The most important thing you can do if someone is having a heart attack is to call 911. Heart attacks are medical emergencies and require you to act fast to get medical care for the victim. Follow the emergency operator's instructions. Perform CPR if the heart attack victim isn't breathing.
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What is a heart attack?
A heart attack—also called a myocardial infarction—occurs when your heart doesn't have enough blood flow due to a blockage in the cardiovascular system. When that happens, your heart can't function properly, and the heart tissue begins to die. The dying heart tissue can't pump blood, so your heart becomes less efficient, and other body parts stop getting the blood they need. This chain reaction of reduced blood flow can quickly lead to death if you don't get medical attention. Get medical help immediately if you exhibit signs of a heart attack.
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Stages of heart attack
In 2023, a staging system for heart attacks was established. It categorizes heart attacks into four stages based on the extent of tissue damage to the heart:
- Stage 1: Also called "aborted myocardial infarction," the first stage doesn't cause tissue death in the heart.
- Stage 2: The second stage causes cardiomyocyte necrosis (damage to the heart tissues that regulate heartbeat) but doesn't affect microvascular structures (small arteries and capillaries).
- Stage 3: The third stage of heart attack causes microvascular obstruction as well as cardiomyocyte necrosis.
- Stage 4: In the fourth and most severe stage, the heart attack causes significant cardiomyocyte necrosis and microvascular hemorrhage (ruptured blood vessels) in the heart.
Adding this staging system based on tissue damage may allow for a better analysis of patient status and the development of new treatment approaches.
Types of heart attack
There are three main types of heart attack, based on how long the heart goes without blood supply and how much damage it sustains as a result. From most to least severe, the three types of heart attack are:
- STEMI: Short for "ST segment elevation myocardial infarction," a STEMI heart attack means your heart has gone without blood for a long time. It's associated with severe damage to the heart and requires urgent medical attention.
- NSTEMI: A NSTEMI or "non-STEMI" heart attack is a shorter interruption in blood flow but still damages the heart. It's a medical emergency that can turn into a STEMI heart attack if you don't get care quickly.
- Unstable angina: An unstable angina is a condition in which there's restricted blood flow to the heart, but the heart hasn't been permanently damaged. It's sometimes called a "silent heart attack" because it doesn't always present symptoms. However, it's still serious and can raise your chance of having a more severe heart attack in the future.
Heart attack symptoms
Signs of a heart attack are varied, but the most commonly reported symptoms are:
- Chest pain
- Difficulty breathing/shortness of breath
- Fainting
- Heart palpitations (being unpleasantly aware of your heartbeat)
In addition to the "classic" signs of a heart attack, you might experience these uncommon heart attack symptoms:
- Anxiety
- Cold sweat
- Dizziness
- Fatigue
- Heartburn/indigestion
- Insomnia
- Nausea/vomiting
- Radiating pain through the shoulder to the neck and jaw
Heart attack symptoms don't vary only from one person to another—they also vary by gender. Biological females are less likely to have chest pain and more likely to report shortness of breath, fatigue, and insomnia compared to biological males.
Learn more about the signs of a heart attack in men and women.
What side is heart attack pain most common on?
Heart attack chest pain occurs on the left side or center of the chest. People describe it as a heavy, crushing feeling, or a squeezing sensation.
What causes a heart attack?
Usually, the blockage that results in a heart attack is due to plaque, a buildup of fat, or cholesterol. Over time, plaque forms in the arteries in the heart until the blood vessel is so full that blood can't get through. In other cases, more commonly, the plaque ruptures, forming a blood clot that blocks proper blood flow.
Risk factors for heart attack
A heart attack can happen to anyone, but certain factors increase your likelihood of having one. Unfortunately, most of the risk factors are out of your control:
- Age: Heart attacks become more common with age.
- Family history: Heart attacks, like many heart diseases, have a genetic component. If you have close relatives who have had heart attacks, you're more likely to have one.
- Other medical conditions: Conditions that strain your heart, such as diabetes, obesity, high cholesterol or high blood pressure, increase your likelihood of heart attack. Controlling these conditions can help.
- Gender: Men are more likely to have a heart attack than women, though heart disease is the leading cause of death in both sexes.
Your lifestyle is the risk factor you can control. Heart attacks are less common in people with heart-healthy habits like:
- Diet: A healthy diet limits salt, sugar, and fat. Include lots of fresh fruits and vegetables and prefer lean proteins over fattier ones.
- Exercise: Getting plenty of physical activity can lower your risk for many heart diseases, including heart attacks.
- Substance use: Avoid drugs, alcohol, and tobacco, all of which raise your risk of heart attack.
How does a heart attack start?
Most heart attacks are sudden, but others cause symptoms hours or days before the heart attack occurs. Most heart attack victims report chest pain, and many report shortness of breath and pain elsewhere in the upper body. If you have symptoms of a heart attack, call 911 and get help immediately.
Diagnosing and treating heart attack
There are two main ways to diagnose a heart attack: blood tests and EKGs.
When you have a heart attack, the damage to your heart releases specific proteins into the blood. A blood test can look for these proteins, which are an indicator that you've had heart damage associated with a heart attack.
An electrocardiogram (EKG)—a test that measures and displays the heart's activity as an electrical wave—shows distinct patterns in the case of heart attacks. If your EKG displays one of these patterns, it indicates a heart attack.
Treatment for heart attacks focuses on restoring blood flow to the heart and, later, on managing complications.
Side effects from a heart attack
Even if you get treatment quickly, the damage from a heart attack can provoke severe complications, including:
- Arrhythmia: An irregular heartbeat
- Cardiogenic shock: Damage to the heart muscle that makes it ineffective at supplying blood to the body
- Heart failure: Gradual weakening of the heart
- Heart rupture: Structures in the heart tear apart
- Pericarditis: Inflammation of the membrane surrounding the heart
FAQs about heart attacks
"Massive heart attack" is a colloquial term for a STEMI heart attack, while "minor heart attack" usually refers to an NSTEMI heart attack.
Heart attack symptoms typically don't last continuously for more than an hour or so at most. However, it's not uncommon to have recurring symptoms for several days before a heart attack happens.
Heart attacks are most likely to occur in the morning, soon after you wake up.
There's no way to stop a heart attack in progress without emergency medical attention. If you think you're having a heart attack, call 911 and get help immediately. Sometimes, immediately chewing an aspirin can help decrease the damage from a heart attack.
The most common age for a heart attack varies by gender. The average age for a first heart attack is 65.6 years old in males and 72 years old in females.
