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

Is the heart attack going out of style?

Hospitalization rates for heart attacks are going down, so maybe prevention efforts are paying off. Two studies published in 2010 show that the American heart attack rate is continuing to decline. The first, published in Circulation, was based on Medicare data. The main finding was that hospitalization rates for heart attack dropped by about 23% between 2002 and 2007, which by the authors' calculations might have translated into 100,000 fewer hospitalizations a year for the 45 million Americans enrolled in the Medicare program. The second study, published in The New England Journal of Medicine, was based on the hospitalization records of 3 million people ages 30 and older enrolled in the Kaiser Permanente Northern California health plan. Again, the overall finding was the decline in hospitalizations for heart attack at a clip — 24% — that was nearly identical to that found in the Medicare study, and for a time period, 1999 to 2008, that was roughly the same. More »

Chest pain: A heart attack or something else?

Chest pain is an indicator of a possible heart attack, but it may also be a symptom of another condition or problem. Chest pain isn't something to shrug off until tomorrow. It also isn't something to diagnose at home. If you are worried about pain or discomfort in your chest, upper back, left arm, or jaw; or suddenly faint or develop a cold sweat, nausea, or vomiting, call 911 or your local emergency number to summon an emergency medical crew. It will whisk you to the hospital in a vehicle full of equipment that can start the diagnosis and keep you stable if your heart really is in trouble. More »

On the alert for deep-vein blood clots

Deep-vein thrombosis is a clot that forms in a leg or arm vein. Sometimes a piece of the clot can break away and travel through the bloodstream. If the clot lodges in a lung, it can be fatal. More »

Treating depression after a heart attack

Surviving a heart attack is cause for celebration. It's also a trigger for depression. Up to half of heart attack survivors get the blues, and many go on to develop clinical depression. Early experiences with antidepressants weren't that promising because older tricyclic drugs such as clomipramine and nortriptyline sometimes threw off heart rhythms and further endangered the heart. This made doctors leery about recommending antidepressants, even when selective serotonin reuptake inhibitors (SSRIs) such as Prozac (fluoxetine), and Zoloft (sertraline), and others came along. However, a small study published in 2002, dubbed SADHART, suggested that Zoloft could safely treat depression after a heart attack and might be good for the heart to boot. And an analysis of a larger trial, called ENRICHD, lends support to the notion that treating post-heart-attack depression with an SSRI may also reduce the chances of having, or dying from, a heart attack. More »

When You Visit Your Doctor - After a Heart Attack

Have you had chest pain or pressure since you were discharged from the hospital? How severe is it? How long does it last? Does it stay in your chest or radiate to other parts of your body? Did you have this pain before your heart attack? What brings it on? How frequently do you get it? What were you doing just prior to the chest pain? Do you ever get chest pain or pressure at rest? What relieves the chest pain? If you take nitroglycerin, how many doses do you usually need to take before the pain goes away? How often do you take nitroglycerin? Do you get short of breath when you lie down or exert yourself? Do you awaken in the middle of the night short of breath? Do your ankles swell? Do you ever feel lightheaded? Have you fainted? Do you get rapid or pounding heartbeat for no reason? Do you know what each of the medications you are taking does? Do you know the side effects of each medication? Are you having any side effects? Are you taking an aspirin every day? Are you doing everything you can to modify the risk factors that can worsen your coronary artery disease (cigarette smoking, high blood pressure, high cholesterol, and diabetes are the most important risk factors)? Are you participating in a supervised exercise program? Are you resuming your normal activities? Are you sexually active? Have you returned to work? Have you been feeling depressed since your heart attack? Have you been able to reduce the stress in your life? Have you been fatigued? Heart rate, blood pressure, and weight Pulses in your wrist, groin, and feet Listen over the major arteries in the neck, groin, and feet (for abnormal noises) Look at the veins in the neck to see if there is extra fluid in your body Heart and lungs Ankles and legs (for swelling) Blood tests for glucose, lipid panel (cholesterol levels) and C-reactive protein (CRP) Electrocardiogram Echocardiogram Exercise stress test   More »