart attack, the doctors will order blood tests to check for heart muscle damage. One of the most important markers is troponin, which is a protein that your heart and other muscles release when it is injured.

They will also perform a test called an electrocardiogram (ECG or EKG). Some pads are placed on you that detect the electrical activity in your heart. Certain patterns seen in the tracings can indicate a heart attack.

They may also order some imaging tests, such as a special heart ultrasound, or ask the cardiology team to perform a coronary angiogram. An angiogram is a test where doctors inject contrast dye through your heart muscles and take a series of X-rays to see if there is any blockage or narrowing in the vessels.

Once your heart attack has been treated, doctors may order further tests and imaging to identify and reverse any contributing factors.

How are Heart Attacks Treated?

Treatment in the hospital can involve medications or surgery. They are all focused around restoring blood flow to the heart as soon as possible.

Doctors will give you medications that help break up the clots in your heart, blood thinners, and ones that make it easier for your heart to keep pumping blood. After this, you may be sent for a procedure to open up the blocked arteries, commonly called an angioplasty, and the placement of a stent [2]. In really severe cases, you may need heart surgery, where new connections between vessels are created to avoid the blockage.

Figure 2. The process of an angioplasty procedure (stent placement). — **Figure 2.** The process of an angioplasty procedure (stent placement).

How Can I Prevent a Heart Attack?

Prevention is focused around protecting your blood vessels, reducing plaque buildup, and decreasing the changes of clot formation [3].

Stop smoking
Control blood sugar, blood pressure, and cholesterol control
Regularly attend appointments scheduled by your family doctor
Improve diet by focusing on fruits, vegetables, whole grains, nuts and legumes. Limit processed foods and sugary drinks.
Stay physically active - aim for at least 150 minutes of moderate-to-intense aerobic* activity per week.
Take medications as prescribed.
Manage stress.
Weight loss.

*aerobic activity is also known as "cardio". It involves activities that get your blood pumping like running, swimming, or biking.

Frequently Asked Questions (FAQs)

Questions to Ask Your Doctor

What medications do I need to take?
What medications should I avoid?
What is my heart function?
What should my blood pressure, blood sugar, and cholesterol targets be?
What is the single most important thing I can do right now to protect my heart?

Sources:

Sachdeva P, Kaur K, Fatima S, Mahak F, Noman M, Siddenthi SM, et al. Advancements in myocardial infarction management: Exploring Novel Approaches and Strategies. Cureus. 2023 Sept 19; doi:10.7759/cureus.45578
Huffman JC, Celano CM, Beach SR, Motiwala SR, Januzzi JL. Depression and cardiac disease: Epidemiology, mechanisms, and diagnosis. Cardiovascular Psychiatry and Neurology. 2013 Apr 7;2013:1–14. doi:10.1155/2013/695925
Ghodeshwar GK, Dube A, Khobragade D. Impact of lifestyle modifications on Cardiovascular Health: A Narrative Review. Cureus. 2023 Jul 28; doi:10.7759/cureus.42616

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Medical Disclaimer: HealthDecoded content is for education only and does not replace professional medical advice. Always seek guidance from a qualified healthcare provider.