Heart Attack – Symptoms and Causes

Understanding Blood Flow Issues to the Heart

A heart problem happens when blood can’t flow properly to the heart muscle. This serious condition occurs when arteries become blocked.

Over time, substances like fat and cholesterol build up in the heart’s arteries, forming deposits called plaques. This buildup process is known as atherosclerosis.

In some cases, these plaques can break open, causing blood clots to form. When a clot blocks an artery completely, the heart muscle doesn’t receive the oxygen and nutrients it needs. Without blood flow, heart tissue begins to die quickly.

Medical professionals also call this condition myocardial infarction. This is a medical emergency requiring immediate attention.

If you experience symptoms like:

• Chest pain or pressure
• Pain spreading to arms, neck, or jaw
• Shortness of breath
• Nausea or cold sweat

Call emergency services (911) immediately. Quick treatment is essential to prevent permanent heart damage or death.

Every minute matters when dealing with this potentially life-threatening condition.

Signs of a Heart Attack

Heart attack symptoms can range from mild to severe, and some people may experience no symptoms at all.

Common signs include:

• Chest discomfort (pressure, tightness, squeezing or aching)
• Pain that spreads to shoulder, arm, back, neck, jaw, teeth or upper abdomen
• Cold sweat
• Unusual tiredness
• Stomach discomfort that feels like heartburn or indigestion
• Sudden dizziness or lightheadedness
• Nausea
• Trouble breathing

Additional Facts

Women often experience different symptoms than men. They may have brief, sharp pains in the neck, arm or back rather than the classic chest pain.

In some cases, a sudden cardiac arrest might be the first sign of a heart attack.

Not all heart attacks happen without warning. Many people notice signs hours, days or even weeks before.

One early warning sign is ongoing chest pain (angina) that doesn’t improve with rest. This happens when your heart temporarily doesn’t get enough blood.

When to Get Medical Help

Steps to Take if Someone Has a Heart Attack

If you think someone is having a heart attack, act quickly. Time matters and getting proper medical care can save lives.

Call emergency services (911) immediately if you or someone else shows signs of a heart attack. Don’t try to drive yourself to the hospital unless absolutely necessary. Having someone else drive you is safer.

If you’ve been prescribed nitroglycerin, take it as directed while waiting for emergency help to arrive. This medication helps expand blood vessels and improve blood flow.

About aspirin during a heart attack:

• Take aspirin only if recommended by medical professionals
• Don’t delay calling 911 to take aspirin
• Emergency help comes first
• Aspirin can help reduce heart damage by preventing blood clots
• Be aware it may interact with other medications

If you find someone unconscious who might be having a heart attack:

1. Call 911 first
2. Check if they’re breathing and have a pulse
3. Begin CPR only if there’s no breathing or pulse

CPR Guidelines

• For untrained rescuers: Perform hands-only CPR

  • Push hard and fast on the center of the chest
  • Aim for 100-120 compressions per minute
  • Continue until help arrives

• For trained rescuers:

  • Do 30 chest compressions
  • Follow with 2 rescue breaths
  • Repeat this cycle until help arrives

Causes

Heart attacks mainly happen due to coronary artery disease. This condition occurs when one or more arteries that supply blood to the heart become blocked.

The blockage is typically caused by plaque buildup—deposits containing cholesterol that can narrow the arteries and reduce blood flow to the heart.

When a plaque ruptures, it may lead to blood clot formation in the heart. The severity of a heart attack often depends on whether the blockage is complete or partial.

Doctors classify heart attacks based on electrocardiogram (ECG) results:

• ST-Elevation Myocardial Infarction (STEMI): Usually results from a complete blockage of a medium- to large-sized heart artery.
• Non-ST Elevation Myocardial Infarction (NSTEMI): Often caused by a partial blockage, though some NSTEMI cases involve total blockages.

Not all heart attacks stem from blocked arteries. Other causes include:

1. Coronary Artery Spasm: A severe squeezing of a blood vessel that isn’t blocked but may have cholesterol plaques or early hardening due to risk factors like smoking.

   • Also known as Prinzmetal’s angina, vasospastic angina, or variant angina.

2. Viral Infections: COVID-19 and other viruses can damage heart muscle tissue.

3. Spontaneous Coronary Artery Dissection (SCAD): A life-threatening condition caused by a tear inside a heart artery.

When blood flow to the heart is reduced or stopped, the heart muscle doesn’t receive enough oxygen.

This can damage or destroy part of the heart muscle, resulting in a heart attack. The amount of damage depends on the size of the affected area and how quickly treatment begins.

Risk Factors

Several factors can increase your chance of having a heart attack. Some you can control, while others you cannot.

Age and Gender

• Men 45 years and older
• Women 55 years and older

Lifestyle Factors

• Tobacco use (including smoking and secondhand smoke exposure)
• Lack of regular exercise
• Poor diet high in sugars, processed foods, and salt
• Emotional stress, especially extreme anger
• Illegal drug use (cocaine and amphetamines)

Health Conditions

• High blood pressure
• High cholesterol levels (especially high LDL or “bad” cholesterol)
• High triglycerides
• Low HDL or “good” cholesterol
• Obesity
• Diabetes
• Metabolic syndrome (combination of three or more: enlarged waist, high blood pressure, low good cholesterol, high triglycerides, high blood sugar)

Medical History

• Family history of early heart attacks (before age 55 in male relatives or age 65 in female relatives)
• History of preeclampsia during pregnancy
• Autoimmune conditions like rheumatoid arthritis or lupus

When you have high blood pressure over time, it damages the arteries leading to your heart. This risk grows when combined with other conditions like obesity or diabetes.

The relationship between cholesterol and heart attacks is clear. Your risk increases with high levels of LDL cholesterol, which narrows arteries. Having good levels of HDL cholesterol may help protect your heart.

Obesity links to many other risk factors, creating a dangerous combination. People with diabetes face higher risks because their high blood sugar harms blood vessels.

Metabolic syndrome doubles your chance of heart disease compared to people without this condition. If close relatives had early heart attacks, your risk may be higher.

Not moving enough hurts your heart health. What you eat affects your heart directly. A diet rich in fruits, vegetables, fiber, and healthy oils supports heart health, while processed foods do the opposite.

Stress can trigger heart problems, particularly when it leads to extreme emotions or unhealthy coping habits. Certain drugs like cocaine can cause coronary artery spasms that may lead to a heart attack.

Women who experienced preeclampsia during pregnancy face a higher lifetime heart disease risk. People with autoimmune conditions have increased inflammation that can affect heart health.

Complications

Heart attacks can lead to several serious issues due to damage to the heart muscle. When a person has a heart attack, they may develop abnormal heart rhythms (arrhythmias).

These rhythm problems happen because damage affects how electrical signals travel through the heart. Some arrhythmias can be life-threatening.

In rare cases, patients might experience cardiogenic shock. This dangerous condition occurs when the heart suddenly loses its ability to pump enough blood to meet the body’s needs.

Heart failure is another possible complication. When too much heart muscle is damaged, the heart cannot pump blood effectively. This failure may be temporary or become a long-term problem.

Some people develop pericarditis after a heart attack. This inflammation of the sac around the heart happens when the immune system responds abnormally to heart damage.

Cardiac arrest is perhaps the most serious complication. The heart suddenly stops beating due to electrical signal problems.

This is a medical emergency that requires immediate treatment to prevent death. Having a heart attack significantly increases a person’s risk for cardiac arrest.

Stopping Heart Attacks Before They Happen

Taking steps to prevent heart attacks is possible at any age—even after experiencing one already.

A healthy lifestyle forms the foundation of heart attack prevention. Avoid smoking completely. Eat foods that support heart health and maintain a healthy weight. Make time for regular exercise and find effective ways to manage stress.

Health conditions like high blood pressure and diabetes raise heart attack risk. Regular checkups help keep these conditions under control. Ask your doctor how often you should schedule appointments.

Take all medications exactly as prescribed. Your doctor may recommend specific drugs to strengthen and protect your heart.

Learning proper CPR techniques is also valuable. This skill could help someone experiencing a heart attack. Consider taking a certified first-aid course that includes CPR training and instructions on using an automated external defibrillator (AED).