Heart Attack

To do its job—pump blood to every part of the body—the heart needs its own supply of oxygen-rich blood. That pipeline is provided by the coronary arteries. No wider than strands of spaghetti, these arteries deliver blood to hard-working heart muscle cells. A heart attack occurs when blood flow through a coronary artery is suddenly blocked. A blood clot can block flow; so can a sudden spasm of the artery.

Each coronary artery supplies blood to a specific part of the heart. A blockage damages that part of the heart. Depending on the location and amount of heart muscle affected, a blockage can seriously interfere with the heart's ability to pump blood. Since some of the coronary arteries supply areas of the heart that regulate heartbeat, blockages there can cause potentially deadly abnormal heartbeats.

The most common symptom of a heart attack is chest pain, usually described as crushing, squeezing, pressing, heavy, stabbing, or burning. The pain or feeling tends to be focused either in the center of the chest or just below the center of the rib cage, but it can spread to the arms, abdomen, neck, lower jaw or neck. Other symptoms can include sudden weakness, sweating, nausea, vomiting, breathlessness, or lightheadedness.

If you think that you, or someone you are with, is having a heart attack, call 911 right away. The sooner you call, the sooner treatment can begin — "time is muscle," as emergency room doctors say. The most effective treatments are artery-opening angioplasty with stent placement or an infusion of a clot-busting drug.

Heart Attack Articles

Returning to work after a heart attack

My 59-year-old husband just came home after being hospitalized for a mild heart attack. He was only in the hospital for five days and he feels great, though he does have to take three prescription medicines plus aspirin. I’m writing because my husband’s doctor doesn’t want him to go back to work for another six weeks even though his job doesn’t involve any lifting. I think the stress of staying home would be worse than going to work. Please advise. (Locked) More »

Can anxiety cause a heart attack?

Several studies have shown that about a quarter of people with cardiovascular disease have some kind of anxiety problem and, in some cases, the anxiety seems to make the heart condition worse. Researchers have reported, for example, that heart patients who have generalized anxiety disorder — constant, pervasive worrying, even about mundane matters — are more likely to have heart attacks and serious heart problems than heart patients who don't. (Locked) More »

Follow-up

If heart attack victims have to wait to be transferred to another hospital for emergency angioplasty, the delay is life threatening. (Locked) More »

Small step forward for stem cells, giant leaps remain

In a very small study, stem cells from heart tissue helped boost pumping power in the hearts of heart attack survivors. But as encouraging as the findings were, stem cell research is still in its infancy and has a long way to go before yielding effective treatments for heart disease. (Locked) More »

Niacin + a statin does not add up to benefit

In 2011, federal health officials ended an important government-funded clinical trial designed to test whether taking niacin in addition to a cholesterol-lowering statin might do more to lower heart attack and stroke risk than just taking a statin alone. Interim data indicated that the niacin had no benefit and may have been associated with a small, unexplained increase in stroke risk. (Locked) More »

Ask the doctor: Should I switch to generic Lipitor?

After a heart attack six years ago, I went on Lipitor because my doctor said it was proven to reduce the risk of a second heart attack. Three years ago, I switched to a generic to save money. Now that Lipitor is going generic, should I switch back? (Locked) More »

You could be one in a million

Dr. Thomas Lee, the editor in chief of the Harvard Heart Letter, introduces an issue focused on the Million Hearts initiative, which aims to reduce heart disease. More »

Angioplasty a day after a heart attack not worth it

In 2006, the Occluded Artery Trial (OAT) determined that performing angioplasty — an invasive and expensive procedure — delivered no tangible benefit to people who'd had a heart attack more than 24 hours earlier and who no longer had symptoms. In 2007, the American College of Cardiology and the American Heart Association endorsed the OAT findings and issued this guideline: angioplasty to unclog an artery implicated in a heart attack, when performed more than 24 hours after the event, is not appropriate as long as the person is stable. More »

December 2011 references and further reading

Deyell M, Buller C, Miller L, Wang T, Dai D, Lamas G, Srinivas V, Hochman J. Impact of National Clinical Guideline Recommendations for Revascularization of Persistently Occluded Infarct-Related Arteries on Clinical Practice in the United States. Archives of Internal Medicine 2011; 171: 1636-1643. Terkelsen C, Jensen L, Tilsted H, Trautner S, Johnsen S, Vach W, Bøtker H, Thuesen L, Lassen J. Health care system delay and heart failure in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention: follow-up of population-based medical registry data. Annals of Internal Medicine 2011;155:361-7. Greenspon A, Patel J, Lau E, Ochoa J, Frisch D, Ho R, Pavri B, Kurtz S. 16-year trends in the infection burden for pacemakers and implantable cardioverter-defibrillators in the United States 1993 to 2008. Journal of the American College of Cardiology 2011; 58:1001-6. (Locked) More »